Most chronic diseases don’t start suddenly—they begin with a malfunctioning metabolism. When your body can’t efficiently convert food into energy, the effects can show up in multiple areas, affecting your skin and teeth, and even contributing to conditions such as Alzheimer’s, cancer, and depression.

“I believe that metabolism, and health or disease in this area, is a root cause for chronic diseases that we’re facing in the 21st century,” Dr. Robert Lufkin, a medical school professor at the University of California–Los Angeles and the University of Southern California, and a New York Times bestselling author, told The Epoch Times.

Early detection and prevention are now more accessible than ever, offering a window to act before disease takes hold.

How Metabolic Damage Spreads

Although often used interchangeably, the terms metabolic disease and metabolic dysfunction are not the same. Diseases are disorders such as Type 2 diabetes, obesity, or fatty liver that have clear diagnostic criteria and require intervention, while dysfunction refers to early metabolic imbalances—such as insulin resistance or prediabetes—that may not yet qualify as disease but signal future risk.

“In short, dysfunction often precedes disease,” Lufkin said.

Metabolic dysfunction primarily revolves around two core issues: insulin resistance and chronic inflammation. When cells become resistant to insulin, the pancreas compensates by producing more insulin, which can overwhelm the body and contribute to systemic metabolic issues.

• Heart: Persistently elevated insulin and glucose levels harm the lining of blood vessels, promoting arterial stiffening, high blood pressure, and plaque formation, all of which are key factors that raise the risk of heart attacks and strokes.


• Cancer: Insulin is a powerful growth factor. High, sustained levels of insulin and hormones such as IGF-1 signal cells to grow and divide, creating an environment that can foster the growth of malignant tumors.


• Brain: Metabolic dysfunction plays such a central role in cognitive decline that Alzheimer’s disease is sometimes called Type 3 diabetes. Insulin resistance in the brain impairs the use of glucose for fuel, leading to oxidative stress and the buildup of toxic plaques. Chronic inflammation, driven by poor blood sugar control, is also a driving factor in both depression and anxiety.


• Liver: Excess glucose and fat overwhelm the liver and force it to store the surplus as fat, leading to fatty liver disease, which can eventually progress to fibrosis and cirrhosis.

Why Everyone Is at Risk

Despite conventional assumptions, experts warn that the escalating rates of Type 2 diabetes and insulin resistance indicate that everyone is potentially at risk, including those who are physically active and maintain a healthy weight.

“We’ve never seen numbers like this in the history of mankind, even corrected for population differences,” Lufkin said. “As a physician, I used to think—and many of my colleagues still do—that it’s a binary system: You’re either Type 2, or you’re not.”

However, Type 2 diabetes and insulin resistance are not an on-and-off switch that some people get and others don’t. This reality was illustrated by Dr. Adonis Saremi, a triple board-certified obesity medicine physician, who shared his personal experience with The Epoch Times.

“Being a person who actually has prediabetes, surprisingly, because I am extremely active, I try to eat a well-balanced diet. Nonetheless, for the past two years, my A1C [a blood test that measures average blood glucose levels] is 5.7.”

An A1C of 5.7 percent marks the threshold for prediabetes, while 6.5 percent indicates Type 2 diabetes. Saremi’s health and biomarker disconnect underscores how dysfunction can start silently, even in those who appear healthy.

Weight alone is a poor measure of metabolic health—about 20 percent of lean people are not metabolically healthy, according to Michal Mor, who has a doctorate in physiology and is co-founder of the metabolic health company Lumen. “Metabolic health is not only for sick people—it’s also for healthy people,” she told The Epoch Times.

Subtle Signs of Early Dysfunction

Your body often gives subtle signals before metabolic disease fully develops.

Dental issues, such as cavities, may indicate early metabolic imbalance long before a diabetes diagnosis, as poor metabolic health and tooth decay share dietary roots, particularly frequent consumption of refined carbohydrates.

Your skin can also provide early clues. Skin tags and acanthosis nigricans—dark, velvety patches often found on the neck—are strongly associated with insulin resistance. A 2018 narrative review published in Clinics in Dermatology found that people with psoriasis have a significantly higher prevalence of metabolic syndrome, including insulin resistance and Type 2 diabetes.

Persistent acne and inflammatory conditions such as asthma, allergic rhinitis, and eczema also commonly occur alongside metabolic dysfunction.

