Aged just 39, Dan Hayes viewed going to the doctor as no more than a sensible precaution when he started to feel a bit sluggish and less energetic than normal.
Dan, a business analyst, thought he was in reasonable shape – despite carrying a few extra pounds – and that the worst-case scenario was that he might need his blood pressure medication altering.
He had been taking the same dose since his late-20s (picked up, coincidentally, after seeking his GP’s help for recurrent headaches), but he was convinced he just needed reassurance all was in fact well.
To be on the safe side, the GP took a blood test but, a few days later, called him back in urgently.
The results showed Dan’s blood sugar level – or HbA1c, a measure of average blood sugar over the previous three months – was 95mmol/mol. Normal is 42 or under. The diagnosis was type 2 diabetes.
‘I really panicked when they told me,’ says Dan. ‘I was thinking about the risk of amputations and a lifetime of needing injections.’
Dan, who lives in Southport, Merseyside, with wife Rebecca, 45, and their children, aged 17 and 15, adds: ‘My GP said my blood sugar levels were dangerously high and that we needed to get them down right away.’
As well as panic, he felt surprise. While type 2 diabetes is often related to lifestyle factors – obesity is the underlying cause in about 80 per cent of cases, according to the National Institute for Health and Care Excellence (NICE) – Dan says: ‘No one would have pointed me out and said, ‘He’s overweight.’ ‘
Business analyst Dan Hayes, from Southport, had dangerously high blood sugar levels
He weighed just above 15st and is 6ft 1in tall, meaning his BMI was 26 – slightly over the top end of the ‘normal’ range (24.9).
But Dan, now 45, says: ‘I certainly didn’t think my weight was at a level that would put my health at such serious risk.’
It was, however – and there is a reason for that: men’s health is affected more by them being overweight than women’s.
As Naveed Sattar, a professor of cardiometabolic medicine at the University of Glasgow, explains: ‘For any BMI above 25 – the threshold for being classified as overweight – men tend to experience more harmful health effects than women.
‘In men, every additional five BMI units above 25 is associated with a 51 per cent higher risk of premature death.
‘By contrast, the same increase corresponds to about a 30 per cent higher risk in women.’
Statistics such as these are causing growing concern, particularly because, while there are more overweight or obese men than women – 67 per cent of men fall into the overweight or obese category (with a BMI of 25 or above), compared with 61 per cent of women, according to the Health Survey for England – they’re considerably less likely to do anything about it.
‘Out of every ten patients coming to me for help with obesity – seeking, for example, anything from diet advice to bariatric surgery – seven are women and three are men,’ says Alex Miras, a professor of endocrinology at the University of Ulster.
And evidence suggests that the majority of the estimated 2.5 million people in the UK using weight-loss jabs are women.
‘I have been involved in some weight-loss drug trials and we have to restrict the number of women taking part as we would get seven or eight women for every one man,’ says Professor Sattar.
He points to the Step One trial, one of the first to investigate the effectiveness of semaglutide – the active ingredient in Wegovy and Ozempic, for weight loss. ‘Most of the volunteers who came forward to take part – about 75 per cent – were women.’
And, as we can reveal, while men are less likely than women to use weight-loss jabs, when they do they appear more vulnerable to experiencing severe, even fatal, outcomes.
Men tend to develop type 2 diabetes at a lower BMI and younger age than women
The reason for this disparity is simple: men’s fat tends to be both more harmful and settle in parts of the body more likely to damage health than in women.
Now, a growing band of experts is calling for the way we define obesity to change in order to better identify men whose weight may be putting their health at risk – and for steps to be taken to encourage men to seek help to tackle their weight sooner. It has even being suggested that the threshold for weight-loss measures such as fat jabs should be lower for men.
What’s driving the concern is the fact that virtually every part of a man’s body suffers the ill-effects of excess weight more intensely and rapidly than in women.
