Does A Large Waist Mean You Have A Metabolic Disorder?

Here at Westchester Health, we often get questions from our patients wanting to know the difference between metabolic syndrome, metabolic disorder and metabolic diseases. Since there seems to be some confusion, we thought we’d offer this blog as a way to clarify these conditions that, if left untreated, pose serious risks to your health, particularly diabetes and cardiovascular disease.

Some metabolic definitions


This is the process your body uses to get energy from the food you eat (nutrition), which is made up of proteins, carbohydrates and fats. Chemicals in your digestive system then break down foods into sugars and acids, which are your body’s fuel.

Metabolic syndrome or metabolic disorder

Mindy Sotsky, MD, FACE

This is a group of conditions—increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels—that occur together, increasing your risk of heart disease, stroke and diabetes. A metabolic disorder occurs when the metabolism process fails and causes the body to have either too much or too little of the essential factors needed to perform its functions and stay healthy. For example, the brain needs calcium, potassium and sodium to generate electrical impulses, and lipids (fats and oils) to maintain a healthy nervous system.

Other names for metabolic syndrome:

  • Dysmetabolic syndrome
  • Hypertriglyceridemic waist
  • Insulin resistance syndrome
  • Obesity syndrome
  • Syndrome X

Metabolic syndrome is becoming more common due to rising obesity rates in adults

Metabolic syndrome is closely linked to obesity and a lack of physical activity. In fact, it may overtake smoking as the leading risk factor for heart disease. In addition, your risk for heart disease, diabetes and stroke increases with the number of metabolic risk factors you have.

Metabolic risk factors to be aware of

Most metabolic syndrome risk factors have no signs or symptoms, although a large waistline is a visible sign. The 5 conditions below are metabolic risk factors — you can have any one of them by itself, but they tend to occur together. NOTE: You must have at least 3 metabolic risk factors to be diagnosed with metabolic syndrome.

  1. A large waistline. This also is called abdominal obesity or “having an apple shape.” Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
  2. A high triglyceride level (or you’re on medicine to treat high triglycerides, a type of fat in the blood).
  3. A low HDL cholesterol level (or you’re on medicine to treat low HDL cholesterol). HDL sometimes is called “good” cholesterol because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease.
  4. High blood pressure (or you’re on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and cause plaque buildup, which can lead to a heart attack or stroke. Symptoms can include dull headaches, dizzy spells or nosebleeds.
  5. High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes. Symptoms of high blood sugar include increased thirst, increased urination especially at night, fatigue and blurred vision.
  6. Insulin resistance, a condition in which the body cannot use its insulin properly (a hormone that helps move blood sugar into cells where it is used for energy). Insulin resistance can lead to high blood sugar levels and is closely linked to obesity.
  7. Diabetes. You’re more likely to have metabolic syndrome if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type 2 diabetes.
  8. Genetics. Ethnicity and family history
  9. Older age. Your risk of metabolic syndrome increases with age.
  10. Race. In the U.S., Mexican-Americans appear to be at the greatest risk of developing metabolic syndrome.
  11. Other diseases. Your risk of metabolic syndrome is higher if you have ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome.

You can prevent or delay metabolic syndrome with lifestyle changes

What we tell our patients at Westchester Health is that the best way to prevent metabolic syndrome is to adopt heart-healthy lifestyle changes. These include:

  • Heart-healthy eating
  • Achieving and maintaining a healthy weight
  • Managing stress
  • Physical activity
  • Quitting smoking
  • Routine doctor visits to keep track of your cholesterol, blood pressure and blood sugar
  • A blood test called a lipoprotein panel, which reveals your levels of total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides
  • Regularly taking any medicines your doctor recommends

Concerned that you may have a metabolic disorder? Come see us.

If you think you may have a metabolic disorder, or are experiencing some of the symptoms mentioned above,please call (914) 232-1919 to make an appointment with one of our Westchester Health Internal Medicine specialists. He/she will perform a thorough examination, determine which conditions you may have, and together with you, choose the best course of treatment to improve your health and prevent future disease. Whenever, wherever you need us, we’re here for you.

By Mindy Sotsky, MD, FACE, an endocrinologist with Westchester Health, member of Northwell Health Physician Partners

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