Syndrome W Publications & Presentations

1999: Internal Medicine News

Recognizing Syndrome W

Dr. Mogul offered a few simple questions that can help to identify patients who have syndrome W:

  • First ask about midlife weight gain. Self-reported weight increases of more than 20 pounds since the patient was in her 20s are suggestive, especially if the gains are concentrated around the abdomen and hips and the patient is an active exerciser.
  • Ask about waist size. An increase in waist measurement of 2 inches or more, or a pants/skirt waist size increase of 2 sizes since the patient's 20s, is also indicative. Dr. Mogul noted that a 1-inch gain in waist size is roughly equivalent to a 10-pound total weight gain.
  • Pay close attention to the patient's appetite and eating patterns. if she tends to go all day without eating, and then binges once she does stop to eat, she likely has syndrome W.
  • Other key indicators include mildly elevated office blood  pressure measurements (140/90 mm Hg or greater) in an otherwise healthy and active patient with no history of CVD, diabetes, or hyperinsulinemia in the context of euglycemia or mildly impaired glucose tolerance.

 

2000 : Discovery Health

Syndrome W
By Christine Soares

Midriff weight gain in mid-life could be the sign of a serious metabolic problem. Ilene Cohen couldn't figure out what was wrong, and neither could her doctors. "I was always tired," she recalls, "working full-time and running a home, on my day off I didn't want to do anything. "I felt I was missing a lot because I only wanted to rest." Cohen, now 42, is just shy of five feet tall. She had been gaining weight too, and was up to 167 pounds. Over the years, she had sought help.

"I had different doctors, and I always complained about being very lethargic, and I went for more thyroid and glucose tolerance tests, and they all came back negative. 'Everything's fine, maybe you're working too much' they said."

Cohen remained baffled and miserable until a friend recommended one more doctor for her to try. An endocrinologist at New York Medical College in Valhalla, Dr. Harriette Mogul had been screening hundreds of women since the college started their Menopause Health Program in 1994. She had quickly begun noticing a cluster of symptoms in a certain type of patient who came in to be evaluated for hormone replacement therapy.

"Among these patients—a narrow range of health-conscious, non-smoking, physically-active women approaching menopause—there were many complaints of weight gain, usually around the waist, after years at a constant weight. When we began seeing these symptoms clustered together with elevated blood pressure and insulin levels, we decided there was a pattern," Dr. Mogul recalls.

 

2000 : Internal Medicine News

Metformin for Midlife Spread in Woman
By Bruce Jancin

Metformin may promote long term weight loss in nondiabetic women with midlife weight gain and hyperinsulinemia, Dr. Harriette R. Mogul said at the annual meeting of the Endocrine Society.

 

2001 : Metformin Article

Metformin and Carbohydrate - Modified Diet: A Novel Obesity Treatment Protocol
Preliminary Findings From a Case Series of Nondiabetic Women With Midlife Weight Gain and Hyperinsulinemia
By Harriette R. Mogul, MD, MPH, Stephen J. Peterson, MD, Bernard I. Weinstein, PhD, Shaochun Zhang, MD, MS, and A. Louis Southern, MD

The authors conducted a retrospective analysis of a new obesity treatment protocol, metformin and hypocaloric, carbohydrate -modified diet, in high-risk, nondiabetic hyperinsulinemic women with progressive midlife weight gain (refractory to diet and exercise).

 

2002 : Journal News Article

Diabetes Pills Spur Weight Loss
Metformin, diet low in carbs help woman take off 160 pounds
By Melissa Klein

In an era when gastric surgery has helped thousands of obese people peel off pounds, Shirley Williams has instead dieted her way down the scale to a weight she hasn't seen in so many years, she can't remember when.
 

 

2003 : Heart Disease

Long-Term (2-4 Year) Weight Reduction With Metformin Plus Carbohydrate - Modified Diet in Euglycemic, Hyperinsulinemic, Midlife Women (Syndrome W)
By Harriette R. Mogul, MD, MPH, Stephen J. Peterson, MD, Bernard I. Weinstein, PhD, Jianyu Li, MD, MS, and A. Louis Southern, MD

Long-term weight reduction remains the ultimate objective and challenge of obesity management.

 

2003 : Long-term (2-4 year) weight reduction with metformin plus carbohydrate-modified diet

Long-term (2-4 year) weight reduction with metformin plus carbohydrate-modified diet

Dr. Mogul authored a study entitled "Long-term (2-4 year) weight reduction with metformin plus carbohydrate-modified diet in euglycemic, hyperinsulinemic, midlife women (Syndrome W)."

Authors: Mogul HR, Peterson SJ, Weinstein BI, Li J, Southren AL

Source: Divisions of Endocrinology, Department of Medicine, New York Medical College, Valhalla, NY 10595, USA. [email protected]

Abstract
Long-term weight reduction remains the ultimate objective and challenge of obesity management. Few long-term dietary or pharmacointervention studies have been conducted and there is a critical need for long-range treatment strategies that are effective, safe, and acceptable. The authors conducted a retrospective cohort analysis of 21 euglycemic, hyperinsulinemic women with progressive, refractory, midlife weight gain (Syndrome W) who had previously lost weight (> or =10% reduction from baseline) with a comprehensive 1-year treatment program that included metformin and a hypocaloric, carbohydrate-modified (low-glycemic index) diet, as well as, other lifestyle modifications.

