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The primary goal in treatment of those with metabolic syndrome is reduction of risk factors for atherosclerotic disease. If the person does not already have type 2 diabetes, prevention of diabetes is another critical goal in management and treatment. Lifestyle changes and medications are utilized to meet these goals.

Lifestyle changes that reduce obesity are critical: increase physical activity, reduce the fat in the diet, and decrease calorie intake. Exercise provides benefits beyond just burning calories. Exercise stimulates anabolic metabolism, raises basal metabolism rate, decreases stress, and increases hormonal sensitivity. Cessation of smoking is also important.

Often drug therapy is needed to address the patient's hyperlipidemia, hypertension, and/or hyperglycemia. Low-dose aspirin and other antiplatelet agents may be used to prevent thrombosis.