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“I Just Gain All The Weight Back Again”

Our patients have been having some real success with the HCG Weight Loss Program here at WholeHealth Chicago. Next week we’ve scheduled a sort of dog-and-pony presentation on HCG weight loss. If you’re interested, call and reserve a seat. If you can’t make it, don’t fret. We’ll be hosting more of these programs and in any case you’ll get a good overview in this Health Tip.

If you’re not familiar with the use of HCG (human chorionic gonadotropin, a hormone produced by the placenta of a pregnant woman) as a weight loss aid, take a look at this earlier Health Tip. Toward the end of today’s article, I’ll discuss the biggest villain with weight loss, which (sigh) even occurs with the HCG approach–namely, regaining your lost weight.

“Frustration” with a capital “F.”

HCG, the hormone
The purpose of HCG is to protect the developing fertilized egg. A typical pregnancy test looks for the presence of HCG in blood or urine. Once HCG was synthesized in the lab it was found to be helpful in boosting fertility. No surprise, then, that high doses are a routine part of treatment for women at fertility centers. For men with pituitary deficiencies, HCG increases sperm production.

British endocrinologist Albert T.W. Simeons, MD, first reported that extremely small amounts of HCG, when combined with a very restrictive 500-calorie diet, forced the body to flush out abnormal fat accumulations. It’s important to appreciate what Dr. Simeons meant by abnormal fat: pot bellies, mega-buttocks, thunder thighs, and triple chins. Physiologists call this adipose tissue, in contrast to the healthy structural fat that cushions and protects organs.

Every one of you with abnormal fat accumulations understands that no matter how diligent your diet and exercise efforts, this fat remains. With HCG and calorie restriction, the areas of abnormal fat are “tapped,” the HCG releasing 1,500 to 4,000 calories daily into the bloodstream, where the calories are promptly burned as fuel. This incredible mobilization of fat stores is why when using HCG you can tolerate an otherwise intolerable 500-calorie-per-day eating program.

And yes, by limiting fat loss to these adipose storehouses, HCG actually re-sculpts your body. You don’t develop the unfortunate Shar Pei rolls of loose skin that later require extensive, and expensive, plastic surgery to tighten up.

Dr. Simeons operated a weight-loss clinic in Rome until his death in 1970, turning away more than a few potential patients because their perceptions of being overweight didn’t align with the adiposity of abnormal fat storage. He focused on body fat percentage rather than actual poundage.

HCG story shape-shifts
Sadly, after Simeons’ death HCG took a wrong turn. An HCG diet was publicized by Kevin Trudeau, the self-styled and utterly untrained popular infomercial salesman, who gave HCG a bad reputation when he insisted it would work only when used in a spa setting with about $18,000 worth of add-ons like colonics and massage. The situation was not helped when later Trudeau received a prison sentence for fraud.

By the 1990s, HCG diets had been relegated to the ever-expanding Museum of Failed Weight-Loss Treatments. But then Mark H. Mandel, a doctor of pharmacology, resurrected the original Simeons protocol from the 1950s and, working with a variety of physicians, began seeing some pretty spectacular results.

HCG weight loss basics
Now, after some 40,000 users nationwide, I’ll share the basics of his plan:

  • You eat a nominal amount (500 calories) while using HCG, lose weight, and aren’t hungry because compensatory calories are being released from adipose tissue.
  • You lose abnormal fat rather than necessary subcutaneous, organ-cushioning fat.
  • The weight generally stays off if you’re honest about following the 1500-calorie, low-carb diet that follows. If weight starts returning (see below), you begin another HCG cycle or consider other options.
  • What’s most exciting is that your health risks plummet. With weight loss, down come cholesterol, blood pressure, and predispositions to metabolic syndrome, diabetes, and heart disease.

HCG can be administered by injection, nasal spray, or sublingual (under the tongue) lozenge. We use the injectable form as well as the nasal spray. It’s available by prescription only from a compounding pharmacy like Mark Drugs, but because it’s not FDA-approved for weight loss it isn’t covered by health insurance. I personally think it’s reasonably priced (about $140 per 40-day course), though I’ve learned that some medical centers are charging considerably more.

