Despite the prevalence of obesity, gender differences in obesity prevalence and complications are often overlooked in clinical practice, according to authors of a paper published in Frontiers in Endocrinology.

Obesity prevalence is higher in women (24%) compared to men (22%), with notable regional variations. Valeria Guglielmi, MD, PhD, and colleagues explained that gender norms and identities, eating behaviors, and physical activity patterns contribute to these differences.

Environmental factors and genetic predispositions also play significant roles in obesity pathogenesis. In addition, genetic studies have identified numerous susceptibility genes, many of which are expressed in the brain, highlighting the central nervous system’s role in energy homeostasis.

Gender-specific differences in fat distribution are evident from early life and become more pronounced during adolescence and older age. Age-related changes in body composition, such as increased fat mass and decreased muscle mass, vary by gender, with men typically experiencing a faster decline in muscle mass. Sarcopenia, a condition of low muscle mass and strength, is more common in older men but carries a higher mortality risk in women. Sarcopenic obesity exacerbates morbidity and mortality risks.

BMI is a widely used tool for tracking obesity trends and identifying health risks, but it has limitations. The researchers explained that BMI poorly reflects individual adiposity and does not account for fat distribution, particularly abdominal fat, which is crucial for assessing health risks. Waist circumference is preferred for diagnosing central obesity but also bears limitations.

“It should be noted that waist circumference, though improving the predictive value of BMI, remains a suboptimal predictor of mortality,” Dr. Guglielmi and colleagues wrote.

The authors wrote that the Edmonton Obesity Staging System (EOSS) provides a comprehensive assessment of obesity-related complications and is useful for guiding treatment prioritization and management. EOSS stages correlate with mortality, adverse outcomes, and healthcare utilization, offering a more nuanced approach to obesity management than BMI alone.

The authors concluded that by integrating gender-specific considerations into clinical practice, clinicians can enhance the effective – ness of obesity treatments and address the unique challenges faced by men and women who are obese