15 July 2026

How is your metabolic health?

Modern lifestyles have made our most basic systems dysfunctional

How is your mental health? What thoughts went through your mind when you read that question? Possibly you conducted a swift inventory of your stress levels, your recent mood, the quality of your sleep, any feelings of anxiety. I can pretty much guarantee that you won’t have been offended or perplexed at being asked. And if your answer was anything like “not great, actually”, you might have had some thoughts as to what you might do to improve matters: change job, prioritise “me time”, tackle a difficult relationship, get on top of the booze.

Yet if we had a time machine and could whizz back two or three decades, your reaction would have been very different. Unless you were someone with a diagnosed psychiatric condition, you would have been puzzled as to why I was asking; affronted, even, by an implication that I thought there must be something “wrong” with you. You wouldn’t have had a conception of “having” a mental health. People were either normal or they were psychiatrically unwell, and people in the latter camp keenly felt the stigma.

This illustrates how profoundly our notions of health and disease can change over relatively short time spans. So, here’s another question: how is your metabolic health?

Did you know how to answer that? Did it make any sense? Probably for most of us, we don’t have a conception of “having” a metabolic health. Yet I predict that over the coming decades, this will emerge as a notion every bit as normal as mental health is today. In formulating an answer, you’ll call to mind your current waist-to-height ratio, what your home blood pressures are like, possibly read-outs from a body composition scan of your visceral fat and skeletal muscle percentages, maybe a clutch of blood test results from a recent health check.

One of the evangelists leading the drive to popularise the notion of metabolic health is Dr Campbell Murdoch, a GP in Wincanton. I got up early one morning recently to join a webinar he was hosting. Here in British Columbia, it was 6am; in Somerset, it was 1pm. The thumbnails on my Teams screen showed lots of GPs, some of them former colleagues of mine, all clad in work attire – they were snatching half an hour over lunch to attend. I switched my camera off; I was still in my dressing gown.

Murdoch began by sketching a patient profile: a 52-year-old man with acid reflux, high blood pressure, depression, prediabetes, irritable bowel syndrome, back pain, an arthritic knee and fatigue. He was taking five different medications, none of which were making him feel better. Knee-replacement surgery was in the offing, but the wait was long. He wanted to lose weight but couldn’t. And more than that, he desperately wanted to feel well.

All GPs meet multiple such patients each day and Murdoch’s point was that we are failing them. Our health system, established 70-odd years ago, was built around brief appointments that focus on single issues. Our therapeutics is biased towards a-pill-for-every-ill. And we fail to recognise the common thread that runs through these kinds of problems (we could add heart disease, dementia, sleep apnoea, kidney failure, polyendocrine metabolic ovary syndrome, several types of cancer, and many others to the list).

Murdoch has been interested in the topic for the past 15 years, ever since realising how many of the diseases afflicting us today have their roots in metabolisms made dysfunctional by contemporary lifestyles. And rather than looking to drugs as the answer (they don’t solve anything), he set about devising a simple ten-point plan that can effect noticeable improvements in wellbeing in under 28 days. Laudably, it is available free of charge via his website healthshelf.org. If you are interested in thinking about your own metabolic health, I commend you to pay it a visit. It will put you ahead of an evolving curve.

[Further reading: I thought I might be saving a patient’s life. What if the opposite were true?]