But why does someone get to this point?  For the chronic dieter they arrive with metabolic damage because they hold tightly to the “Eat less, exercise more” mantras they were taught.  When weight loss slows down, they eat less and push harder in their exercise routine, pushing metabolism into the ground.  For the person with the unknown metabolism problem their road to metabolic damage is much more subtle.  This person simply isn’t feeling well, starts putting on weight, and progresses all the way to metabolic damage because no doctor was able to identify what was going wrong.

In type 2 diabetes (adult onset diabetes), the pancreas makes insulin, but it either doesn't produce enough, or the insulin does not work properly. Nine out of 10 people with diabetes have type 2. This type occurs most often in people who are over 40 years old but can occur even in childhood if there are risk factors present. Type 2 diabetes may sometimes be controlled with a combination of diet, weight management and exercise. However, treatment also may include oral glucose-lowering medications (taken by mouth) or insulin injections (shots).

As of 2015, an estimated 415 million people had diabetes worldwide,[8] with type 2 DM making up about 90% of the cases.[16][17] This represents 8.3% of the adult population,[17] with equal rates in both women and men.[18] As of 2014, trends suggested the rate would continue to rise.[19] Diabetes at least doubles a person's risk of early death.[2] From 2012 to 2015, approximately 1.5 to 5.0 million deaths each year resulted from diabetes.[8][9] The global economic cost of diabetes in 2014 was estimated to be US$612 billion.[20] In the United States, diabetes cost $245 billion in 2012.[21]
The symptoms may relate to fluid loss and polyuria, but the course may also be insidious. Diabetic animals are more prone to infections. The long-term complications recognized in humans are much rarer in animals. The principles of treatment (weight loss, oral antidiabetics, subcutaneous insulin) and management of emergencies (e.g. ketoacidosis) are similar to those in humans.[123]
In type 2 diabetes (adult onset diabetes), the pancreas makes insulin, but it either doesn't produce enough, or the insulin does not work properly. Nine out of 10 people with diabetes have type 2. This type occurs most often in people who are over 40 years old but can occur even in childhood if there are risk factors present. Type 2 diabetes may sometimes be controlled with a combination of diet, weight management and exercise. However, treatment also may include oral glucose-lowering medications (taken by mouth) or insulin injections (shots).
^ Nagele, Eva; Jeitler, Klaus; Horvath, Karl; Semlitsch, Thomas; Posch, Nicole; Herrmann, Kirsten H.; Grouven, Ulrich; Hermanns, Tatjana; Hemkens, Lars G.; Siebenhofer, Andrea (2014). "Clinical effectiveness of stress-reduction techniques in patients with hypertension". Journal of Hypertension. 32 (10): 1936–44. doi:10.1097/HJH.0000000000000298. ISSN 0263-6352. PMID 25084308.
^ Jump up to: a b Daskalopoulou, Stella S.; Rabi, Doreen M.; Zarnke, Kelly B.; Dasgupta, Kaberi; Nerenberg, Kara; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain (2015-01-01). "The 2015 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension". Canadian Journal of Cardiology. 31 (5): 549–68. doi:10.1016/j.cjca.2015.02.016. PMID 25936483.
Insulin is released into the blood by beta cells (β-cells), found in the islets of Langerhans in the pancreas, in response to rising levels of blood glucose, typically after eating. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage. Lower glucose levels result in decreased insulin release from the beta cells and in the breakdown of glycogen to glucose. This process is mainly controlled by the hormone glucagon, which acts in the opposite manner to insulin.[61] https://www.clairekerslake.com/wp-content/uploads/2011/10/young-woman-planning-in-calendar-app-on-white-iphone-picjumbo-com-1024x683.jpg

