Abdominal obesity is sometimes accompanied by at least one of the following – high blood pressure, low HDL (good cholesterol), high LDL (bad cholesterol), high triglycerides, high blood sugar and a family history of diabetes. This constellation of abnormalities is known as Metabolic Syndrome or “Syndrome X”. It’s not a disease per se, but a combination of risk factors leading to obesity, diabetes and cardio-vascular disease. Dr Gerald Reaven in 1988 provided the conceptual basis of Syndrome X and insulin resistance as its underlying cause.

An insulin-resistant person does not respond to a given quantity of insulin — the blood glucose regulating hormone — the way a normal body does. Thus, the pancreas (insulin secreting glands) need to produce more insulin than normal to control blood sugars.
Syndrome X results from an excess of insulin in blood—-hyperinsulinemia—-and resistance to its actions. This, in turn, causes a cluster of risk factors including abdominal obesity, abnormal cholesterol levels, glucose intolerance, high blood pressure and high uric acid.

All obese people, to some degree, are insulin-resistant, but those with abdominal obesity are far more insulin-resistant.
Poly-cystic ovarian syndrome in women is also an insulin-resistant state which results in irregular menstrual periods and infertility.
Other visible manifestations of Metabolic Syndrome include darkening and thickening of skin behind the neck, under arms and thigh folds, skin tags, buffalo hump, abnormal breast development in men and excessive hair growth in women.

Environmental and genetic factors act together to cause the syndrome. Obesity, insulin resistance, diabetes and cardiovascular disease are all about interaction of genes with the environment. Over the past half-century, sedentary lifestyles and increased intake of calories have accentuated the effect of the genes of insulin resistance.

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