Men and women: different risks with extra kilos, need precision treatment
Obesity is not a 'one-size-fits-all' disease: hypertensive and liver-diseased males, more inflamed and dyslipidemic women, and therapies will have to manage differences
Key points
Men come from Mars and women from Venus also in the way they put on weight. And above all in the consequences that result. In short, extra kilos are not all the same and men and women do not play the same game on the scales. It is science, which day after day, is dismantling piece by piece the false conviction of a risk that is measured simply in extra kilos, without declining it by gender. And it is doing so with increasingly solid data, such as those that will be presented in a few weeks' time by Dr Zeynep Pekel and colleagues from Dokuz Eylul University (Izmir, Turkey) at the European Congress on Obesity (ECO 2026), which tell a much more multifaceted and, in some ways, even more intriguing reality.
Because no, it is not true that we all get fat in the same way. More importantly, we do not all pay the same price: more 'pot-bellied', hypertensive and liver-diseased males, more inflamed and dyslipidemic women with obesity.
Gender differences
Let us imagine two people, a man and a woman, with the same body mass index (the BMI, i.e. the number that is calculated by dividing the weight in kilos by the square of the height in metres). On paper, they are similar, sharing the same BMI. In reality, their bodies are reacting profoundly differently to the extra kilos. In men, fat tends to accumulate where it does the most damage: around the internal organs, in the belly. It is the visceral fat, the metabolically most active and dangerous one, capable of impacting badly on blood pressure, blood sugar, triglycerides and even liver health. It is certainly an accumulation that can be seen, but it works in silence, increasing the risk of heart attack, diabetes and metabolic diseases.
In women, however, excess weight takes a different route. The 'pink' fat is more often distributed in the subcutaneous tissue, on the hips and thighs (the infamous pads on the hips and the culotte de cheval on the buttocks and thighs), a type of accumulation that for years was considered 'less dangerous'. But the new study, which will be presented at the ECO congress, corrects this perspective: the risk in females is not less than in males, it is just different. Women with obesity tend to have higher levels of cholesterol, particularly 'bad' cholesterol (LDL), but above all they exhibit more systemic inflammation. A risk that is certainly more insidious and less immediately perceptible than the 'belly', but just as threatening, because it involves the entire organism and paves the way for cardiovascular disease and diabetes.
Turkish researchers came to these conclusions by analysing data on 886 women (average age 45 years) and 248 men (average age 41 years) with obesity, who were followed at the Obesity Clinic of the Department of Internal Medicine at Dokuz Eylul University.