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2006 : Obesity: new perspectives and pharmacotherapies

Obesity: new perspectives and pharmacotherapies

Dr. Mogul contributed to a study entitled "Obesity: new perspectives and pharmacotherapies."

Authors: Palamara KL, Mogul HR, Peterson SJ, Frishman WH.

Source: Department of Medicine, Harvard Medical School/Massachusetts Medical General Hospital, Boston, Massachusetts, USA.

Abstract
There is a widespread epidemic of obesity in the United States, which has been associated with an increased risk of diabetes mellitus, cancer, and cardiovascular diseases. Although lifestyle modifications and long-term dietary vigilance remain cornerstones of weight reduction treatment, the continued availability of U.S. Food and Drug Administration-approved pharmacotherapies has expanded the options available for the management of obesity....

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2008 : Growth hormone treatment of adults with Prader-Willi syndrome

Growth hormone treatment of adults with Prader-Willi syndrome

Dr. Mogul authored a study called "Growth hormone treatment of adults with Prader-Willi syndrome and growth hormone deficiency improves lean body mass, fractional body fat, and serum triiodothyronine without glucose impairment: results from the United States multicenter trial."

Authors: Mogul HR, Lee PD, Whitman BY, Zipf WB, Frey M, Myers S, Cahan M, Pinyerd B, Southren AL.

Source: Department of Medicine, Division of Endocrinology, New York Medical College, 490 Munger Pavilion, Valhalla, New York 10595, USA. [email protected]

CONTEXT:
GH replacement in Prader-Willi syndrome (PWS) children has well-defined benefits and risks and is used extensively worldwide. Its use in PWS adults has been limited by documentation of benefits and risks, as determined by larger multisite studies.

OBJECTIVES:
Our objective was to evaluate the effectiveness and safety of GH in GH-deficient genotype-positive PWS adults.

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2010 : The Complete Guide to Lifelong Nutrition

The Complete Guide to Lifelong Nutrition

Dr. Mogul contributed a chapter entitled "Maximizing Health by Minimizing Midlife Weight Gain" to The Complete Guide to Lifelong Nutrition by Jeffrey I. Mechanick and Elise M. Brett.

2011 : Cardiovascular Pharmacotherapeutics, 3rd Edition

Cardiovascular Pharmacotherapeutics, 3rd Edition

Dr. Mogul contributed a chapter to Cardiovascular Pharmacotherapeutics, 3rd Edition by William H. Frishman and Domenic A. Sica. 

A critically acclaimed classic reference now in its third edition, Cardiovascular Pharmacotherapeutics provides current information regarding the contemporary use of all available cardiovascular medications for adults and children. Strongly emphasizing the scientific rationale behind the use of such therapies in cardiac disease, it discusses new drugs and novel compounds that are under development and may emerge as the cardiac therapies of the future....

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2015 : A modified carbohydrate diet and insulin sensitizers that reduce body weight

A modified carbohydrate diet and insulin sensitizers that reduce body weight

Dr. Mogul authored a studied called "Carbohydrate Modified Diet & Insulin Sensitizers Reduce Body Weight & Modulate Metabolic Syndrome Measures in EMPOWIR (Enhance the Metabolic Profile of Women with Insulin Resistance): A Randomized Trial of Normoglycemic Women with Midlife Weight Gain"

Authors: Harriette R. Mogul , Ruth Freeman, Khoa Nguyen, Michael Frey, Lee-Ann Klein, Sheila Jozak, Karen Tanenbaum

Source: Department of Medicine, Division of Endocrinology, New York Medical College, 19 Skyline Dr., Hawthorne, New York 10532, USA. [email protected]

CONTEXT: Progressive midlife weight gain is associated with multiple adverse health outcomes and may represent an early manifestation of insulin resistance in a distinct subset of women. Emerging data implicate hyperinsulinema as a proximate cause of weight gain and support strategies that attenuate insulin secretion.

Objectives: To assess a previously reported novel hypocaloric carbohydrate modified diet alone (D), and in combination with metformin (M) and metformin plus low-dose rosiglitazone (MR), in diverse women with midlife weight gain (defined as >20lbs since the twenties), normal glucose tolerance, and hyperinsulinemia.

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2016 : METFORMIN SUSTAINED WEIGHT LOSS AND REDUCED ANDROID FAT TISSUE

METFORMIN SUSTAINED WEIGHT LOSS AND REDUCED ANDROID FAT TISSUE

Dr. Mogul has just authored Metformin Sustained Weight Loss And Reduced Android Fat Tissue At 12 Months In Empowir (Enhance The Metabolic Profile Of Women With Insulin Resistance): A Double Blind, Placebo-Controlled, Randomized Trial Of Normoglycemic Women With Midlife Weight Gain.

Authors: Harriette R. Mogul , Ruth Freeman, Khoa Nguyen


Source: Department of Medicine, Division of Endocrinology, New York Medical College, 19 Skyline Dr., Hawthorne, New York 10532, USA. [email protected]


CONTEXT: Progressive midlife weight gain is associated with multiple adverse health outcomes and may represent an early manifestation of insulin resistance in a distinct subset of women. Emerging data implicate hyperinsulinema as a proximate cause of weight gain and support strategies that attenuate insulin secretion.


Objectives: To assess 12-month body weight (BW) and body composition changes in normoglycemic women with midlife weight gain, after dietary and pharmacological interventions targeting hyperinsulinemia.
 

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