New York, NYFor years, Americans have been fascinated—some say blindsided—by an obsession with their weight. The fast food nation, coupled with modern-day conveniences like television remotes that don't require you to get up to change the channel or volume, don't help. And while most health advocates agree that weight control is a careful balance of food choice, caloric intake and regular exercise, most Americans go looking for the quick fix—a diet that's easy, as it is effective.
The gain (or loss, if you will) without the pain.
Some Americans think they have found it with hCG therapy. Human Chorionic Gonadotropin is a hormone derived from the urine of pregnant women and first surfaced as a weight-loss regimen in the 1950s, following the publication of a paper by Dr. A.T.W. Simeons in the Lancet, the British Medical Journal, way back in 1954.
Simeons, who hailed from Rome, theorized that hCG tricks the body into a state of pregnancy, burning off fat so the developing fetus can acquire sufficient calories, while protecting muscle.
The regimen for dieting calls for daily injections of hCG, together with a sharply restricted daily intake not exceeding 500 calories. In spite of the fact the average person requires a daily caloric intake of anywhere from 1,300 to 3,000 calories per day, advocates of the hCG diet maintain they can vastly diminish their caloric intake in such fashion, while being spared the assumed hunger pangs that such a restricted diet might produce.
And the weight comes off.
But there are concerns. For one, hCG has never carried FDA approval as a weight-loss drug. The US Food and Drug Administration approves hCG for the treatment of infertility and a few other uses, but not for weight loss. Doctors, however, have the capacity to prescribe drugs off-label for uses outside the bounds of FDA approval, and doctors have prescribed hCG as a weight-loss regimen for some time.
The New York Times reported March 7 that the FDA first issued a warning in the 1970s that hCG had not been shown to increase weight loss, cause a more "attractive" distribution of fat or to "decrease hunger and discomfort from low-calorie diets."
There is also a risk, according to a spokesperson for the FDA, of blood cots, depression, headaches, breast tenderness or enlargement. The FDA, said Christopher Henry in comments to The New York Times, did in fact receive a report of a patient on the hCG diet who suffered a pulmonary embolism.
There is also a suspicion that the diet just doesn't work. In 1995 a Dutch study conducted a meta analysis of 14 randomized clinical trials. All but two of the studies appeared to demonstrate no clear benefit of hCG use over a placebo, such as saline injection, for weight loss. One of the two studies that cast hCG in a favorable light was co-authored by an advocate of the diet, suggesting a conflict.
Advocates, however, continue to stress that you can't argue with success. hCG patients appear to be dropping weight effectively. The New York Times referenced doctors who have said that a more-toned body is theoretically possible due to the induced production of male hormones through hCG, which serves to increase muscle mass.
While the hCG debate rages, advocates and proponents continue to pay upwards of $1,000 for a 40-day regimen that includes daily injections, training and consultation. One provider insists on an EKG to ensure the patient's heart can withstand the caloric reduction.