This question comes up constantly and gets answered badly almost everywhere. Here's the honest version: real, measurable average differences, with an enormous amount of overlap between individuals.
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Typical body composition differs
On average, adult female bodies carry a higher share of body fat — roughly 21–33% is a typical healthy range — while adult male bodies typically sit around 8–21%. This isn't a flaw to correct: oestrogen-driven fat stores support menstrual cycles, pregnancy and bone health, and a very low body-fat percentage stops periods entirely.
Male bodies typically carry more skeletal muscle and denser bone, largely from testosterone. That means a man and a woman of identical height and weight will usually look different and burn slightly different amounts of energy at rest — the man's extra muscle costs more to maintain.
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Fat tends to be stored in different places
Oestrogen encourages storage around hips, thighs and bottom ('pear'); testosterone and low oestrogen favour the abdomen ('apple'). Trunk fat around the organs is more metabolically active and more strongly linked to blood-sugar and heart risk, which is one reason waist measurement often tells a doctor more than weight.
These are averages across populations with enormous overlap. Plenty of women store centrally and plenty of men store on hips and thighs — genetics writes the individual version.
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Cycles move the number every month
In the week before a period, progesterone and aldosterone shifts commonly hold 1–5 lb (0.5–2 kg) of extra fluid. Appetite genuinely rises in the luteal phase — resting energy use goes up a little too — and cravings are hormonal, not weak.
Conditions like PCOS (affecting up to 1 in 10 women) involve insulin resistance and make weight loss physically harder while making weight gain easier. Endometriosis, fibroids and thyroid disease also cause bloating and weight change that no amount of discipline touches.
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Gender-affirming hormones change the map
Starting oestrogen typically softens the skin, redistributes fat toward hips and chest, and reduces muscle mass over 1–3 years — often with a modest weight increase that is mostly redistribution.
Starting testosterone increases muscle mass, shifts fat toward the abdomen, and raises appetite. Weight commonly rises while clothing size in some places falls. Both changes are expected, gradual, and largely reverse if hormones stop.
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Medicine has studied male bodies more
Women were excluded from many clinical trials until the 1990s, so a lot of dosing, symptom lists and diagnostic thresholds were built on male data. Heart-attack symptoms, pain conditions and thyroid problems are still diagnosed later in women on average.
Practically: if you feel dismissed, you may be. Bringing written symptoms, dates and questions to an appointment measurably improves how you're heard — that's what the Visit Prep room is for.
