Effect of human chorionic gonadotrophin on weight loss, hunger, and feeling of well-being”2

W. L. Asher, M.D., and Harold W. Harper,3 M.D.

Since Simeons (1, 2) introduced his other parameters. The code was not broken until

Patient selection

method of treating obesity using human chorionic gonadotrophin (HCG), there has been continuing controversy concerning the effect of HCG on the program. Simeons and his followers have generally not claimed that patients eating 500 kcal daily will lose more requiring significant medications. They were se-

weight when have claimed and feel better thus more apt to remain in treatment. There have been a number of literature reports of

double-blind effect of indicated placebo. However, as pointed out by Gusman (4), most investigators significantly altered

well-motivated patients de- program for weight reduc-

Simeons’ basic his followers that strict adherence

and to the basics of Simeons’

program Because

is essential of the

receiving HCG. They

(2-4) hungry

that patients because of the HCG

studies (5-9) concerning HCG on weight loss. Only

the one (8)

HCG may be of more value

than

a

program. Both Simeons

to be stopped

nor started during the study period. to be pregnant were excluded from

have

vociferously maintained

Patients the study.

Para␣nelers

known

if HCG increasing it was

placebo.

is to be useful. popularity of

␣neasured

are less

who had previously been Also excluded from the

and are

Simeons’ tempts should be made to assess, in a double- blind manner, not only weight loss but the degree of hunger and the feeling of well-be- ing of patients receiving HCG or an identi- of those reporting hunger were recorded as “little,”

program,

felt further at-

cally appearing

Patients and One of us (HH), who has an active practice us-

ing HCG in weight reduction, did the clinical work.

“some,” or “much.” each visit how they recorded as “excellent,”

Injections

Patients felt, and

“good,”

were also asked on the responses were

methods

The vials suits. double-blind manner, either HCG injections placebo injections. HCG and placebo were pre- pared by Glogau & Co., Chicago, illinois, in identi- cally appearing vials. The HCG preparation was 1 From the American Society of Bariatric Physi-

other (WA) prepared of HCG and placebo, Forty female patients

the protocol, labeled the

re- or

prepared in the usual commercial manner. It con- tamed, in addition to HCG, mannitol with mono- basic and dibasic sodium phosphates as buffers. The placebo preparation consisted of mannitol with monobasic and dibasic sodium phosphates as buf- fers.

and analyzed the received, in a modified

basis before the vials investigator (HH). A HCG or an identically

were shipped series of six

to the clinical vials, of either

All patients were evaluated for weight loss and The A,nerican Journal ofClinical Nutrition 26: FEBRUARY 1973, pp. 211-218. Printed in U.S.A.

the clinical work was completed and the data had all been gathered.

All patients were females 18 years of age or older who had no known serious disease processes

lected from apparently siring to enter the HCG tion. None was selected on Simeons’ program. study were patients who had received appetite sup- pressants or other weight medications in the 6 weeks prior to the start of the study. None had lost more than S lb in the 3 months prior to treatment. No patients were to receive diuretics during the study. Oral contraceptives, estrogen, or thyroid products needed to maintain a euthyroid state could be continued if the patients were receiving them prior to the start of the study. They were neither

Blood pressure was taken at the start and at the end of treatment with the patient in a sitting posi-

tion. The patients the same amount were questioned

were weighed with approximately of light clothing each day. They

daily about hunger; the responses

Three patients vial. Numbers of jections from each vial were assigned on a random

received the three

injections patients

from each

were

cians Research Council, 333 West Hampden Aye- nue, Englewood, Colorado 80110.

2 Requests for reprints should be addressed to W. L. Asher, M.D., at the American Society of Bariatric Physicians Research Council.

3 Present address: 3959 Laurel Canyon Blvd., Suite F, Studio City, California 91606.

211

appearing

placebo,

“fair,”

or “poor.”

to receive

in-

Downloaded from www.ajcn.org by on May 14, 2007

212 ASHER AND HARPER

labeled for each trio of patients. Two series of time but foods from both meals could not be vials, however, had only two numbers on each vial. eaten at the same time. For each meal, one item A new vial was used each 7 days. The study mater- was to be chosen from each of four food groups, ial was kept refrigerated after mixing with bac- protein, vegetable, bread, and fruit.

teriostatic water. Injections were given while at no time did the medications remaln at temperature. Patients were to return to the 6 days each week for 36 injections (unless the de- sired weight was achieved prior to this). They re- ceived 125 IU of the study material intramuscularly

in the upper-outer quadrant of the buttocks on each visit. Injections were discontinued on the days of

heavy menstrual flow of a few patients (usually or 3 days). No appetite suppressants or other medi- cations were given. Patients were advised to use no laxatives but were permitted to use a Fleet’s or Baxter enema if needed.

of any They

Patients all cosmetics containing

or frozen, un- (sole, flounder),

were advised to

“avoid the use fats or oils.”

and were fats. cough patients were encouraged to drink 8 to 10 glasses of water daily.

sea bass, hali- Shellfish: Lobster, crab, shrimp, only. Iris- dietetic canned Cohoe salmon, 3.75 oz (oil

also to avoid skin contact with other Chewing gum, throat pastilles, vitamin syrups, and alcohol were not permitted.

oils or pills, The

but. brand must smoked fish, or other seafood allowed.

