Beyond Discrete Diagnoses: Conceptualizing Obesity-associated Metabolic Disorders as a Unified, Dynamic Continuum

Area of Science:

• Metabolic disorders
• Obesity-related diseases
• Internal medicine

Background:

• Metabolic dysfunction-associated fatty liver disease (MAFLD), metabolic syndrome (MetS), and type 2 diabetes mellitus (T2DM) are often treated independently.
• These conditions share common underlying mechanisms and can represent progressive stages of metabolic deterioration.

Purpose of the Study:

• To propose a unified framework viewing obesity-related metabolic disorders as a continuum.
• To clarify shared mechanisms driving disease progression.
• To explore the clinical utility of this integrated perspective.

Main Methods:

• Review of current literature on metabolic dysfunction.
• Analysis of shared pathophysiological drivers (e.g., insulin resistance, inflammation).
• Examination of longitudinal and genetic data supporting disease progression.

Main Results:

• Insulin resistance, inflammation, adipokine imbalance, and ectopic fat accumulation are key drivers.
• Dysfunction in adipose tissue, liver, muscle, pancreas, and gut microbiota is coordinated.
• A typical progression exists from obesity to MAFLD, MetS, and T2DM, with individual variations.

Conclusions:

• Reframing these disorders as a continuous process enhances risk assessment and intervention.
• An integrated approach supports mechanism-based, individualized treatment.
• This perspective can reduce disease progression and complications.