When it comes to type 2 diabetes, for instance, men tend to develop it at a lower BMI and a younger age, according to a review of the evidence in Diabetologia in 2023. While the review did not mention specifics, previous research has found men had an average BMI of 31.8 at diagnosis and women 33.6 – but the difference ‘was most marked at younger ages’.
Men who gain weight are also more prone to having a fatty liver (when fat builds up in the liver, ultimately leading to damage), high blood pressure and developing weight-related cancers, such as kidney and liver cancers.
Obese men are several times more likely to develop obstructive sleep apnoea, where excess fat puts pressure on the airways. The condition causes patients to repeatedly stop breathing during sleep and is linked to an increased risk of stroke and heart attack.
Some 51 per cent of men with a BMI of 40 and over develop sleep apnoea compared with only 30 per cent of women, according to 2018 research based on more than 160,000 people, published in the European Respiratory Journal.
Obesity also affects men’s brains more swiftly. Being obese causes damage partly because fat cells release inflammatory chemicals that cross into the brain, harming nerve cells.
A 2024 study in the Journal of Neurology, Neurosurgery and Psychiatry, based on data from 34,000 people, found that, whereas obese men started to show a reduction in brain volume between the ages of 55 to 64, the brain changes happened a decade later in obese women.Â
These changes, especially a loss of grey matter (which contains nerve cells), are linked to a higher risk of dementia.
Yet most men appear unaware of the urgent need to address their weight.
‘Women suffer more psychologically from being overweight,’ says Professor Sattar, ‘which means they are more inclined to do something about it.’
Men, by comparison, ‘tend to laugh it off’. ‘If they start putting on weight, it gets referred to as a ‘dad bod’ or a ‘beer belly’ – it’s become more trivialised and normalised,’ says Dr David Unwin, a GP in Southport and the Royal College of General Practitioners’ expert in diabetes.
‘They don’t tend to ask for help until they have reached some sort of crisis – quite often, it is sleep apnoea and their partner has asked them to get help as their loud snoring is keeping them awake. By then, you often find there is an awful lot else wrong with them as well.’
And this may explain the alarming pattern Good Health has identified from our analysis of the yellow card reports regarding weight-loss jabs.
Yellow card reports are logs made by the public, doctors or a pharmaceutical company itself when a patient experiences an adverse event or side-effect thought to be connected to a medication.
The system is run by the Medicines and Healthcare products Regulatory Agency (MHRA).
With semaglutide, there have been 14,217 reports in total between 2019 and October 18, 2025 – and, while women account for the vast majority of reports (11,068), when it comes to those involving a fatal outcome, men account for 23 out of 26.
Similarly, with liraglutide (Saxenda), there have been 1,320 reports involving women and 557 involving men reporting heart or kidney problems, for example – but when it comes to reports with a fatal outcome, men outnumber women 18 to 16.
There have been 24,982 reports involving women and 4,652 involving men for tirzepatide (Mounjaro); while the larger disparity with this drug might reflect how few men take it, there have been 46 reports involving a fatal outcome for women and 15 for men – suggesting men are still statistically more at risk.
The MHRA emphasises that ‘reactions can be part of the condition being treated rather than being caused by the medicine’.
But Professor Sattar says the figures reflect that men may be in poorer health as a result of their obesity when they start on the drugs. ‘It’s not that the jabs themselves are more harmful to men, it’s that being overweight is more harmful to them,’ he says.
The main reason being overweight is so damaging for men is that they tend to store fat centrally. Women, on the other hand, are more likely to store fat on their buttocks and thighs.
‘The fat in those latter areas tends to be relatively benign, even if it can cause mechanical effects – putting weight on the joints, for instance,’ says Professor Miras.
‘But the central abdominal fat that men tend to gain is different. It accumulates around the organs such as the heart, pancreas and liver and it causes inflammation. This will be felt directly on the organs themselves – and within the nearby blood vessels – increasing the risk of heart disease, fatty liver or, in the case of the pancreas, leading to type 2 diabetes.’
