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It’s a term that’s starting to appear more and more in wellness circles yet few people really understand what it means. Metabolic syndrome might sound like just another medical buzzword but experts say it’s a condition that can quietly disrupt your energy, weight and long-term health if left unchecked. To find out what’s really going on inside the body and what you can do to prevent it, as an accredited nutritionist, I spoke to Dr Sue Decotiis, a New York–based medical weight loss doctor, and Dr Maz Ghodsian, a board-certified physician from Beverly Hills to get their opinion on how best we can manage this condition. What is metabolic syndrome "Metabolic syndrome is a very common condition that can markedly reduce the body’s ability to burn fat and metabolize carbohydrates," explains Dr Sue Decotiis. "It often develops as we age, during menopause or andropause, or from genetic predisposition, poor diet and even exposure to food toxins such as lead and other metals." According to Dr Maz Ghodsian, "Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes." To be diagnosed, a person usually has three or more of the following markers: abdominal obesity with a waist measurement greater than 40 inches for men or 35 inches for women, high triglycerides of 150 mg/dL or more, low HDL or "good" cholesterol, elevated blood pressure, and high fasting glucose. "The underlying driver is insulin resistance when your body’s cells stop responding properly to insulin, leading to elevated blood sugar, fat accumulation and systemic inflammation." It’s this cascade of effects that explains why metabolic syndrome can cause weight gain that doesn’t respond to diet or exercise, fatigue and even brain fog. "Patients often feel frustrated because they’re doing everything right, but the weight won’t shift," says Dr Decotiis. "That’s because the metabolism itself is out of sync." The role of the mitochondria If metabolism is the body’s engine, mitochondria are the batteries that power it. "The mitochondria are the battery of the body," says Dr Decotiis. "They produce energy for every cell, and metabolic syndrome is believed to be a form of mitochondrial dysfunction when the body can’t efficiently turn food into energy." Dr Ghodsian describes mitochondria as microscopic power plants that convert nutrients into energy called ATP. But their role goes far beyond that. "They also regulate cell death, maintain calcium balance, and neutralize harmful free radicals," he explains. "When they stop functioning efficiently, energy levels drop, metabolism slows, and inflammation rises, which is exactly what we see in metabolic syndrome." What are the signs of metabolic syndrome The symptoms can vary from person to person, but most people notice persistent tiredness, sugar cravings, or weight gain around the midsection that feels impossible to lose. "Typical signs include fatigue, brain fog, and centripetal (abdominal) obesity," says Dr Decotiis. "Other red flags include elevated cholesterol and triglycerides, high blood pressure, fatty liver, and an increased risk for cardiovascular disease. Even if you never develop diabetes, it’s still a state of chronic inflammation." Dr Ghodsian adds that "people often notice fatigue after meals, difficulty fasting, and low energy. A blood panel measuring fasting glucose, lipid profile, waist circumference and blood pressure is typically used to confirm the diagnosis." Can metabolic syndrome be reversed The good news, like myself as a nutritionist, both doctors agree, it can be reversed. "In the past, the medication Metformin was commonly used," says Dr Decotiis. "It delivered mediocre results, but newer GLP-1 medications such as Ozempic or Mounjaro can help reverse insulin resistance in patients with higher body fat who don’t respond to lifestyle changes alone. Diet and exercise are the foundation, but sometimes they need medical support." Dr Ghodsian agrees that lifestyle is key. "Metabolic syndrome is largely reversible through targeted changes. A Mediterranean-style diet or one low in refined carbohydrates improves insulin sensitivity. Regular aerobic and resistance exercise helps increase mitochondrial density and glucose uptake. Even a modest five to 10 percent weight loss can significantly improve markers." He also highlights the importance of sleep and stress management. "Consistent seven to eight hours of sleep each night reduces insulin resistance and stress hormones," he says. "Mindfulness, deep breathing, or therapy can also help regulate cortisol, one of the silent drivers of weight retention." Do mitochondrial supplements work While mitochondrial supplements like CoQ10, NAD+ and alpha-lipoic acid are popular, experts say they’re best used as part of a holistic plan, not a shortcut. "Mitochondrial supplements can be helpful for increasing energy," says Dr Decotiis. "They could include NAD or Methylene Blue, but I haven’t seen them significantly reduce insulin resistance or cause fat loss." Dr Ghodsian says the research is promising, though still developing. "Nutrients like CoQ10, L-carnitine, magnesium and B vitamins support mitochondrial enzymes," he explains. "Newer compounds like NAD+ precursors and polyphenols such as resveratrol and curcumin may enhance mitochondrial health, but they work best when paired with good diet, exercise and sleep." He also believes that simple habits matter most. "HIIT and resistance training increase mitochondrial density," he says. "A nutrient-dense diet rich in greens, fatty fish, olive oil and nuts helps. Occasional fasting and omega-3s can also reduce inflammation and protect mitochondria." The bottom line Metabolic syndrome is not a single disease, it’s a warning light that your metabolism, hormones and mitochondria are out of sync. But with the right combination of lifestyle shifts, medical supervision and time, it can be reversed. "As doctors, we want people to understand that metabolic syndrome isn’t a life sentence," says Dr Ghodsian. "It’s a signal to take charge of your health. Small, consistent changes, the kind you can sustain, have a profound effect on reversing insulin resistance and restoring energy." Dr Decotiis agrees. "When patients realise this isn’t a matter of willpower but of biology, they feel empowered," she says. "With the right treatment and support, metabolic balance and vitality can absolutely be restored." This content is for informational and educational purposes only. It should not replace professional medical advice. Always consult a qualified healthcare provider before starting any new treatment or lifestyle intervention. Expert bios Faye James is an accredited nutritionist based in Sydney and author of The Menopause Diet and Perimenopause Plan Sue Decotiis is a New York–based medical weight loss doctor Dr Maz Ghodsian is a board-certified physician from Beverly Hills
