ISLAMABAD:
Doctors have reported diagnosing the simultaneous development of diabetes, hypertension and obesity in young patients, highlighting the rise of metabolic health risks in Pakistan’s urban population.
Experts across Pakistan are witnessing an earlier rise in metabolic health disorders as clinics are increasingly seeing younger adults with conditions once known to occur in the middle ages.
“There is a clear shift,” said Aga Khan University Hospital Endocrinologist Dr Najam ul Islam. “We are seeing younger patients present conditions that were once more common in middle age.”
Diseases such as diabetes, hypertension and abnormal cholesterol are now appearing earlier in life and more often than not, they occur simultaneously.
Most people view 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,” Dr Najam explains. “They share common underlying mechanisms, particularly involving insulin resistance and hormonal imbalance.”
In other words, these conditions are interconnected components of a broader metabolic dysfunction. Treating them individually, without recognising their shared biological roots, risks missing the larger picture. Understanding this relationship allows for more comprehensive management and earlier intervention.
“Multiple genes are involved in regulating appetite, metabolism and fat storage,” Dr Najam explained. Most obesity reflects polygenic predisposition interacting with environmental factors. Calorie-dense diets, limited physical activity and modern lifestyles may trigger weight gain, but genetic susceptibility means some individuals are more vulnerable than others.
Hormonal regulation also plays a critical role. Appetite and energy expenditure are controlled by complex hormonal signals. When these signals become disrupted, losing weight becomes significantly harder.
Modern urban routines are amplifying these vulnerabilities. Physical inactivity has become common, particularly among people who spend long hours sitting at desks or on screens. Fast food and processed meals have increasingly replaced balanced home-cooked diets. Chronic stress adds another layer, disrupting hormonal balance, sleep patterns and eating behaviour.
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 Najam. A lipid profile helps assess cholesterol and triglycerides, while thyroid testing can detect hormonal imbalances affecting metabolism.
Doctors also rely on structured measurements to assess risk. Body Mass Index (BMI) remains a starting point, but it does not tell the full story. In South Asian populations, metabolic risk begins at lower thresholds and fat distribution matters greatly.