Our HCG program follows the Simeons-Mandel protocol 
There are three phases:

  1. Detoxification. If you’re a WholeHealth Chicago patient, schedule with one of our nutritionists: Marla Feingold, Seanna Tully, or Marcy Kirshenbaum. If you’re not a WHC patient you’ll need an appointment with either me or one of my associate, Casey Kelley, MD after which we’ll refer you to a nutritionist for detox. Conventional physicians know detoxification only in terms of drug or alcohol rehab. In integrative medicine, detoxing means clearing accumulated environmental and dietary toxins stored deep in adipose tissue. If you suddenly started flushing out this tissue, the toxins would be released into your system during your initial weeks of HCG, which would likely make you feel quite uncomfortable, sort of like you’d been poisoned.
  1. Starting the 40-day HCG cycle. For the first few days there’s a fat-loading period where we encourage you to store up on healthy fats to stave off hunger. For the remainder of the diet, our nutritionists will help you learn how to put together a 500-calorie eating day and actually enjoy it. The food is mainly lean protein with a few vegetable and fruit servings. There are virtually no fats, starches, or sugars allowed during this cycle, to the extent you’ll be switching to oil-free moisturizers, cosmetics, and sunscreens. (Because of the number of patients interested in HCG, our nutritionists plan to supervise participants both individually and in small groups.)
  1. Slowly reintroducing fats first, then starches and sugars. You’ll maintain at about 1,500 calories a day. If you’re happy with your new weight, fine. We’ll teach you how to maintain it. If you need to lose more, you’ll start another HCG/low-calorie cycle with adjustments made based on your activity level.

Keeping the weight off
It’s the villainous #3, keeping the weight off, that I want to comment on. If you lose weight, whether or not you’re overweight, your body thinks something is seriously wrong and initiates several very complex, hormonally mediated mechanisms to restore the weight. This has been studied in great detail and if you’re prepared for a long article on the subject, click here (or just read the abstract at the beginning).

In a nutshell, imagine two people each weighing 120 pounds. One of the two has weighed 120 pounds for years while the other has just arrived at 120 pounds from an obese 180 pounds. Obviously the latter is in a state of bliss from her weight-loss success. However, if each starts to eat the same healthful menu (one that’s a little more flexible than the obese woman had been following) the woman who always weighed 120 pounds will stay there but within weeks the woman who lost weight will start regaining it.

In other words, once you’ve lost weight you’re incredibly susceptible to gaining it back. The medical term for this is homeostasis and it means your body just wants everything where it’s always been. Don’t make waves. In this situation, the heavier body wants to return to its obese state, whether or not it was unhealthy.

If you manage to lose weight to your satisfaction, you need to maintain that weight literally by any means possible for one year in order to reset your homeostatic mechanism. Once the weight has been held in place for approximately 12 months, you’ll be as resistant to regaining it as someone who has been 120 pounds for years.

We’ll talk more about keeping it off during the introductory meeting. If you’re unable to attend, basically we add one of the three newly released FDA-approved weight-loss prescription medications, Contrave, Qsymia, or Belviq.

The first two are simply combinations of older generic medications used for weight-loss for years. Belviq is a new drug altogether. From my own experience, none of the three has fulfilled its advertising hype and, most annoyingly, none is covered by insurance. But if their weight-loss effect is undramatic, these meds, especially Contrave, are useful in keeping weight off, preventing the homeostatic rebound.

Moreover, the makers of Contrave (a combination of the antidepressant bupropion and low-dose naltrexone) have sensibly dropped the price to a reasonable $70 per month. The others are about $250 a month.

Again, learn more about all this at the intro meeting or simply schedule an appointment with one of our nutritionists.

Be well,
David Edelberg, MD




Leave a Comment

  1. cep says:

    The last part on keeping the weight off was helpful, indeed. There’s a lot of hope in the idea that if the weight can be kept stable for a year, the body will work to maintain it, rather than the before-weight-loss number. I was disappointed, though, to read that drugs might be the solution to keeping the weight off as I have been on weight loss drugs for a year before and the weight rebound (without changing eating habits) once coming off of them is even worse than when coming off of a diet. And unfortunately, I couldn’t just stay on them because I developed tolerance and they no longer worked.
    Still….I am intrigued with the research on rebound weight gain and appreciate that you wrote about that as I have not seen any articles or research into that before.

  2. Anonymous says:

    After reading two consecutive posts touting the HCG diet, I really feel compelled to comment. These are observations from my personal experience with this diet, as a patient at Whole Health Chicago. Respectfully, these are my opinions only… tread carefully.

    This is reckless medicine. I’d file this one under “if it seems too good to be true, it probably is”. I did have success. In my 42 days on the diet, I lost 40 pounds. I was constantly hungry (and predictably miserable), never able to maintain the 500 calorie per day restriction, and have now developed significant gallbladder problems, a well known possible result of crash diets. It’s been extremely frustrating.

