ISLAMABAD:
Doctors have reported diagnosing the simultaneous development of diabetes, hypertension and obesity in young patients, highlighting the increased metabolic health risks in Pakistan’s urban population.
Experts across Pakistan are seeing an earlier rise in metabolic health disorders as clinics increasingly serve younger adults with conditions once known to occur in middle age.
“There is a clear change,” said Dr. Najam ul Islam, an endocrinologist at 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 now appear at a younger age and, in most cases, occur simultaneously.
Most people see heart disease, diabetes and obesity as separate problems. Clinically, that distinction is rarely met. “High blood pressure, diabetes, obesity, and lipid abnormalities rarely exist in isolation,” explains Dr. Najam. “They share common underlying mechanisms, particularly related to insulin resistance and hormonal imbalance.”
In other words, these conditions are interconnected components of a broader metabolic dysfunction. Treating them individually, without recognizing their shared biological roots, risks missing the bigger picture. Understanding this relationship allows for more comprehensive management and earlier intervention.
“Multiple genes are involved in regulating appetite, metabolism and fat storage,” explained Dr. Najam. Most obesity reflects a polygenic predisposition that interacts with environmental factors. High-calorie diets, limited physical activity and modern lifestyles can lead to weight gain, but genetic susceptibility means some people are more vulnerable than others.
Hormonal regulation also plays a fundamental 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 are amplifying these vulnerabilities. Physical inactivity has become common, particularly among people who spend long hours sitting at desks or in front of screens. Fast food and processed foods have increasingly replaced balanced homemade diets. Chronic stress adds another layer, altering hormonal balance, sleep patterns, and eating behavior.
In Pakistan, weight is often judged by appearance. If someone doesn’t look overweight, they are assumed to be healthy. Doctors say this can be misleading.
“We should look beyond blood sugar levels or body weight alone,” Dr. Najam said. A lipid profile helps evaluate cholesterol and triglycerides, while thyroid tests can detect hormonal imbalances that affect metabolism.
Doctors also rely on structured measurements to assess risk. Body mass index (BMI) is still a starting point, but it doesn’t tell the whole story. In South Asian populations, metabolic risk starts at lower thresholds and fat distribution is very important.
