ISLAMABAD:
Physicians have reported diagnosing the simultaneous development of diabetes, hypertension, and obesity in young patients, highlighting increased metabolic health risks among Pakistan’s urban population.
Experts across Pakistan are seeing an early rise in metabolic health disorders as clinics see more young adults with diseases once known to occur in middle age.
“There is a clear change,” said Dr Najam ul Islam, an endocrinologist at the Aga Khan University Hospital. “We are seeing younger patients presenting with conditions that were once more common in middle age.”
Diseases such as diabetes, hypertension and abnormal cholesterol levels now appear earlier in life and, more often than not, they occur simultaneously.
Most people view heart disease, diabetes and obesity as separate problems. Clinically, this distinction is rarely valid. “High blood pressure, diabetes, obesity and lipid abnormalities rarely exist in isolation,” says Dr. Najam. “They share common underlying mechanisms, including insulin resistance and hormonal imbalance.”
In other words, these conditions are interconnected elements of a broader metabolic dysfunction. Treating them individually, without recognizing their common biological roots, risks missing the broader vision. Understanding this relationship allows for more comprehensive management and earlier intervention.
“Several genes are involved in the regulation of appetite, metabolism and fat storage,” explained Dr. Najam. Most obesity reflects a polygenic predisposition interacting with environmental factors. High-calorie diets, limited physical activity and modern lifestyles can trigger weight gain, but genetic predisposition means some people are more vulnerable than others.
Hormonal regulation also plays an essential role. Appetite and energy expenditure are controlled by complex hormonal signals. When these signals are disrupted, losing weight becomes much more difficult.
Modern urban routines amplify these vulnerabilities. Physical inactivity has become common, especially among people who spend long hours sitting at a desk or in front of a screen. Fast food and processed meals are increasingly replacing healthy, home-cooked diets. Chronic stress adds another layer, disrupting hormonal balance, sleep patterns and eating behavior.
In Pakistan, weight is often judged by appearance. If a person does not appear overweight, they are considered healthy. Clinicians say this can be misleading.
“We should look beyond just blood sugar levels or body weight,” Dr. Najam said. A lipid profile can assess cholesterol and triglycerides, while thyroid tests can detect hormonal imbalances affecting metabolism.
Doctors also rely on structured measures to assess risk. Body mass index (BMI) remains a starting point, but it doesn’t tell the whole story. In South Asian populations, metabolic risk begins at lower thresholds and fat distribution is very important.
