Metabolic syndrome, also known as syndrome X, insulin resistance, and other terms, is a cluster of conditions including abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. It is a major health issue globally, driven by increased consumption of high-calorie, low-fiber fast food and reduced physical activity due to mechanized transport and sedentary lifestyles. It is linked to diseases like type 2 diabetes, coronary diseases, and stroke, and its prevalence is higher in urban populations of developing countries than in Western counterparts. The global cost of metabolic syndrome is in the trillions, and without lifestyle changes, it is unsustainable. Prevention strategies include better urban planning, subsidizing whole grains, taxing high-calorie snacks, and promoting healthier lifestyles. Metabolic syndrome is not always synonymous with obesity, as some individuals, called metabolically healthy obese (MHO), may not have all its features. The syndrome is influenced by genetic and epigenetic factors, and its prevalence varies based on definitions. Recent research highlights biological mechanisms such as adipose tissue function, macrophage activity, and gut microbiome. Prevention involves exercise, diet, and lifestyle changes, with effective drugs like metformin. Societal and governmental efforts are crucial to combat the epidemic, including public awareness, policy changes, and education. The global prevalence of metabolic syndrome is estimated to be about a quarter of the world's population, with significant variations across regions. Effective interventions include promoting healthy diets, physical activity, and policy measures to reduce unhealthy food consumption.Metabolic syndrome, also known as syndrome X, insulin resistance, and other terms, is a cluster of conditions including abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. It is a major health issue globally, driven by increased consumption of high-calorie, low-fiber fast food and reduced physical activity due to mechanized transport and sedentary lifestyles. It is linked to diseases like type 2 diabetes, coronary diseases, and stroke, and its prevalence is higher in urban populations of developing countries than in Western counterparts. The global cost of metabolic syndrome is in the trillions, and without lifestyle changes, it is unsustainable. Prevention strategies include better urban planning, subsidizing whole grains, taxing high-calorie snacks, and promoting healthier lifestyles. Metabolic syndrome is not always synonymous with obesity, as some individuals, called metabolically healthy obese (MHO), may not have all its features. The syndrome is influenced by genetic and epigenetic factors, and its prevalence varies based on definitions. Recent research highlights biological mechanisms such as adipose tissue function, macrophage activity, and gut microbiome. Prevention involves exercise, diet, and lifestyle changes, with effective drugs like metformin. Societal and governmental efforts are crucial to combat the epidemic, including public awareness, policy changes, and education. The global prevalence of metabolic syndrome is estimated to be about a quarter of the world's population, with significant variations across regions. Effective interventions include promoting healthy diets, physical activity, and policy measures to reduce unhealthy food consumption.