R. D. P. H. H. R. Mogul - Syndrome W: A Womans Guide to Reversing Midlife Weight Gain

SYNDROME W

Harriette R. Mogul, M.D. M.P.H.
With Diane Stafford

The information contained in this book is not intended to serve as a replacement for professional medical advice. Any use of the information in this book is at the readers discretion. The author and publisher specifically disclaim any and all liability arising directly or indirectly from the use or application of any information contained in this book. A health-care professional should be consulted regarding your specific situation.

Copyright 2005 by Harriette R. Mogul, M.D., M.P.H.

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without prior permission in writing from the publisher.

M. Evans and Company, Inc.
216 East 49th Street
New York, NY 10017

Library of Congress Cataloging-in-Publication Data

Mogul, Harriette R.

Syndrome W : a womans guide to reversing midlife weight gain /
Harriette R. Mogul.

p. cm.

ISBN 978-1-59077-048-1

1. Middle-aged women--Health and hygiene. 2. Weight loss. 3.
Hormones. I. Title.
RA778.M685 2005
613.2082--dc22

2005009794

Designed and Typeset by Chrissy Kwasnik and Evan Johnston
Printed in the United States of America

Dedication

Dedicated to my phenomenal parents, progeny, partner, and patients for
their vision and their voices along the path to Syndrome W.

Poetry is Naming Things... Gertrude Stein

PART I
Your Question: Whats Happened to My Body?

PART II
Your Answer: The Mogul Protocol

PART III
Your Eating Plan: Waist Management

PART IV
Your Lifestyle: Strategies for Change

PART V
Delicious Recipes from Great Chefs

THIS BOOK IS ABOUT ALL the women over thirty I see in my office and talk to as I go through my day. Im asked questions while Im waiting for my low-fat latte at Starbucks, picking up cash at the ATM, or changing in the locker room at the gym.

Weight is the word, and its definitely the topic of conversation of every woman over thirty I meet or greet, at any and every store I visit for any reason, especially when they hear me order food (turkey and veggies at the gourmet grocer, pasta with broccoli and sun-dried tomatoes at the pizzeria, stir-fried veggies and chicken Chinese fare, or fajitas, hold the sour cream and cheese). They suspect that I may know something they dont know, and they stare at me and usually ask if Im a nutritionist. No, I respond, and the conversation just evolves from there.

This book is for them, so that when I need to dash out the door after describing what they have (Syndrome W) and what they need for permanent weight loss (The Mogul Protocol: metformin and the Carb-Modified Diet), and they ask after this brief interlude, But, what can I do? I can now say, Read my book!

AS I THINK OF THE MANY individuals who made this book possible, I understand the length of Academy Award speeches. Writing Syndrome W was the product of many mentors and collaborators, and my thank-you list is a long one.

When you retrain (in a new field) at age fifty, you have to learn quickly. I was fortunate to have had access to a large number of highly experienced basic science researchers and clinicians when I was transitioning back into academic medicine. Special thanks go to Dr. Bernard I. Weinstein, professor of biochemistry; and Dr. Stephen R. Gambert, former chairman of the Department of Medicine at New York Medical College, who reviewed our initial data and helped formulate hypotheses about the Syndrome; and also to A. Louis Southren, chief of the Division of Endocrinology. Other important mentors along the way were Dr. Harold Lebowitz, who first taught me about Syndrome X; Drs. Luciano Rossetti, Harry Shamoon, and Nir Barzilaiat my alma mater, Albert Einstein College of Medicinewho critiqued my initial data in 1996; and their colleague, Dr. Judith Wylie-Roach at the Diabetes Care Center; and Dr. Leonard Meggs, renowned leaders in diabetes and hypertension and superb physician-scientists.

Id like to recognize my decade-long research collaborators at WestchesterDr. Stephen J. Peterson, vice-chairman and professor of clinical medicine; and Dr. Michael Frey, director of our laboratory, for always going that extra mile at the end of some very long days. And I also thank my extramural collaborators Dr. Philip D.K. Lee, professor of pediatrics; and Dr. Barbara Lippe, former director of pediatric endocrinology at UCLA.

My sincere appreciation goes to Dr. William B. Frishman, chairman of medicine, for encouraging me to write Syndrome W and reviewing key chapters; Simone Wilker and Lucille DAgnillo for their dedication; and Information Services at New York Medical College.

The book would not have been possible without PJ Dempsey at M. Evans; my talented and energetic editor Diane Stafford; Mel Berger at The William Morris Agency; Bernadette Ezring from Weil-Gotshal; and the wonderful staff at Manor Vail in Vail, Colorado.

Finally, of course, are my eternal thanks to my extraordinary family: my daughter, Dr. Jennifer Mogul, who never doubted I could complete the book; my son Fred Mogul, a public radio reporter, who read and edited chapters and discussed recipes in between assignments at NPR; my son Douglas B. Mogul, M.P.H., soon-to-be M.D., now in the Clinical Research Scholars Program at The National Institutes of Health, who taught me molecular biology and named Syndrome W; and, most of all, to my husband, Malcolm, who postponed his dreams of post-retirement travel so that I could realize mine in writing Syndrome W.

I AM A HAPPY DIET DOCTOR.

Ive helped countless women lose weight permanently, regain the waistlines of their youth, and fit into new wardrobes (or very old ones that were reminders of another life, when they were slimmer and shapelier).

In the past decade, as Americans have gotten fatter, my patients have gotten thinner and healthier. Ive heard their frustration when they first walked in and told me that nothing was working despite their having tried all the latest diet and exercise programs. Then, I would witness their elation while reviewing the results of the tests Id ordered that showed conclusively the metabolic cause for the 20-plus pounds they had gained since their twenties.

Its called Syndrome W, I tell them, and then I get to outline the best part of allthat the metabolic problem can be reversed with The Mogul Protocol, a combination of a widely used diabetes drug, metformin, and our Carb-Modified Diet, which act together to reduce the insulin and appetite elevations that are key players in the progressive weight spiral of Syndrome W sufferers.

My patients are happy, too, because they no longer relate to the nightly news reports on the war on obesitythose segments on a revolutionary new medication or the celebrity victory over ten pounds in 10 days. My patients are able to smile confidently, watch with detachment, and change the channel. That kind of news doesnt apply to them anymore. They have finally conquered their midlife weight gain. Theyve worked hard to fit into the clothes they wore before they got Syndrome W, and they have the confidence to know that this time its forever!