^ Jump up to: a b c d e f Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr. JL, Jones DW, Materson BJ, Oparil S, Wright Jr. JT, Roccella EJ, et al. (December 2003). "Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure". Hypertension. Joint National Committee On Prevention. 42 (6): 1206–52. doi:10.1161/01.HYP.0000107251.49515.c2. PMID 14656957. Archived from the original on 20 May 2012. Retrieved 1 January 2012.
Naturally, since the metabolic syndrome is a disorder of energy distribution and storage, fat accumulation explains for a significant proportion of cardiovascular risk. However, obesity without metabolic syndrome does not confer a significant cardiovascular risk, whereas metabolic syndrome without obesity is associated with a significant risk of diabetes and cardiovascular disease. This association of metabolic syndrome with diabetes can be illustrated by generalized lipodystrophy (near complete absence of adipose tissue). The animals and humans with generalized lipodystrophy develop signs of metabolic syndrome in the absence of adipose tissue; and the metabolic syndrome progresses to type 2 diabetes. Adipose tissue transplantation in transgenic mice with lipodystrophy can cure the type 2 diabetes.
Hypertension results from a complex interaction of genes and environmental factors. Numerous common genetic variants with small effects on blood pressure have been identified[34] as well as some rare genetic variants with large effects on blood pressure.[35] Also, genome-wide association studies (GWAS) have identified 35 genetic loci related to blood pressure; 12 of these genetic loci influencing blood pressure were newly found.[36] Sentinel SNP for each new genetic locus identified has shown an association with DNA methylation at multiple nearby CpG sites. These sentinel SNP are located within genes related to vascular smooth muscle and renal function. DNA methylation might affect in some way linking common genetic variation to multiple phenotypes even though mechanisms underlying these associations are not understood. Single variant test performed in this study for the 35 sentinel SNP (known and new) showed that genetic variants singly or in aggregate contribute to risk of clinical phenotypes related to high blood pressure.[36]
The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical exercise, and weight loss. Though these have all been recommended in scientific advisories,[111] a Cochrane systematic review found no evidence for effects of weight loss diets on death, long-term complications or adverse events in persons with hypertension.[112] The review did find a decrease in blood pressure.[112] Their potential effectiveness is similar to and at times exceeds a single medication.[12] If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication.
The exact cause of metabolic syndrome is unknown. It is frequently influenced by diet and lifestyle, but also seems to be genetically driven. As stated, many features of metabolic syndrome are associated with “insulin resistance,” which causes cells to lose their sensitivity to insulin, the hormone needed to allow blood sugar to enter cells for use as fuel. As glucose levels in the blood increase, the pancreas tries to overcompensate and produce even more insulin, which ultimately leads to the characteristic symptoms of metabolic syndrome. When insulin levels spike, a stress response occurs that leads to elevations in cortisol, the body’s long-acting stress hormone. This in turn creates an inflammatory reaction that if left unchecked begins to damage healthy tissue.
The primary problem in metabolic syndrome is insulin resistance. In the body's attempt to compensate for insulin resistance, extra insulin is produced, leading to elevated insulin levels. The elevated insulin levels can lead, directly or indirectly, to the characteristic metabolic abnormalities seen in these patients. Frequently, the insulin resistance will progress to overt type 2 diabetes, which further increases the risk of cardiovascular complications.
With secondary hypertension, if the condition causing the high blood pressure can be resolved (e.g., by removing an adrenal tumor or stopping a medication) or controlled (e.g., by controlling diabetes or thyroid disease), then blood pressure levels may fall to normal or near normal levels. When a cure is not possible and control of the underlying condition consists of minimizing further damage, as may occur with kidney disease, then hypertension will be controlled with a combination of medications and the person will be monitored closely to help maintain organ function and address acute problems as they arise.
Type 1 diabetes is caused by an autoimmune reaction (the body attacks itself by mistake) that stops your body from making insulin. About 5% of the people who have diabetes have type 1. Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you’ll need to take insulin every day to survive. Currently, no one knows how to prevent type 1 diabetes.
Type 2 DM is primarily due to lifestyle factors and genetics.[45] A number of lifestyle factors are known to be important to the development of type 2 DM, including obesity (defined by a body mass index of greater than 30), lack of physical activity, poor diet, stress, and urbanization.[16] Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60–80% of cases in those of European and African descent, and 100% of Pima Indians and Pacific Islanders.[11] Even those who are not obese often have a high waist–hip ratio.[11]

The undiagnosed/untreated metabolic condition that spreads.  Metabolism is an intricate system of organs communicating with one another to do a job.  If you have a problem in one area, it will affect other areas as well.  The example I use with patients is to picture metabolism as an orchestra playing a song.  If the flutes are playing off key or out of time, the other instruments in the band will likely wander off key and timing as well.  In the end, everyone is off and the song is a mess.  This is how metabolic damage can develop as well.  An untreated thyroid condition will negatively affect all other systems and metabolism as a whole.

According to guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC), a reading below 120/80 mm Hg is classified as normal blood pressure. Those with a blood pressure reading anywhere from 120/80 up to 129/80 are classified within a category called elevated blood pressure. Hypertension is defined as a reading of 130/80 or higher.
At the end of the twelve-week study both groups lost weight, but the difference in the amount of muscle vs. fat loss was telling. The aerobic group lost 37 pounds over the course of the study. Ten of those pounds came from muscle. In contrast, the resistance-training group lost 32 pounds. None of the weight they lost came from muscle. When the resting metabolic rate of each group was calculated, the aerobic group was shown to be burning 210 fewer calories per day. The resistance-training group avoided this metabolic decline and instead was burning 63 more calories per day.