Metabolic syndrome: could you have it?

More than 1 in 3 adults in the United States have a condition that could increase their risk of developing many other serious medical problems—and many don’t even know it. It’s called metabolic syndrome, also known as syndrome X or insulin resistance syndrome, and it’s on the rise.

The list of health problems that metabolic syndrome can lead to is long. It doubles a person's risk of both heart attack and stroke. It may also lead to high blood pressure (hypertension), type 2 diabetes, polyendocrine metabolic ovarian syndrome (PMOS), a condition previously known as polycystic ovary syndrome (PCOS), fatty liver, cholesterol gallstones, asthma, and even some forms of cancer.

But here's the good news: Metabolic syndrome is treatable with lifestyle changes. And sometimes, it can be reversed.

Do you have metabolic syndrome?

Most of the symptoms of metabolic syndrome are silent. Finding out if you have it requires medical testing. But you can ask yourself the following questions to help determine whether a medical appointment is in order:

• Do you carry excess weight around your middle?
• Are you physically inactive?
• Does someone in your family have diabetes?
• Have you had gestational diabetes during a pregnancy?
• Do you have nonalcoholic fatty liver disease, PMOS, or sleep apnea?
• Do you take medications that cause weight gain or that change your blood pressure, cholesterol, or blood sugar?
• Are you Hispanic?

Answering yes to any of the above questions means that you have at least one personal factor that may be cause for concern. In addition, older age is associated with especially high risk. But metabolic syndrome is also increasing in younger adults, affecting more than 1 in 5 between the ages of 20 and 39.

If you suspect you are at risk, make an appointment with your healthcare provider (HCP). An early diagnosis may help prevent the serious health problems associated with metabolic syndrome.

Five criteria for metabolic syndrome

The following health measures will help your HCP make a diagnosis. Having three of the five can indicate the presence of metabolic syndrome.

• Abdominal obesity: Obesity in general has been linked to metabolic syndrome, but excess fat around the waistline correlates even more closely. For men and people assigned male at birth, a waistline of 40 inches or more is considered high-risk. For women and people assigned female at birth, it’s a waistline of 35 inches or more.
• Elevated blood pressure: In particular, a level over 130/85.
• High blood triglycerides (a kind of fat in the blood): Specifically, a level over 150 mg/dL.
• Low HDL (aka “good” cholesterol): For men, low HDL is below 40 mg/dL. For women, low HDL is below 50 mg/dL.
• Insulin resistance: As indicated by a fasting blood glucose level at or above 100 mg/dL.

Key lifestyle changes

If you do have the syndrome, your HCP can introduce you to immediate lifestyle changes that can reverse it.

Manage your weight with exercise

Reversing metabolic syndrome often involves exercising more and losing extra weight. Weight loss can improve all characteristics of metabolic syndrome, from your blood fat levels to your body's resistance to insulin. An exercise program as simple as walking a couple of miles each day is a good way to start.

Adopt a healthy diet

You can also make basic changes to your diet. For example, try reducing your intake of animal-based fats such as those in red meat or full-fat dairy. These foods are high in unhealthy saturated fats, which are typically solid at room temperature and which raise your levels of low-density lipoprotein (LDL or "bad" cholesterol).

Instead, seek more foods high in healthy polyunsaturated and monounsaturated fats. These typically come from plant foods (such as nuts, avocados, and olive oil) and seafood (such as salmon and trout). Doing so may reduce your body's LDL levels and increase high-density lipoprotein (HDL or "good" cholesterol) levels.

If you need help managing your diet and cutting back on unhealthy foods, talk to an HCP about seeing a dietitian or nutritionist. These experts can set you up with a healthful eating plan.

Medication? Maybe

In addition to lifestyle changes, medication therapies may be useful.

GLP-1s

Medications called glucagon-like peptide-1 (GLP-1) receptor agonists, or GLP-1s, can be used to treat several issues related to or contributing to metabolic syndrome.

Wegovy (semaglutide) and Zepbound (tirzepatide) are approved by the U.S. Food and Drug Administration (FDA) to help people lose weight. Other GLP-1 drugs are approved to help treat type 2 diabetes.

Metformin

Metformin is another drug that can be used to help treat metabolic syndrome. It is formulated to treat type 2 diabetes and complications that may come from the disease.

Other medicines may also help to treat some of the factors involved in metabolic syndrome, such as high blood pressure, high triglycerides, and low HDL.

Take evasive action

It's not completely clear what causes metabolic syndrome. Some people may be genetically predisposed, while others may have a combination of lifestyle and medical factors that put them at risk. But metabolic syndrome is preventable. By getting plenty of exercise and maintaining a healthy weight, there is a strong possibility that you can avoid this condition.