Safe, effective weight loss?

By KRISTI EATON

VIEW ON HEALTH

Before Atkins and the Zone became the go-to diets for weight loss there was the hCG, or human chorionic gonadotropin, diet.

When it died out a few decades ago, low-carb diets became the name of the game.

In the last year or so, though, the hCG diet has experienced a resurgence thanks to the ease and anonymity of the Internet. Type in hCG diet into Google and more than a million hits come up, many of them websites selling guides, books and the actual hormone in the form of drops or pellets.

The websites are making it easier than ever for people to order and obtain the diet aid, but is it safe? No, say some medical professionals, who warn against it. Still, others swear by the homeopathic drops they call the "magical diet drug" to help them shed the extra pounds.

WHAT IS THE HCG DIET?

The hCG diet is a combination of a low-calorie diet and the use of hCG weight-loss products, often in the form of injections, pellets, sprays or drops. HCG is a hormone produced by the placenta during pregnancy so the body is able to metabolize fat as an energy source for the growth and nourishment of the baby.

British endocrinologist A.T.W. Simeons is credited with discovering the use of hCG as a weight loss aid. He first discussed the use of the hormone as a diet drug in a 1954 report while studying pregnant women in India on a very low-calorie diet as well as men with pituitary problems who were treated with low-dose hCG, according to an article written by Marion Goldsmith, public relations director of hCG Medical in Tulsa, Okla. Simeons found that even people without a fetus could benefit from the hormone. Moreover, he believed the hormone helps to redistribute fat from the waist, hips and thighs. The physician reported that both groups lost fat rather than lean muscle mass, and he reasoned that the hCG was responsible for this because the hormone was able to reset and adjust the hypothalamus. He began recommending extremely low-calories diets of around 500 calories a day in combination with injections of hCG. "Its goal is to have someone utilize calories from fat stores, instead of only from what they're eating or taking way from lean muscle," said Dr. Misti Song, an internist at the University of Nevada School of Medicine.

Simeons noticed the patients taking hCG were better able to handle the extremely low-calorie diets, as well as the common side effects like hunger pains, irritability and headaches commonly associated with such diets.

In 1970, Simeons released a book, "Pounds and Inches," describing his discoveries regarding human chorionic gonadotropin.

Around that time, said Miriam Een, a nutritionist at the University of Nevada School of Medicine, more studies examined hCG's use as a weight loss aid.

"A couple studies showed that hCG helped to maintain the weight loss and some claim it may help with lowering appetite and help overall weight loss," she said, adding that later studies couldn't duplicate the initial studies. "The vast majority showed hCG did not have that capability."

Since 1975, the Food and Drug Administration has required a label on hCG products to state the hormone has not been found to be an effective treatment for individuals who are overweight.

"HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity," the warning label states. "There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or 'normal' distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets."

The lack of FDA approval is one reason Song believes the hormone is not safe for weight loss use, she said.

"It's not FDA approved. It's not, in my opinion, a safe diet because the hCG hormone hasn't been proven in medical studies or scientist literature to cause weight loss," the doctor said. "The diets people are on, calorie-wise, are really restrictive."

The diet varies in length depending on the person and the amount of weight they want to lose, but most people stay on it for about 40 days at a time with varying phases of calorie restriction. People on the diet are supposed to eat about 500 calories a day made up of organic foods. An organic food diet is healthy, Song said, but she questioned whether people could meet their nutritional needs with 500 calories.

"There's no way to get optimal protein and carbs out of 500 calories a day," she said. "You actually hurt yourself while you're on this diet just because the caloric intake is so low."

Song has a few friends on the diet who have lost weight quickly, she said.

"It's very dramatic. But they do tend to lose fat and lean muscle, also. The two people I do know personally gained the weight quickly back when they stopped the regimen," said Song. "And unfortunately, they gained back more fat than muscle."

Often used as a fertility treatment in women, human chorionic gonadotropin can also increase the sperm count in men. Young boys sometimes use it if puberty is delayed, said Een. One of the main concerns about using hCG relates to estrogen-sensitive cancers, like breast, ovarian and uterine cancers. "It's a tumor marker for people who have had cancer. That's one of the things they are watching for, " said Eeen. "So if someone has one of those issues and start taking hCG, could that then start stimulating those cancers?"