Patients were adherence to the told the slightest their weight loss. of the details will result in utter disaster.”

that absolute They were slow or stop

from any

3) Meat

Vegetable group

One-half to one cup of one type of the follow- ing vegetables at each meal: asparagus, beet greens (not beets), cabbage, celery, chard, chicory, Chinese

Diet for days of tile first t/lree Patients were encouraged

injections’

of the foods allowed. No feine were permitted during

they wished caf-

cabbage, cucumbers, dill-sour pickles (these be unsweetened), endive, escarole, fennel, kale, let-

Breakfast and lunch, beef, veal, lamb, pork,

1st

lean) or veal

tuce salad, Mung bean parsley, red radishes, mer squash, tomatoes, dressings containing spoon might be used.

Bread group

sprouts, mushrooms, spinach, string beans,

no

onions, sum-

heart. sprouts, spinach asparagus, oranges,

Hard cooked cauliflower,

chicken, eggs. green

turkey, beef Vegetables: peppers, cucumbers,

(not and

canned), tomatoes, grapefruit

Swiss kohlrabi.

calorie 1 kcal/table-

repeatedly program

advised was essential.

4

infractions “The slightest deviation

the whites only of six hard-cooked taken as a protein substitute. No cottage

would

to eat all beverages containing

this period. day. Meat: (all

must

brussels chard, cabbage, fresh

watercress. Low

more than

Fruit: apples, at any time until lunch.

to noon 2nd day. Patients were to fast after lunch the 1st day until noon the

Afternoon

of 1st day

cold; room office

Protein group

All meat and fish were to be weighed on a postal scale. Three and one-half ounces (raw weight) were to be eaten at each meal.

2

chicken in the roast,

following c) loin

purchased raw lean cuts only: chop. Lean beef

and cooked. a) sirloin, b) hearts, dried

Choice of one of the following: one average size 2nd day. There was no limit on noncaloric, non- bread stick (Grissino), melba toast, Finn crisp caffeine fluids during this period. cracker (very thin), one square of Norwegian flat-

Noon 2nd day until noon 3rd day. Patients bread, or one-third of an English muffin containing could have only fruits and vegetables to be selected 75 kcal or less per muffin (actual calories must be

from the fruit and vegetable groups of the 1st day. Lunch and evening meal 3rd day. Same as break-

fast and lunch of the 1st day.

Diet for remainder of tile study period

On the 4th day of injections, the patients were started on a low fat diet of 500 to 550 kcal (no

listedon the package).

Fruit group

Choice of one: apple, orange, berries (approximately 8 oz), or one-half grapefruit, one-fourth

handful of straw- one-half cantaloupe,

casaba or honey- cooked rhubarb #{189c}up of the fol-

and/or artificially

mention was were warned substitutions an improvement pointed.”

made of “you must

calories, however). They not make any changes or you may think they are

dew melon, 1/2 (artificial sweetener lowing (fresh or

cup sugar-free permitted),

waterpacked,

even though or you will be utterly disap-

4 The basic 500- to 550-kcal diet was suggested by Simeons. The specific details of this and the diet

Patients were advised to keep a daily food diary for the first 3 days in toto were designed by Peter and bring it with them each day. Two meals each G. Lindner, M.D., and are reprinted with his per- day were to be eaten. Meals could be eaten at any mission.

Chicken livers

2) Seafoods: White fish, fresh breaded, as the following: flat fish haddock, pollock, perch, pike, white

1)

breast (white meat, excluding

Meal:

skin), Veal, rump chipped beef (3.5 oz). No other beef allowed. All meats and seafoods to be prepared by fat-free cook- ing.

be washed from top). No dried, pickled, or

cheese, casionally, might be cheese was allowed.

substitutions: Hoop (farmer oz mixed with water and seasoning.

or pot) Oc- eggs

Downloaded from www.ajcn.org by on May 14, 2007

EFFECT OF HCG

sweetened): sliced peaches, apricots, gooseberries,

ON WEIGHT LOSS 213 jection was 0.585 ± 0.044 lb in the HCG

group and 0.403 ± 0.047 lb in the placebo

or papaya. One cup D-Zerta sugar-free brands allowed).

gelatine

dessert

(other

The following were also 1) juice of one lemon daily for all purposes; 2) one tablespoon of milk/day; 3) salt, Lawry’s seasoning, placebo group five lost I5 lb or more.

