Metabolic Syndrome

Waist circumference should be measured in all people because even people who are not overweight or appear lean can store excess fat in the abdomen. The greater the waist circumference, the higher the risk of metabolic syndrome and its complications. The waist circumference that increases risk of complications due to obesity varies by ethnic group and sex.

If waist circumference is high, doctors should measure blood pressure and blood sugar and fat levels after fasting. Levels of both blood sugar and fats are often abnormal.

Metabolic syndrome has many different definitions, but it is most often diagnosed when the waist circumference is 40 inches (102 centimeters) or more in men or 35 inches (88 centimeters) or more in women (indicating excess fat in the abdomen) and when people have or are being treated for two or more of the following:

The initial treatment of metabolic syndrome involves physical activity and a heart-healthy diet. Each part of metabolic syndrome should also be treated with medications if necessary.

If people have diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Symptoms of diabetes may... read more or a high blood sugar level, medications that increase the body’s sensitivity to insulin, such as metformin or a thiazolidinedione (such as rosiglitazone or pioglitazone), may help. Also, physical activity is important for people with diabetes because it enables the body to use blood sugar more efficiently and can often help lower the blood sugar level.

High blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more and abnormal fat levels in blood are also treated. Medications to lower blood pressure (antihypertensives Medications for Treatment of High Blood Pressure High blood pressure is very common. It often does not cause symptoms; however, high blood pressure can increase the risk of stroke, heart attack, and heart failure. Therefore, it is important... read more ) or to lower lipid levels Lipid-lowering drugs Dyslipidemia is a high level of cholesterol and/or triglycerides or a low level of high-density lipoprotein (HDL) cholesterol. Lifestyle, genetics, disorders (such as low thyroid hormone levels... read more are used if needed.

People with abnormal levels of cholesterol and other fats in the blood (lipids) may be treated with lipid-lowering medications Lipid-lowering drugs Dyslipidemia is a high level of cholesterol and/or triglycerides or a low level of high-density lipoprotein (HDL) cholesterol. Lifestyle, genetics, disorders (such as low thyroid hormone levels... read more (statins).

Obesity is treated with anti-obesity medications Medications Obesity is a chronic, recurring complex disorder characterized by excess body weight. Obesity is influenced by a combination of factors that includes genetics, hormones, behavior, and the environment... read more , such as orlistat, phentermine, and liraglutide, and if needed, weight-loss (metabolic and bariatric) surgery Metabolic and Bariatric Surgery Metabolic and bariatric (weight-loss) surgery alters the stomach, intestine, or both to produce weight loss in people have obesity or overweight and have metabolic disorders related to obesity... read more .

Other risk factors for coronary artery disease Risk Factors Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked. The heart muscle needs a constant supply of oxygen-rich blood. The coronary... read more , if present, should be controlled. For example, smokers are advised to stop smoking.

Ways to reduce stress (which can increase the risk of metabolic syndrome) include deep breathing exercises, meditation, psychologic support, and counseling).