MEDICALLY SUPERVISED HCG DIETS

Despite the questions and concerns raised by some, other doctors say they are big proponents of the hormone for weight loss, as long as it's combined with medical supervision.

About a year ago the state Board of Medical Examiners voted to eliminate the drug from a list of banned substances prescribed for weight loss.

Dr. Rachel Azoulay, a naturopathic doctor, and Dr. Dr. William R. Maranon, medical director of The Center for Colorectal Health in Las Vegas, prescribe human chorionic gonadotropin out of their Revive Weight Loss & Anti-Aging Clinic at 2911 N. Tenaya Way.

"HCG is a wonderful, wonderful thing, if you do it right," Azoulay said. She noted the hormone is natural, with men even producing some. The problem, she said, is when people buy the drug off the Internet and do not take the correct dosage or take it for too long. Too much and the body develops resistance.

Depending on their medical history and how much weight they want to lose, patients at Revive pay between $375 and $549 to be on the medically supervised hCG diet. Patients at Revive weigh themselves every morning, when the reading is the most accurate, Azoulay said. They also keep a log with their measurements. Azoulay sees patients without any major medical issues every 20 days. For people with health complications, like those with diabetes or on high blood pressure medication, Azoulay will talk to them by phone every night.

Revive patients receive the hCG in an injection form. "It's the least amount with the most effectiveness," Azoulay said.

Most Internet sites selling the hormone sell it in a spray or oral form, which, Azoulay said, can make it difficult for patients to know how much they are putting it into their body.

She added that most hCG is not make in the United States. It's shipped from places like China, India or Singapore, where the regulations on medications are not the same as they are in the United States.

"There's not quality control on those medications," she said. "You don't know where they are taking the hCG from. Is it from a healthy women?"

Nonna Callaghan, 59, isn't worried about where the four hCG pellets drops she takes three times a day come from. In one year, Callaghan has lost 87 pounds and plans to try to lose 30 more pounds with hCG.

The Las Vegas nurse began the weight loss program a year ago after watching her daughter drop 20 pounds in one month.

"Of course I was really jealous and said, 'Get me some of that stuff.' I couldn't believe it. I couldn't believe it would take away my appetite without any side effects," Callaghan said.

Initially, when her daughter told her what she would be able to eat on a 500-calorie-a-day diet, Callaghan balked at the idea. The diet includes 3 ounces of protein at lunch and dinner, two vegetables at lunch and dinner and two fruits during the day. "If I was on it normally, I might last one day," said Callaghan, adding that the hCG helps with the hunger pains.

"You do get hungry, but you feel like you're really hungry and then you eat one orange and you actually feel very full after. You can go another three to four hours and then eat protein and vegetables."

She prefers to use the pellets, while her daughter swears by the hCG drops that are placed under the tongue.

Callaghan believes word of mouth has caused the recent resurgence in the six-decade old diet. She herself heard about it through her daughter, and once she began using it and losing weight, she also received inquiries from co-workers interested in learning more about human chorionic gonadotropin.

LOW-CALORIE DIETS

Low-calories diets -- those between 500 to 800 calories -- like the hCG diet should be medically supervised because there are a lot of risks with them, said Een.

"It's not something that would be done by someone who just has a few pounds to lose," said Een. "It will typically be limited to someone who needs to lose 50 pounds or more."

She said the weight loss typically varies between 3 and 5 pounds each week, although losing more than 1 percent of body weight each week can be dangerous. "That's kind of one of those protocol issues. They shouldn't be losing more than that because of the concerns that can happen with such rapid weight loss."

People undergoing extreme diets need to have their blood pressure and body fat composition tested regularly. They should also have an EKG to check their heart, she added. But one of the biggest concerns about a low-calorie diet is a loss of potassium, one of the major intercellular electrolytes in the body.

"It's associated with building muscle, maintaining muscle, muscle contractions and neurotransmissions," she said. "Because of those actions, it's important with the regulation of blood pressure and overall function, especially with the heart. Too much potassium is not good and too little potassium is not good. Either one can have problems with the heart."

Song, for her part, said anybody looking to lose weight should remember that for long-lasting results you need a lifestyle change, not just a diet. "I think it puts people in a dangerous territory when they're kind of reactively or reflexively trying something, or their friend says, 'Here, try something. I feel good.' That's maybe their story, but it may not be safe for everyone."