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Obesity is increasing worldwide in both sexes and a challenge for health professionals and the health care system. Women have more subcutaneous fat and are more insulin sensitive while men have more visceral and liver fat and higher cardiovascular risk. Women more often show the metabolically healthy obese phenotype than males. However, with increasing BMI the risk for type 2 diabetes and cardiovascular diseases increases more dramatically in women compared to males. Obese women suffer more from weight-related problems, have a higher rate of depression and seek more often medical help to reduce weight. Both biological factors and psychosocial factors contribute to the disease and interact with each other. In this special edition of the journal sex and gender aspects in prevention, treatment and development of complications will be discussed, as proposed by the Austrian Obesity Association. Data available from the Austrian population will be included in the Austrian Gender Obesity Report.