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Understanding how metabolic syndrome affects us

Manila Bulletin

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June 25, 2025

Here's what you need to know about the silent epidemic targeting Filipino bodies

- SKINVESTING DR. KAYCEE REYES

Understanding how metabolic syndrome affects us

As a Dresden Preventive Medicine-trained physician working in aesthetic medicine, I have witnessed a troubling pattern emerging in our Filipino patients—one that challenges everything we thought we knew about metabolic health. Metabolic syndrome now affects one in four Filipino adults, nearly doubling from 14 percent just two decades ago. More concerning still, Filipinos develop this “civilization syndrome” at body measurements that would be considered healthy by Western standards.

The stark reality confronting our community is this: Asian bodies, including Filipino physiology, accumulate dangerous visceral fat and develop inflammatory responses at significantly lower BMI levels than Caucasians. While Western medicine sets obesity thresholds at 30 kg/m², Filipino bodies begin showing metabolic dysfunction at just 23 kg/m². This isn’t a matter of different standards—it’s fundamental biology.

The numbers tell a compelling story about our genetic inheritance meeting modern lifestyle. Filipino men with waist measurements over 90 centimeters (cm) and women over 80 cm face dramatically elevated risks—thresholds far below the 102 cm and 88 cm used for Caucasian populations. Recent research from our Harvard colleagues demonstrates that normal-weight Asians with higher visceral fat areas face over 30 times the metabolic syndrome risk, creating what we term the “thin-fat” phenotype that’s particularly prevalent in Filipino-American communities.

This genetic predisposition stems from what researchers call the “thrifty gene hypothesis”—centuries of selection pressure during famine periods that favored efficient fat storage and slower metabolism. Modern Filipinos carry genes optimized for survival during scarcity, but these same genes become liabilities in our current environment of caloric abundance and sedentary lifestyles.

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