Your Weight Isn’t The Whole Story: 5 Signs Of Metabolic Trouble
Five clues that may reveal metabolic health concerns.
Weight alone does not provide a complete picture of metabolic health, according to Dr Ashish Gautam, principal director of robotic and laparoscopic surgery at Max Super Speciality Hospital, Patparganj. He explained that metabolic health involves how the body uses and stores energy, regulates blood sugar, processes fats and responds to hormones. A person can maintain a relatively stable weight while developing conditions such as insulin resistance, abnormal cholesterol or fatty liver.
Dr Gautam highlighted that this issue is particularly relevant in India, where metabolic problems can occur even among people who are not considered overweight. Citing findings from the National Family Health Survey-5 and an ICMR study published in The Lancet Diabetes & Endocrinology in 2023, he pointed to the prevalence of abdominal obesity among Indian adults. He outlined five indicators that can offer useful clues about metabolic health beyond the number shown on a weighing scale.
The first is an increasing waist circumference despite stable body weight. Abdominal fat includes visceral fat surrounding internal organs and is associated with insulin resistance, unhealthy blood lipid levels and cardiovascular disease. Because BMI does not indicate where fat is stored, a growing waistline can be an important warning sign even when overall weight changes very little.
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The second and third indicators are changes in blood sugar and cholesterol levels. Insulin resistance can develop gradually, initially requiring the pancreas to produce more insulin to maintain normal blood glucose. Over time, this compensation may become less effective, causing blood sugar levels to rise. HbA1c can provide information about average blood glucose over roughly three months, while a lipid profile can identify changes such as high triglycerides, elevated LDL cholesterol and low HDL cholesterol.
The fourth sign is a change in body composition, particularly losing muscle while gaining body fat. Muscle plays an important role in glucose use and insulin sensitivity, while inactivity and ageing can contribute to declining muscle mass. Regular physical activity, including resistance exercise, can help maintain muscle and support metabolic function. Dr Gautam also highlighted estimates that a large proportion of Indians do not meet recommended physical-activity levels, making prolonged sitting and insufficient movement relevant factors.
The fifth indicator involves changes in energy, sleep and appetite, although these symptoms are not specific to metabolic problems. Persistent tiredness can have several causes, including inadequate sleep, anaemia, thyroid disorders and stress. Poor sleep can affect appetite and glucose regulation, while chronic stress may influence eating patterns and abdominal fat accumulation. Dr Gautam's broader message is that metabolic health should be assessed through a combination of indicators, rather than relying solely on body weight.
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