Syndrome W: Syndrome W F.A.Q.

Q. Don't all women gain weight with age?
Other than a lucky few – less than 5% of all the women we saw for general health evaluations, most women DO gain weight after their thirties. The fortunate few who avoided midlife weight gain were "athletic" Anglo-saxon, African-American, and Asian women who watched what they ate and exercised all of their lives.

Q. So what differentiates midlife weight gain from Syndrome W?
Syndrome W is about weight gain that starts at the waist. This contrasts with weight gain that hits the hips and the butt and then the arms and on and on. The classic Syndrome W woman was thin throughout her childhood, adolescence and early adult years. She was not the chunky child that struggled to stay size ten or twelve in the teen years. Early on, Syndrome W women do not look "fat." In fact, they may be normal weight by current US and world standards that are based on the BMI (body mass index) a measure of body "fatness." It's all about where you've gained that weight that determines if you have Syndrome W.

Q. What's the characteristic contour of Syndrome W?
Women with classic Syndrome W have what I call the prophetic pregnancy profile. Early on, they look like women in their first trimester. Their waists thicken while, initially, there's no change in hip dimension. As their waists continue to expand, they begin to look more "mid-trimester," as the defining defect—hyperinsulinemia, worsens. Eventually, they become those women in their fifties who look five months pregnant perennially! Look around and you can see Syndrome W in every crowd of over-fifties.

Q. I've been fighting the battle of the bulge all my life, and have gained weight all over (to size 16-18). Do I have Syndrome W?
There's less chance you have Syndrome W now, but if your weight is escalating, even by just a few pounds each year, you can be sure you'll develop the defect and hyperinsulinemia, once you cross over into size twenty or above two hundred pounds. We have never tested a woman in these higher size and weight ranges that didn't have defect. So start now to avoid Syndrome W later!

Q. Why do women who've been thin most of their lives gain weight?
Women can gain weight for any of many reasons. They:

  • stop smoking
  • develop thyroid problems like "thyroiditis," which slows their metabolism.
  • take commonly used medications that cause weight gain over periods of time.
  • stop exercising after a lifetime of sports participation without decreasing their caloric intake
  • get busier and can't find time to shop wisely and cook healthy.

It doesn't matter what triggers the weight gain. What happens is that women with certain genes gain weight initially at the waist, while others gain it elsewhere. Where you gain those first few fat cells determines whether you get the signs of Syndrome W (See box).

Q. Do men get Syndrome W?
Syndrome W also affects men with expanding waistlines at midlife. I call the male version "The Pre-metabolic Syndrome," since the "W," in Syndrome W is wedded to WOMEN!