Q: In my 20’s and 30’s, losing weight was easy. All I had was jog a little and cut back on sweets and boom the pounds dropped off. Now I’m 46, and the scale won’t budge. What’s going on?

You may developed a common pre-diabetic condition that it thought to be triggered by hormonal changes in women your age. “The switch seems to go off around age 40,” says Harriete Mogul, M.D., MPH, author of Syndrome W: A Woman’s Guide to Reserving Mid-Life Weight Gain and endocrinologist at Westchester Medical Center Valhalla, N.Y.

What Mogul calls, “Syndrome W” is a cluster of symptoms including weight gain around the waist, increase appetite, elevated triglycerides (blood fats), increase blood preasure and elevated insulin levels. “It is the earliest indicator of diabetes down the road at a time when it’s easiest to fix,”Mogul says. Left untreated, the symptoms make your body more adept at storing fat, which compounds the symptoms.

To help break the cycle, Mogul prescribes a common diabetes medication called metformin, which lowers blood sugar levels and makes insulin work more effectively. She recommends a diet high in vegetables, fruits and low-fat protein and relatively lon in carbohydrates, along with increase physical activity. “The medication alone doesn’t work,” Mogul says. “You need to integrate it with lifestyle change.”

To find whether your weight-control problems are related to Syndrome W, ask your doctor to test you for elevated insulin levels.