Maintaining a normal weight is perhaps the most important thing one can do to achieve long term health and chronic disease prevention. Toward that end, a large part of our practice focuses on teaching patients the lifestyle and dietary changes necessary to accomplish long term weight maintenance. But before you can maintain a normal healthy weight, you have to be at a normal weight, and for most Americans, that means losing some weight. That’s right, I’m talking about dieting. As a result of the unlikely pairing of the work of an English endocrinologist from the 1950′s and an entrepreneur/author named Kevin Trudeau, many Americans have recently become acquainted with a diet technique that continually amazes me with its effectiveness and the speed with which many patients lose weight. The diet I’m referring to is called the HCG diet.
Human Chorionic Gonadotrophin, or HCG, is a hormone produced initially by the embryo soon after conception and later by the placenta during pregnancy. Its main effect is to maintain progesterone production in order to maintain and protect a pregnancy in humans. Because of its strong negative charge, it is believed that it may also protect the fetus during the first trimester by repelling immune cells of the mother. HCG is structurally similar to luteinizing hormone (LH) produced by the pituitary gland, and can therefore be used medically to stimulate ovulation in the ovaries as well as testosterone production in the testes. Early pregnancy testing is based on the detection or measurement of HCG in urine or serum.
After observing that pregnant women often rapidly metabolize their own fat stores to nourish the developing baby, Dr. A.T.W. Simeons in the 1950′s, theorized that HCG might be a useful adjunct in combination with a very low calorie diet to treat obesity. After achieving great weight loss success with hundreds of patients, he described his method in a small book written in the 1960′s called “Pounds and Inches.” His observations were the first to suggest a link between HCG, obesity, and the weight regulatory center in our brain. In a very low calorie state, he theorized that HCG allows your body to break down hard to lose fat, as it does for pregnant women under dietary restriction. This effect has not been proven scientifically.
In the late 1960′s and early 1970′s, the Simeons weight loss protocol migrated to the U.S. from Europe and became popular and widely practiced. Several scientific studies were performed at that time trying to duplicate Simeons’ work. Some were positive and others were negative. While the studies verified the safety of HCG use, many questioned its effectiveness. Ultimately, the FDA frowned upon the use of HCG for weight loss and this diet technique faded into obscurity in the U.S., although its use continued elsewhere. Recently, the use of HCG has become popular again based on the recent publication of Kevin Trudeau’s book, “The Weight Loss Cure.”
Most of our patients trying the HCG protocol have previously tried many other diets with limited success and the predictable regain of the lost weight within months after discontinuing treatment. Repeatedly, we have seen these same patients report losing fat from areas of their body that they have never been able to lose before, all the while having more energy, less hunger and an improved sense of well being that was never experienced when they were previously observing other very low calorie diets. As an added bonus, many of our dieting patients with diabetes, high blood pressure and high cholesterol see a significant improvement in these chronic medical conditions, often enabling them to reduce or discontinue some or all of their prescription medications. Many have had their blood pressure return to normal after losing about 20 to 30 lbs.
Many conventional physicians believe that HCG is no better than placebo in promoting weight loss, and we admit that no one is quite sure how it works. From our own personal experience, though, and that of many of our patients, we believe that HCG does exert a positive effect, particularly in reducing the hunger associated with very low calorie diets and inducing a sense of well being and higher energy level that allows normal day to day functioning. The theory is that as an LH and TSH analog, HCG raises certain hormone levels and reduces the metabolic shutdown induced by very low calorie dieting, allowing the patient’s basal metabolism to remain elevated. In addition, it seems that HCG has some effect on making the fat stores more available to be utilized as fuel. As clinicians, we readily admit that we are more interested in helping our overweight patients safely and rapidly lose weight than proving or disproving the physiological mode of action of HCG.
We also believe that the low carbohydrate nature of Simeons’ specific diet has something to do with its success and the ability of patients to stay on the diet, in comparison to other very low calorie diets. In general, the fewer refined carbohydrates we eat, the leaner we are. This is because the consumption of a lot of carbohydrates, particularly highly refined carbs, results in the rapid secretion of insulin. Insulin is the primary regulator of fat storage. When insulin levels are elevated, we tend to stockpile calories as fat. When insulin levels fall, and are kept low and steady, physiologically we are able to release fat from our fat tissue and burn it for fuel. By continually stimulating insulin secretion, eventually resulting in insulin resistance, high carbohydrate diets make us fat and ultimately cause obesity. By driving rapid blood sugar changes, leading to spikes in insulin production, eating a diet high in refined carbohydrates also increases hunger. Eventually, the weight gain of fat accumulation decreases the relative amount of energy we expend in metabolism and physical activity. In our experience, diets that are relatively low in carbohydrates, that emphasize eating only low glycemic carbohydrates such as whole fibrous vegetables and certain fruits, along with an adequate protein intake, with reasonable amounts of healthy fats, are the best diets for controlling hunger and for lifelong weight control.
HCG is a prescription medication which is FDA approved for certain uses, but is not FDA approved for the treatment of weight control or obesity. In fact the FDA requires that a notice that it is not approved for weight loss be in the package insert of every vial of HCG. Therefore using HCG as an adjunct to a very low calorie diet is considered an “off-label” use. Medications are frequently safely and effectively prescribed off-label to treat conditions that are unrelated to their original indication. We prescribe HCG to our patients based on our now considerable experience with it, and the experience of thousands of other people who have successfully used the HCG diet to shed a significant number of pounds in a short period of time. There are many physicians all over the world who have been safely prescribing HCG for many years as an adjunct to Simeons’ low carb, calorie restricted diet, with great results.