Men and women with obesity carry very different metabolic risks

New research presented at the 2026 European Congress on Obesity found that obesity affects men and women in substantially different ways at the metabolic level, and the distinctions have real implications for treatment.

The study, from Dokuz Eylul University in Turkey, analyzed 886 women and 248 men receiving care at an obesity clinic. Men showed significantly larger waist circumference (120 cm versus 108 cm), higher liver enzymes, higher triglycerides, and elevated markers of kidney stress, all pointing toward greater visceral fat accumulation and metabolic burden on the liver. Women showed higher total cholesterol (215 versus 203 mg/dL), higher LDL, and elevated inflammatory markers including C-reactive protein and erythrocyte sedimentation rate.

These differences likely reflect estrogen's influence on fat distribution and immune function. Women tend to store more fat beneath the skin but mount a stronger systemic inflammatory response, while men accumulate the more metabolically dangerous visceral fat that surrounds internal organs.

This pattern is consistent with what I observed over 20 years of clinical practice: two people with the same BMI can have profoundly different risk profiles, and effective treatment requires looking well beyond the number on the scale.

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