Hormonal

In women, visceral adipose tissue (VAT) is significantly more strongly associated with insulin resistance and impaired insulin secretion than abdominal subcutaneous adipose tissue (SAT), whereas in men, both fat depots are associated with insulin resistance to a similar extent.

If you are a woman, carrying fat around your organs (visceral fat) is much more dangerous for your insulin sensitivity than carrying fat under your skin (subcutaneous fat). Men are less discriminating; both types of abdominal fat affect their insulin resistance similarly. Because waist size alone doesn't tell you where the fat is located, relying solely on it may underestimate metabolic risk in women. Focus on reducing overall adiposity, as visceral fat is the primary driver of insulin resistance in women.