Abstract
Introduction: Obesity and metabolic disorders represent rapidly growing public health issues worldwide and in Central Asia, with significant implications for long-term morbidity and health system sustainability. Traditional weight management strategies primarily focus on calorie restriction and pharmacological interventions; however, long-term outcomes remain inconsistent, underscoring the need for alternative conceptual frameworks. Hypothesis: We propose “Metabolic Rehabilitation” as a distinct clinical paradigm that uses structured physical medicine to restore mitochondrial plasticity and myokine signaling, acting as a systemic regulator of metabolic flexibility. Testing the Hypothesis: We suggest randomized trials in Central Asian populations comparing standard diet-therapy with integrated rehabilitation programs, measuring insulin sensitivity and inflammatory biomarkers. Implications: We propose a conceptual framework, “metabolic rehabilitation,” that integrates physical medicine into multidisciplinary models of obesity treatment tailored to Central Asian groups.