inflammation and insulin resistance. IRS is characterized by: Obesity, waist circumference >90 cm in men and >80 cm in women; in women, it has an additional stigmata of PCOS which is characterized by acne, hirsutism, and irregular menstrual cycles. The typical clinical presentation is chaotic, marked by increased incidences of CVD, hypertension, hyperglycemia, hyperinsulinemia, acne, acanthosis, obesity, oligoamenorrhea, skin tags, dyslipidemia, stroke and extensive atheromatous vascular disease. Diagnosis is more of clinical, and based on lab values for which the vulnerable population is annually screened. Treatment is basically directed towards weight loss, by lifestyle modification, i.e., dietary regulation, regular physical activity, drugs for weight loss, or even metabolic surgery. In women with PCOS, oral contraceptives, antiandrogens and newer drugs like drospirenone, inositol, glucomannan, may be used.