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Sex and Race Differences

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Men and women paper cutouts

Sex and race differences underlying the brain-gut microbiome system related to disease and health

Several studies have highlighted race contributing to obesity, especially in non-White populations. However, sex differences still remain largely unexamined in obesity. Sex is considered an important variable that influences the quality and generalizability of biomedical research, and a major focus of our center has been on the characterization of sex-differences in various brain gut disorders. There are clear sex differences in the relationships between various risk factors and obesity. Some of our studies have shown that there are sex differences in the neural pathways associated with the extended reward network, with women showing greater alterations in reward, emotion regulation, and salience regions, while men having greater functional connectivity within interoceptive and somatosensory regions.

One barrier to progress in developing effective treatments for obesity may be the inconsistent consideration of sex and race differences in the underlying mechanisms. Our studies have been the first to identify race and sex-related alterations in specific brain circuits and networks underlying alterations in the extended reward network and in the gut microbiome related to altered ingestive behaviors and obesity.

These findings have implications for more personalized therapeutic strategies tailored to the distinct pathophysiologic mechanisms underlying obesity in each sex and race.


  • Gupta A, Mayer EA, Sanmiguel CP, Bhatt R, Love A, Bal A, Tillisch K, Labus JS, Kilpatrick LA. Sex commonalities and differences in BMI-related alterations in intrinsic brain activity and connectivityLink is external(Link is external) (Link opens in new window). Obesity. 2018. 26(2): 340-350. PMCID: PMC5783781
  • Gupta A, Mayer EA, Hamadani K, Fling C, Alaverdyan M, Torgerson C, Ashe-McNalley C, vanHorn JD, Naliboff B, Tillisch K, Sanmiguel CP, Labus JS. Sex differences in the influence of body mass index on anatomical architecture of brain networksLink is external(Link is external) (Link opens in new window). International Journal of Obesity. 2017: 41(8): 1185-1195. PMCID: PMC5548596
  • Hung TKW, Dong TS, Chen Z, Elashoff D, Sinsheimer JS, Jacobs JP, Lagishetty V, Vora P, Stains J, Mayer EA, Gupta A. Understanding the heterogeneity of obesity and the relationship to the brain-gut axisLink is external(Link is external) (Link opens in new window). Nutrients. 2020 Nov 30;12(12):E3701. doi: 10.3390/nu12123701. PMID: 33266058
  • Osadchiy V, Mayer EA, Gao K, Labus JS, Naliboff B, Tillisch K, Chang L, Jacobs JP, Hsiao EY, Gupta A. Analysis of brain networks and fecal metabolites reveals brain-gut alterations in premenopausal females with irritable bowel syndromeLink is external(Link is external) (Link opens in new window). Transl Psychiatry. 2020 Nov 2;10(1):367. doi: 10.1038/s41398-020-01071-2. PMID: 33139708; PMCID: PMC7608552
  • *Labus JS, *Gupta A, Coveleskie K, Tillisch K, Kilpatrick L, Jarcho J, Feier N, Bueller J, Stains J, Smith S. Suyenobu B, Naliboff BN, Mayer EA. Sex differences in emotion-related cognitive processes in irritable bowel syndrome and healthy control subjectsLink is external(Link is external) (Link opens in new window). Pain. 2013; 154(10):2088-99. PMCID: PMC4049231 *Equal Contributors
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