Diet Plan With HCG, a Fertility Hormone, Has Fans and Critics - NYTimes.com

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Diet Plan With Hormone Has Fans and Skeptics

Caplin for The New York Times

Dr. M. Blyer, right, works with Fulop-Goodling, left, a

Midtown orthodontist.

By ANEMONA HARTOCOLLIS

Published: March 7, 2011

Every morning, Kay Brown engages in a ritual similar to a heroin

addict’s, or a diabetic’s: she sticks herself with a syringe. Only hers

contains hCG, a pregnancy hormone.

Caplin for The New York Times

Dr. Lionel Bissoon of Manhattan, consulting with a patient as she

injects hCG.

Ms. Brown, 35, is not taking hCG to help her bear a child. She believes

that by combining the hormone injections with a 500-calorie-a-day diet,

she will achieve a kind of weight-loss nirvana: losing fat in all the

right places without feeling tired or hungry. “I had a friend who did it

before her wedding,” Ms. Brown said. “She looks great.”

Women like Ms. Brown are streaming into doctors’ offices and weight-loss

clinics all over the country, paying upward of $1,000 a month for a

consultation, a supply of the hormone and the syringes needed to deliver

it. More than 50 years after a doctor at a Roman clinic began promoting

hCG as a dieting aid, it is as popular as ever, even though there is

scant evidence that it makes any difference.

The regimen combines daily injections with a near-starvation diet, and

patients, mostly women, are often enticed by promises that they can lose

about a pound a day without feeling hungry. Perhaps even more

seductively, they are frequently told that the hCG will prompt their

bodies to carry away and metabolize fat that has been stored where they

least want it — in their upper arms, bellies and thighs.

In response to inquiries stirred up by the diet’s popularity, the Food

and Drug Administration warned in January that “homeopathic” forms of

hCG, like lozenges and sprays, sold over the Internet and in some health

food stores, are fraudulent and illegal if they claim weight-loss powers.

The injectable, prescription form of hCG, human chorionic gonadotropin,

is approved as a treatment for infertility and other uses, and it is

legal for doctors to prescribe it “off-label” for weight loss.

But the F.D.A. has also reiterated a warning, first issued in the

mid-1970s, that is required on hCG packaging: It has not been shown to

increase weight loss, to cause a more “attractive” distribution of fat

or to “decrease hunger and discomfort” from low-calorie diets.

The F.D.A. recently received a report of a patient on the hCG diet who

had a pulmonary embolism, said , a spokesman for the

agency. He said the hormone carried risks of blood clots, depression,

headaches and breast tenderness or enlargement.

Dr. Pieter Cohen, an assistant professor at Harvard medical school who

researches weight-loss supplements, said that aside from the issue of

side effects, the use of hCG as a diet tool was “manipulating people to

give them the sense that they’re receiving something that’s powerful and

potent and effective, and in fact they’re receiving something that’s

nothing better than a placebo.”

But unlike other popular diet supplements, hCG, which is derived from

the urine of pregnant women, has acquired an aura of respectability

because the injections are available only by prescription.

Ms. Brown’s physician, Lionel Bissoon, a well-known society doctor with

an office off Central Park West, charges $1,150 for his hCG program,

which covers an examination, injection training, a month’s supply of the

hormone and syringes, and blood work to monitor for possible trouble.

“From an anecdotal point of view,” Dr. Bissoon said, “physicians all

around the country have seen people losing a tremendous amount of weight

with this stuff, and you cannot afford to ignore that.”

Another New York doctor, M. Blyer, offers the hCG diet as an

adjunct to his cosmetic surgery practice, working with

Fulop-Goodling, an orthodontist, out of her office in Midtown. Dr.

Fulop-Goodling does not prescribe hCG, but she counsels patients. They

charge $800 for a 40-day course of therapy, half-price for repeat

rounds; they also require an EKG to make sure the patient has no heart

trouble.

One of Dr. Blyer’s patients, a 30-year-old business consultant named

May, who asked that her last name not be used because she was

embarrassed to be considering the diet, described herself as an

“emotional eater.” She is 5-foot-3 and 130 pounds, but said she hoped to

shed 20 pounds in time to be a bridesmaid at an April wedding. “So I

have just six weeks,” she said.

Dr. Blyer looked uneasy. “Your legs are thin, your face is thin,” he

told her. “You’re a very attractive woman.” But he reassured her that

she would lose weight where she wanted to, in her stomach. The hCG, Dr.

Blyer said, “tricks your body into a state of pregnancy; it burns off

fat so the fetus can get enough calories, but it protects muscle.”

May eventually decided that she did not need to lose much weight and did

not go through with the diet.

Dr. Blyer’s explanation of how the hCG diet works resembles a theory

first popularized in the 1950s by A. T. W. Simeons, a doctor in Rome who

said he had used it on more than 500 patients, and published a paper

about it in The Lancet, the British medical journal, in 1954.

In 1995, a Dutch study in The British Journal of Clinical Pharmacology

tried to resolve the question of whether the hCG diet really worked by

analyzing 14 randomized clinical trials of the diet. Only two, including

one co-written by an advocate of the diet, found that people on hCG lost

more weight, felt less hunger and had an improved body shape, compared

with people on the same 500-calorie diet who received a placebo, like

saline injections.

But several studies concluded that the ritual of the daily injection and

the instant gratification of quick weight loss helped motivate people to

stay on the diet.

However arcane the theory, some doctors say it is theoretically

plausible that hCG would create a more toned body, because it can induce

the production of male hormones and increase muscle mass.

“There’s a reason Manny took it,” said Dr. Keltz,

director of the division of reproductive endocrinology and infertility

at St. Lukes-Roosevelt Hospital Center in Manhattan. Mr. , the

baseball star, was suspended for 50 games in 2009 after evidence

surfaced that he had used hCG, which is banned by Major League Baseball.

Dr. Keltz said he thought it was possible to redistribute fat with hCG,

but, he added, “there are risks, like cardiovascular risks.”

“I would shy away from them,” he continued.

Then there are the nutritional concerns about a diet that some say

mimics anorexia. “The average person is going to eat 1,800 to 3,000

calories,” said , a bariatric surgery dietitian at

Montefiore Medical Center.

“I don’t think it promotes healthy long-term eating habits,” she added.

Doctors who prescribe hCG for dieting say that experience is in their

favor, even if the research is not. They point to women like Guldal

Caba, a 53-year-old psychologist from Toledo, Ohio, who traveled to New

York for treatment from Dr. Bissoon. “It was the fat that needed to go —

you know behind my bra, that back fat, my belly,” Dr. Caba said.

Ms. Brown, a theater administrator who is 5-foot-8, said she was

thrilled to lose six pounds in seven days, and hopeful about reaching

her goal of losing 30, which would bring her close to her ideal weight

of 135. She said she did not feel hungry and did not obsess about food

as she had years ago, when suffering from anorexia.

“A lot of people have a lot of opinions,” Ms. Brown said, “but I don’t

want to be a person who feels like my weight is not under my control.”

Alain Delaquérière contributed reporting.

A version of this article appeared in print on March 8, 2011, on page A1

of the New York edition.

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