    The promise of “no hunger” is laughable, frankly, and the only thing I truly learned while on the diet was that you can lose a lot of weight quickly if you rarely eat. While I do respect Dr. Edelberg and his staff overall… it’s been my experience that behavior modification, MORE THAN ANY OTHER ASPECT, plays the key role in weight loss overall. If you’re an emotional eater, or one of the countless millions who mindlessly consumes food throughout your day, this program is virtually worthless. The HCG diet teaches you very little about living your life at a healthier weight.

    Ask yourself if $140 out of pocket, with the followup recommendation of uncovered prescription meds to keep the weight off, make sense to you, ultimately. It’s quick fix mentality. Borderline quackery. Why the need for radical and rapid weight loss in the scheme of things? I found the whole experience to be alluring, and disappointing, ultimately. Your mileage may vary.

    And yes, I gained all the weight back.

  3. Dr E says:

    Dear cep

    You needn’t go on the prescription drugs to prevent regaining weight. If you find your weight heading upward, you can simply do another round of HCG

  4. cep says:

    Thanks for the response to my post, but I did do a follow-up round. I did two rounds of HCG about a year apart. This was 2010 and 2011 or 2011 and 2012. I think the latter.

  5. cep says:

    One other comment I’d make after Anonymous’s comment reminded me…. I don’t think I had gallbladder issues from HCG, but my blood sugar readings spiked up for months afterwards. I am not diabetic but just monitored at home for my own information over a couple of years. Eventually they did seem to come back down again but I’m glad I wasn’t having insurance blood tests at the time. The weight loss is compelling enough that even still I toy with doing this again. The trick is keeping it off.

  6. Dr E says:

    Hi Anonymous
    Really sorry you had a negative experience with HCG and I really appreciate your insights. Concerning a 500 calorie eating program, most HCG patients have reported that while they do feel hungry at first, when their metabolism starts to change, they don’t feel the expected “famished.” Interestingly, a well chosen 500 calories every day is sufficient to prevent problems with malnutrition or vitamin deficiencies. Obviously, it is totally insufficient if you’re going to be especially physically active. It’s the emotional eating you refer to that’s the big enemy of any sustained weight loss. “Carbs,” the food group most avoided during HCG, are comfort foods, raising various feel-good hormones in the brain.
    What’s killing Americans (and Europeans) prematurely are the chronic disease consequences of obesity. When it was recently reported how the rapid weight loss following bariatric surgical procedures reversed heart disease, fatty liver and diabetes, suddenly, what was once deemed “reckless weight loss” didn’t appear so bad after all.
    The many HCG patients around the country who have lost weight and kept it off regard the program as a real turning point in their lives

  7. Bertha says:

    “If you’re interested, the only prescription weight-loss medication I’m currently prescribing is HCG (human chorionic gonadotropin), which I’ve written about in the past.”

    Interesting that just 1.5 years ago you posted a diatribe on how worthless and unsafe weight loss medications are, and here, you mention that you add one of them to HCG treatment. What has changed in the past 1.5 years?

  8. Cheyenne says:

    I completed 2 rounds of hCG under the WHC protocol. The first time I gained the weight back…. But, that’s my fault because I resumed old eating habits almost immediately (I also had a change in relationship status, moved, etc during that time). I did it again and lost 20 lbs and have kept it off for a year! I have to say that I was rarely hungry while on hCG and in fact struggled to get to 500 calories. I found the discipline to be exactly what I needed. At the encouragement of Marla, I started Paleo and lost an additional 5 lbs without counting a single calorie. I feel better and have decreased pain (I have bothe fibromyalgia and lipedema). I thank WHC for introducing hCG after I had snubbed it previously as quackery myself.

  9. Dr E says:

    Hi Bertha
    I’m sorry you can’t tell from this Health Tip that I am still not enamored with the prescription weight loss meds.I have found them disappointing in regard to losing weight but am getting better results when it comes to helping people maintain a weight loss
    Dr E

  10. J J says:

    I found this post while doing a search for “Contrave HCG Chicago”. Unfortunately, I am also a former patient and agree with Anonymous. I don’t think HCG is quackery, but I do think it’s extremely difficult and regaining weight after so much work and pain is crushing to anyone who knows how hypothalamic dysregulation feels. I was not offered any sort of medicine to help after 5 rounds of HCG with full rebound. I was offered follow up visits full of blank stares and vitamin recommendations. As weight loss patients, our suffering seems to not matter. We are told to get over it and see a counselor or get accupuncture, when the truth of the matter is that no one turns to desperate measures like this diet unless they are… desperate. I hope no one else has to suffer through what I did.

  11. Jamie says:

    A lady recommended your clinic for HCG. The problem is I live in Tucson, AZ. Do you do phone consults?
    Thank you

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