Weight gain, especially around the abdomen, can signal that the body is becoming less efficient at turning food into energy and more prone to storing excess calories as fat. Energy crashes after meals are another subtle clue that often reflects impaired glucose handling or insulin resistance. Clinical biomarkers, such as rising blood pressure and high cholesterol or triglycerides, can also appear years before the development of diabetes or obesity.

What You Can Do Today

Lifestyle choices are central to metabolic health, and patients know their lives best, Lufkin said.

“I think we’re entering a new era of health care in which lifestyle is fundamental. For many of us, it may be the most powerful medicine that we ever have access to,” he said.

The key? Just get started.

“You can decide today, this is what I’m going to do. And that’s going to have a huge impact on your near-term and long-term metabolic health,” Momchilo Vuyisich, who has a doctorate in biochemistry, told The Epoch Times.

He recommended starting with the basics: Clean up your diet, eliminate ultra-processed foods, aim for 1 1/2 hours of cardio per week and 1 1/2 hours of resistance training, and get eight hours of sleep. Last but not least, he said, people need to manage stress.

“If people are stressed out, it’s not going to matter,” Vuyisich said.

Chronic stress keeps cortisol levels high, which throws off insulin regulation and encourages belly fat, making diet and exercise less effective.

Many metabolic diseases can be improved—and sometimes reversed—through weight loss, diet, exercise and, when needed, medication.

Measures to Protect Your Metabolic Health

A handful of tools and tests are emerging for proactive monitoring.

Continuous Glucose Monitors (CGMs)

CGMs are small sensors, typically placed on the upper arm, that measure blood glucose levels in your tissue fluid and send real-time readings to your smartphone. Once available only by prescription, some CGMs are now available over the counter.

CGMs act like an engine gauge for your metabolism, showing how foods, exercise, stress, and even pain affect glucose levels.

A meta-analysis published in Diabetes Research and Clinical Practice found that CGMs helped adults with diabetes who are overweight or obese reduce carbohydrate intake and total calories, while a 2024 systematic review published in the International Journal of Behavioral Nutrition and Physical Activity showed modest improvements in health behaviors and glycemic control.

Lufkin recommended trying a CGM regardless of metabolic health. “Spiking glucose isn’t good, whether you’re diabetic or not,” as high glucose can cause damage and drive insulin resistance, he said.

Lab Testing 

Two biomarkers can flag early metabolic issues. Lufkin suggested asking your doctor to check:

Hemoglobin (HbA1c): Reflects average blood sugar over three months. Most annual physicals only check fasting blood sugar, which can miss early dysfunction.

Fasting Insulin: Often not included in routine exams, a high fasting insulin level can signal early dysfunction before HbA1c rises.

Emerging Tools 

Tools to understand your body’s unique metabolic patterns are no longer confined to the doctor’s office—they’re increasingly in your hands.

Wearables: These devices track movement, sleep, and stress and provide real-time feedback. A 2020 narrative systematic review published in JMIR mHealth and uHealth found that wearable devices have potential for health monitoring and chronic disease management.

Personalized Nutrition Tools: Continuous glucose monitors, microbiome testing, and AI-driven recommendations show how the same foods can affect people very differently, allowing for targeted diets. “We know no one diet fits all. But what is the diet for me?” Mor said.

A 2023 review published in The Journal of Medical Internet Research of 15 studies found that AI chatbots can effectively support healthy behaviors, such as improving diet and exercise, because of their personalization, accessibility, and scalability.

Genetic Testing: Genetic testing can reveal predispositions to metabolic dysfunction, providing context for prevention.  A 2019 study published in Cell highlighted that genetic risk scores can identify individuals at higher risk of obesity and associated metabolic diseases.

At-home lab testing provides easy access to markers such as HbA1C, insulin, and lipids, enabling early detection and trend tracking when paired with guidance from a medical professional. When paired with clear guidance, self-testing can be empowering and improve engagement, helping people take an active role in monitoring their metabolic health.

The Road Ahead

Take agency over your health care, Lufkin said. “We’re the CEO of our own health, and doctors are consultants,” he said.

“I think that if you are not there [flagged by biomarkers], you should manage your health on your own, because physicians are not in this mindset yet—they’re not giving treatment for healthy people,” Mor said.

She said she envisions a future in which people wake up thinking, “I want to improve my metabolic health,” not “I want to lose weight,” Mor said.

“Everything is rooted in our metabolism,” she said.

Use data to guide decisions, but remember that food, movement, sleep, and stress management remain the most powerful tools for lifelong metabolic health.

“We’re all at risk for one of those chronic diseases. Why wait until the doctor sounds the alarm?” Lufkin said.