Dr. Mogul is still working to understand why the insulin resistance that underlies Syndrome W begins at mid-life in her patients. "There seems to be a switch that goes off at 40," she observes, "The genes do change and there are some major metabolic changes at 40." Certain groups of women also seem particularly vulnerable, Dr. Mogul adds, including, "A very high percentage of Asian, Middle Eastern and Hispanic women... also, women who have had polycystic ovary syndrome, and Ashkenazi women. It's not typically a syndrome of African American women."
Dr. Mogul says that for all women, the best way to avoid developing Syndrome W in the first place is to keep overall weight down. "Watch the calories and watch the carbohydrates," she recommends, "And don't make the mistake that low-fat means low-calorie. Also, oral estrogen is associated with weight-gain, so work with your doctor to get the prescription right if you're taking hormones. And exercise!