Prior to the menopause, women also benefit from the effects of the hormone oestrogen, which influences where fat is stored, cuts inflammation and protects heart health.
And by the time men seek help they are often in a bad way.
‘The men who come into my surgery looking like an orange on a stick [essentially, their weight is packed around the middle] are the ones I am always most concerned about because we know central obesity can be so damaging,’ says Dr Unwin.
Health Secretary Wes Streeting unveiled the Men’s Health Strategy for England last November
‘First comes the fatty liver, high blood pressure and then type 2 diabetes – the most serious condition. The longer they leave it, the harder it is to treat.
‘If I get someone with pre-diabetes, I have a 93 per cent chance of sorting that out [and achieving normal blood sugar levels].
‘If you wait until you have diabetes, it is a 73 per cent chance. If you wait until you have it for five years, the odds are lower and it’s more likely that they will have complications.’
So should men be given easier access to weight-loss treatments?
Professor Miras says that they should, in principle: ‘There is the question of individual need, of course. It might be that a woman with obesity needs urgent treatment for fertility, for example.
‘But if you were to look at population level and took millions with the same BMI, then there is no doubt that men would be more susceptible to getting sick, and it would make sense to treat men more aggressively and earlier than women.’
The Government recently announced measures to address the problem of men’s weight.
In November, Health Secretary Wes Streeting unveiled the Men’s Health Strategy for England – a ten-year plan aimed at improving men’s health overall, including identifying weight-loss measures that might appeal more to men.
It cited a study of more than 34,000 people referred to a commercial weight-loss programme (largely WeightWatchers) where just 3,600 were men.
However, men comprised 44 per cent of those taking part in an NHS Digital Weight Management Programme, possibly indicating that they ‘respond better’ to programmes they access themselves via their phone or computer.
Moving away from BMI as a sole measure of weight problems may also help. BMI is a calculation based on someone’s height and weight but does not take into account an individual’s build, hence the classic example of a muscular rugby player being labelled overweight and unhealthy. The Lancet Commission last year suggested the need to ‘define obesity more precisely’.
‘They recommended that instead of using one measure, ie BMI, we should use at least two,’ says Professor Miras.
The commission suggested waist circumference, waist-to-hip ratio or waist-to-height ratio in addition to BMI – a move many experts support, including Professor Miras.
He says: ‘People focus on BMI, but we should be trying to highlight that abdominal fat is the greater concern.
‘The waist-to-height ratio identifies those with abdominal fat, and these are more likely to be men than women.’
There have been 4,652 yellow card reports relating to men experiencing ill effects from taking MounjaroÂ
Dr Unwin agrees, and says one way for either sex to check if they have excess central fat is to cut a piece of string to match your height and then cut it in half.
‘If you can’t get it round the widest part of you then you are storing too much central fat,’ he says.
Meanwhile, Dan wishes that men like him were made more aware of how much a risk being even a bit overweight poses.
‘I had no idea,’ he says. ‘I just thought I looked like my friends. No one ever said to me that I needed to slim down.’
The shock of his diabetes diagnosis was enough to kickstart him into action and, under Dr Unwin’s guidance, he switched to a low-carb approach, focusing
on protein and vegetables and cutting right back on cereals, bread and potatoes.
‘For me bread, rice and potato were a real problem – I had them with everything,’ says Dan.
‘When my GP gave me a blood sugar monitor to wear for a couple of weeks, these were the foods that really made my blood sugar levels spike.’
High blood sugar levels over time can damage blood vessels and beyond.
‘So I switched to alternatives such as cauliflower rice, joined the gym and started going for long walks at lunchtime rather than sitting down,’ says Dan.
Within six weeks, his blood sugar was near-normal.
And within six months he had lost 2st – he’s now around 13st, ideal for his height – and not only has he avoided needing diabetes medication, he has also come off the blood pressure drugs he had been taking for years since he started to gain weight.
‘I’m constantly surrounded by temptation,’ says Dan.
‘Food is everywhere. But the fear of what could have been helps pull me back.’