Global estimates of prevalence, deaths, and disability-adjusted life years (DALYs) from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were examined for metabolic diseases (type 2 diabetes mellitus [T2DM], hypertension, and non-alcoholic fatty liver disease [NAFLD]). For metabolic risk factors (hyperlipidemia and obesity), estimates were limited to mortality and DALYs. From 2000 to 2019, prevalence rates increased for all metabolic diseases, with the greatest increase in high socio-demographic index (SDI) countries. Mortality rates decreased over time in hyperlipidemia, hypertension, and NAFLD, but not in T2DM and obesity. The highest mortality was found in the World Health Organization Eastern Mediterranean region, and low to low-middle SDI countries. The global prevalence of metabolic diseases has risen over the past two decades regardless of SDI. Urgent attention is needed to address the unchanging mortality rates attributed to metabolic disease and the entrenched sex-regional-socioeconomic disparities in mortality., Competing Interests: Declaration of interests G.A.F. receives funding from the National Health and Medical Research Council (Australia), New South Wales Office of Health and Medical Research, and Heart Research Australia. She reports personal consulting fees from CSL, Janssen, Amgen, and Boehringer Ingelheim and grants from Abbott Diagnostic outside the submitted work. In addition, G.A.F. has a patent, Biomarkers and Oxidative Stress, awarded USA May 2017 (US9638699B2) issued to Northern Sydney Local Health District. M.Y.C. receives speaker’s fees and research grants from Astra Zeneca, Abbott Technologies, and Boston Scientific. A.S. is the President of Sanyal Biotechnology and has stock options in Genfit, Akarna, Tiziana, Indalo, Durect, and Galmed. He has served as a consultant to Astra Zeneca, Nitto Denko, Enyo, Ardelyx, Conatus, Nimbus, Amarin, Salix, Tobira, Takeda, Jannsen, Gilead, Terns, Birdrock, Merck, Valeant, Boehringer Ingelheim, Lilly, Hemoshear, Zafgen, Novartis, Novo Nordisk, Pfizer, Exhalenz, and Genfit. He has been an unpaid consultant to Intercept, Echosens, Immuron, galectin, Fractyl, Syntlogic, Affimune, Chemomab, Zydus, Nordic Bioscience, Albireo, Prosciento, Surrozen, and Bristol Myers Squibb. His institution has received grant support from Gilead, Salix, Tobira, Bristol Myers Squibb, Shire, Intercept, Merck, Astra Zeneca, Malinckrodt, Cumberland, and Norvatis. He receives royalties from Elsevier and UptoDate. M.N. has been on the advisory board for 89BIO, Gilead, Intercept, Pfizer, Novo Nordisk, Blade, EchoSens, Fractyl, Terns, Siemens, Roche Diagnostic, Altimmune, cohBar, Cytodyn, Madrigial, NorthSea, and Prespecturm. He has received research support from Allergan, BMS, Gilead, Galmed, galectin, Genfit, Conatus, Enanta, Madrigal, Novartis, Pfizer, Shire, Viking, and Zydus. He is a shareholder or has stocks in Anaetos, Chrownwell, Ciema, Rivus Pharma, and Viking. V.W.-S.W served as a consultant or advisory board member for 3V-BIO, AbbVie, Allergan, Boehringer Ingelheim, Echosens, Gilead Sciences, Inventiva, Merck, Novartis, Novo Nordisk, Pfizer, ProSciento, Sagimet Biosciences, TARGET PharmaSolutions, and Terns and a speaker for Abbott, AbbVie, Echosens, Gilead Sciences, and Novo Nordisk. He has received a research grant from Gilead Sciences and is a co-founder of Illuminatio Medical Technology Limited. R.C.W.M. has received research support through his institution for clinical trials from AstraZeneca, Bayer, MSD, Novo Nordisk, Sanofi, and Tricida Inc. and honoraria for consultancy or lectures from AstraZeneca, Bayer, and Boehringer Ingelheim. He is a co-founder of GemVCare, a biotech company set up with partial support from the Hong Kong Government Technology Start-up Support Scheme for Universities (TSSSU). D.E.C. is on the Scientific Advisory Boards of GI Dynamics, Endogenex, and Gila Therapeutics. C.S.M. has been a shareholder of and reports grants through his institution from Merck; grants through his institution and personal consulting fees from Coherus Inc., AltrixBio, and Novo Nordisk; reports personal consulting fees and support with research reagents from Ansh Inc.; reports personal consulting fees from Genfit, Lumos, Amgen, Corcept, Intercept, 89Bio, AstraZeneca, and Regeneron; reports support (educational activity meals at and through his institution) from Amarin and Novo Nordisk; and travel support and fees from TMIOA, Elsevier, the California Walnut Commission, College Internationale Research Servier, and the Cardio Metabolic Health Conference. C.S.P.L. is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research support from Bayer and Roche Diagnostics; has served as consultant or on the Advisory Board/Steering Committee/Executive Committee for Abbott, Actelion, Alleviant Medical, Allysta Pharma, Amgen, AnaCardio AB, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Cytokinetics, Darma Inc., EchoNous Inc., Impulse Dynamics, Ionis Pharmaceutical, Janssen, Medscape/WebMD Global LLC, Merck, Novartis, Novo Nordisk, Prosciento Inc., Radcliffe Group Ltd., Roche Diagnostics, Sanofi, Siemens Healthcare Diagnostics, and Us2.ai; and serves as co-founder and non-executive director of Us2.ai., (Copyright © 2023 Elsevier Inc. All rights reserved.)