ISLAMABAD:
Doctors have reported diagnosing the simultaneous development of diabetes, hypertension and obesity in young patients, highlighting the increase in metabolic health risks in Pakistan’s urban population.
Experts across Pakistan are witnessing an earlier rise in metabolic health disorders as clinics increasingly see younger adults with conditions once known to occur in middle age.
“There is a clear shift,” said Aga Khan University Hospital endocrinologist Dr. Najam ul Islam. “We’re seeing younger patients have conditions that were once more common in middle age.”
Diseases such as diabetes, high blood pressure and abnormal cholesterol now appear earlier in life and most often occur simultaneously.
Most people see heart disease, diabetes and obesity as separate problems. Clinically, that distinction rarely holds. “High blood pressure, diabetes, obesity and lipid abnormalities rarely exist in isolation,” explains Dr. Nayam. “They share common underlying mechanisms, particularly involving insulin resistance and hormonal imbalance.”
In other words, these conditions are interrelated components of a broader metabolic dysfunction. Treating them individually without recognizing their common biological roots risks missing the bigger picture. Understanding this relationship allows for more comprehensive management and earlier intervention.
“Several genes are involved in regulating appetite, metabolism and fat storage,” explained Dr. Nayam. Most obesity reflects polygenic predisposition interacting with environmental factors. Calorie-dense diets, limited physical activity and modern lifestyles can trigger weight gain, but genetic susceptibility means some individuals are more vulnerable than others.
Hormonal regulation also plays a crucial role. Appetite and energy expenditure are controlled by complex hormonal signals. When these signals are disrupted, it becomes significantly more difficult to lose weight.
Modern urban routines reinforce these vulnerabilities. Physical inactivity has become common, especially among people who spend long hours sitting at desks or in front of screens. Fast food and processed meals have increasingly replaced balanced home-cooked diets. Chronic stress adds another layer, disrupting hormone balance, sleep patterns and eating behaviors.
In Pakistan, weight is often judged by appearance. If someone does not look overweight, they are assumed to be healthy. Clinicians say this can be misleading.
“We should be looking beyond blood sugar levels or body weight alone,” said Dr. Nayam. A lipid profile helps assess cholesterol and triglycerides, while thyroid tests can detect hormonal imbalances that affect metabolism.
Doctors also rely on structured metrics to assess risk. Body Mass Index (BMI) remains a starting point, but it does not tell the whole story. In South Asian populations, metabolic risk begins at lower thresholds, and fat distribution is of major importance.
