Study finds obesity affects men and women differently

A team of researchers from Dokuz Eylul University in Turkey have discovered the impact of obesity on men and women in different ways. The research shows that risks related to heart health, metabolism, and inflammation do not develop in the same way across sexes.

According to the research men with obesity are more likely to accumulate abdominal (visceral) fat. This type of fat surrounds internal organs and is strongly linked to serious heart and metabolic conditions.

Men in the study also showed higher levels of liver enzymes, which may signal liver damage. While on the other hand women with obesity were more likely to experience widespread inflammation and elevated cholesterol levels, both of which raise the risk of heart disease and type 2 diabetes.

"Our findings reveal intriguing differences in the way men and women respond to obesity. They show just how important gender-specific research is. Not only are sex differences a powerful player in the pathology and course of obesity, but our results indicate that such differences could be a stepping stone toward finding targeted, sex-based therapies to help in the management of people living with obesity,” said lead author Dr Zeynep Pekel, from Dokuz Eylul University, Izmir, Turkey.

These researchers analysed data from 886 women (average age 45 years) and 248 men (average age 41 years). Participants underwent a range of evaluations. Physical measurements included height, weight, body mass index (BMI), and blood pressure. Blood tests measured lipid levels to assess cardiovascular risk, including total cholesterol, low-density lipoprotein (LDL), or "bad" cholesterol, high-density lipoprotein (HDL), or "good" cholesterol, triglycerides, and fasting blood glucose.

Researchers also examined markers related to liver function (alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) levels), kidney function (creatinine levels), and inflammation. Inflammatory indicators included C-reactive protein, erythrocyte sedimentation rate, white blood cell count, and platelet count.

The results showed that men had a slightly higher body mass index (BMI) than women (37.5 vs 36 kg/m²). However, their waist circumference was much larger (120 vs 108cm), and their systolic blood pressure was also higher (128 vs 122 mmHg), both of which are linked to increased risk of cardiovascular disease and diabetes.

Men also had significantly higher levels of liver enzymes (ALT and GGT), triglycerides, and creatinine. These findings point to a greater likelihood of liver-related and metabolic complications.

Women, in contrast, had higher total cholesterol (215 vs 203 mg/dL) and LDL or "bad" cholesterol (130 vs 123 mg/dL). They also showed higher levels of inflammatory markers, including erythrocyte sedimentation rate, C-reactive protein, and platelet count. These patterns suggest a stronger inflammatory response.

According to Dr Pekel, these differences are likely influenced by hormones, immune system activity, and how fat is distributed in the body. Hormones (especially oestrogen) affect fat storage and the body's inflammatory response.

Women typically store more fat beneath the skin and tend to show higher levels of inflammation-related markers such as C-reactive protein and erythrocyte sedimentation rate. They also generally have a more active immune response, partly due to genetic factors like the X chromosome.

Men are more likely to store fat around internal organs. This visceral fat is closely associated with metabolic disorders and increases the risk of serious health complications.

"It's still early days and these findings need to be confirmed in other patient groups, but they offer important insight into how obesity may affect men and women differently," said Pekel.

In 2023, about 1.54 billion adults worldwide were living with metabolic syndrome (around 1 in 3 women and 1 in 4 men). This condition includes a group of major risk factors for cardiovascular disease and type 2 diabetes, such as abdominal obesity, high cholesterol, high blood pressure, and raised fasting plasma glucose.^[1]

Obesity itself is a complex chronic disease that affects the body in many ways. It involves changes in metabolism and inflammation, and these changes can vary widely between individuals. Biological sex plays a role in where fat is stored, how the liver processes nutrients, and how the immune system responds.