"Hi, I'm Kimmie" she said, pausing to look around the semicircle of awaiting faces, each one trying hard to be non-judgmental. She took a deep breath almost whispering the last few words, "and I've got Syndrome X." 

No sooner had she said the words, once painstakingly passive faces contorted into almost unimaginable features, kicking back their chairs, pointing fingers, pelting tiny stone X's and shouting loudly in a cacophony of mean voices "X, X.. you are X-ed."

Kimmie squeezed her eyes shut and began to scream. In the distance she could hear her name being called "Kimberly, it isn't the end of the world".

She opened her eyes with a jerk, enraged ready to fight back at the selfish voice disregarding her fear.

Kimmie's eyes opened to find her doctor writing in her files as she spoke, completely unaware of Kimmie's transition.

It took a few seconds to kick in but Kimmie soon realized that she wasn't at an AA meeting but safely in her doctor's office. "You're young, there's plenty of opportunity to nip this in the bud before it gets the best of you" her doctor continued with a smile. 

Kimmie looked up, "what kind of name is that anyway? It reminds me of algebra, and I hate algebra!" There she was: 25 years old, new Evo-X, great job, greater boo, lots of friends. She couldn't ask for anything else. At least she thought she couldn't, but here was Dr. Plumber telling her that things were not as great as she thought they were.

"It isn’t algebra," said Dr. Plumber. "It is a lot less complicated. What you have is Metabolic Syndrome X also called Syndrome X or Insulin resistance Syndrome and it is essentially a combination of symptoms that put you at a higher risk for Type 2 Diabetes and Cardiovascular complications." 

"Just perfect" thought Kimmie. "Now I’m gonna die of a heart attack." 

As if reading her mind, Dr. Plumber responded, "don’t worry. You won't have a heart attack. I’ll help you understand how best to alleviate this condition and you should be fine."

Dr. Plumber handed her a pamphlet and proceeded to explain that according to the American Heart Association and the National Heart, Lung, and Blood Institute, Metabolic Syndrome is present in persons with three or more of the conditions listed. She perused the list half-heartedly.

• Blood pressure equal to or higher than 130/85 mmHg
• Fasting blood sugar (glucose) equal to or higher than 100 mg/dL
• Large waist circumference (length around the waist):
  Men - 40 inches or more
  Women - 35 inches or more
• Low HDL cholesterol:
  Men - under 40 mg/dL
  Women - under 50 mg/dL
• Triglycerides equal to or higher than 150 mg/dL

Kimmie sighed. One trip to New York with it's scrumptious pretzels and all-you-can-eat buffets was all it had taken to make the "muffin top" pop. And she hadn’t worried because her then boyfriend found her "love handles" (as he called them), sexy. Next thing she knew she had slid over from overweight to obese on the BMI chart, her seamstress complained that her 39.5 inch waist clashed with her fashion choices, and the store clerks would glare at her when she asked for larger sizes in the petite section.

She glared at the test results on the desk remembering how the numbers were so high she had demanded a retest, sure that the lab's reagents were expired. Only the HDL result said abnormally low, but in comparison to the remaining figures she had considered that a blessing… So much for that thought. As for the blood pressure readings, she secretly believed that Dr. Plumber’s sphygmomanometer was faulty, but that was for another show.

She tried to focus as Dr. Plumber continued: "we can fix this with a proper diet and exercise. It really isn't as overwhelming as it seems." 

"DIET! EXERCISE!" Kimmie almost screamed, "who has time for all of that?" she thought. "My job is demanding. I'm at my desk almost 12 hours a day. When I get home, all I can do is eat and go to bed. I only get a break on weekends when I get to hang out with friends and have fun. This is awful," Kimmie groaned. 

Dr. Plumber pointed to the leaflet which highlighted key changes necessary for improving Metabolic Syndrome Components including:

Exercise: 30 to 60 minutes of moderate-intensity exercise (such as brisk walking) every day.

Lose weight: Losing at least 5 to 10 percent of one’s body weight can reduce insulin levels and blood pressure and decrease risk of diabetes.

Eat healthy: Healthy-eating plans, limit unhealthy fats and emphasize fruits, vegetables, fish and whole grains.

Stop smoking. Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome.

"You see, it isn't so bad after all is it?" Dr. Plumber's voice took her out of her reverie and she nodded. She was given a prescription to help lower her blood pressure and triglyceride level. Dr. Plumber had promised that if she followed the dietary plan that the nutritionist had provided and worked hard on a weight loss and exercise plan she wouldn’t need the tablets for very long. As she walked out the office thinking of all that had been discussed and all that she would have to give up she sighed.  She took a deep breath, thinking of what she remembered about type 2 diabetes and remembering how sick her vivacious aunt Pearl had been after her heart attack. Wiping the one tear of self-pity from her cheek, she whipped out her iPhone and began dialing Xtreme Fitness Gym, "Well I better start somewhere!"