pepper, vinegar, dry mustard

basil, thyme

The diet sheet ends with “Any slight change in the above diet rules will result in downright disap- pointment.” The patient was also impressed that he was to lose weight each day or a reason must be

found, cetera.

i.e.,

fluid retention, dietary

digressions, et

indicated group,

initial of laboratory

Results

workup physician

tests.

included examination,

a

medical and

and die- a number

The tary history,

indicated Of the daily responses

4)

treatment in either group at the P

dressing; tea, dietetic less, and artificial sweeteners.

significant level (Table and 33 were excluded from analysis because of incomplete data.

or seasonings, any amount of

but no oil, butter,

Of the 40 patients starting this study, 17 of 20 in the HCG group and 13 of 20 in the

placebo group

Discussion

(P <

the 0.001)

placebo group completed tions (Table 1). Data

30 or more injec-

the family. These data were

also unavailable and 33 of the

on final

all starting analyses

patients whenever measure-

were included in the possible. Final blood ments were not obtained on patient HCG group who left town due to a death in

The mean centage of starting significantly greater in the placebo group. if both groups had followed their diets strictly

on patients 19, placebo group early. Data concerning hunger and 16 were misplaced and thus not included in evaluating the degree of hunger for this group.

group mean ches placebo inches

was height (range

38.4 years (range 21 to 67). The

thus loss

seems probable of the patients

that the on HCG

was not the HCG 1 1 .05 ±

significant. group

This difference, The mean weight

loss in

in

initial study were negative, double-blind studies reported ture.

group (range

to 70.0), a mean

to 67.5). on all

whereas the height of 64.0

patients are in- starting weight

group than however,

the dietary instructions

Weight loss eluded in Table was 6.3 lb greater in the HCG group.

studies the study of Lebon (8)

20, 25, who dropped

26,

difference Advocates

(1-4) feel

out

The mean age of the HCG group was 37.8 years (range 18 to 63) and that of the placebo

of the 60.2

had

58.5

HCG group was 64.2 in-

fact that they followed than did

data I .

was I 9.96 ± 1 .63

The mean in the placebo

greater weight

in the placebo group

0.001). weight lost in the HCG group was 0.58 and 6.77 ± 0.83 in the placebo (P < 0.001). The mean weight loss per in-

I .29 lb The mean percentage of

(P <

allowed

at any

time:

powder, garlic, sweet

lb or more The change in mean systolic and

or water, black coffee or soft drinks marked 2 kcal/bottle or

blood pressures during

pressures and

loss and weight that

the mean was lost

per- were than that

2 of the

in the It seems unlikely

of treatment in patients 13

in weight loss of this method,

lb starting

1 1 .47 ± group

as have been most in the litera-

There was strict attention given to limiting

and

group (P <

0.025). Fourteen patients in the HCG group and

lost 15 in the

diastolic was not

2). Patients 2, 19, 20,

= 0.05 25, 26,

In the HCG group, 76.6 ± 3.30% of the

daily responses In the placebo daily responses (P < 0.001) (Table 3).

little or no 48.7 ± 4.44%

little or no

of patients 2.66% indicated as compared

responses (Table 3).

hunger. of the

hunger

in the they with

HCG group, 86.5 ± felt “good” to “excellent” 70.0 ± 3.82% of

in

the

weight

there would have been a significant

between the including

that with and generally questioning well-being these views. It increased weight was related to more closely the the placebo group.

in the literature, only showed a significantly the HCG group than (P < 0.05). The results quite unexpected by the author responsible for study design because the results of our

HCG the patients feel better.

hungry to daily feeling of

Of the four reports of double-blind

HCG group

groups. Simeons

are less Responses

regarding hunger and in this study are consistent with

loss the placebo group

in of our study were

Downloaded from www.ajcn.org by on May 14, 2007

214 ASHER AND HARPER

dietary fat. Simeons (3) pointed out that beef was allowed on this program. All fats American beef, which is feed lot fattened, were markedly restricted. Even cosmetics contains much more fat than Italian beef. No containing fats were curtailed, although it is

beef other than beef hearts or dried chipped

difficult to see how this would affect the pro-

TABLE 1 Starting weight

and weight ␣

␣ 26

␣ 23 ␣ 18 ␣ 27

51

36

␣ 43

␣ 57

22

59 ␣ 51 ␣ 34 37 47 ␣34

loss

Height, No. inches injections

Patient

HCG group 1

2

5

7 8 9

14

15

18 21 22 23 28 29 30 32 34 36 38 40

Mean

SEM

Placebo

3

4

6 10 11 12 13 16 17 19 20 24 25 26 27 31

no.

of

Starting

weight, lb

177.5

149

Loss, lb

31 .75 13.25 11.5

Percent

weight

17.9 8.9 8.1 8.3 9.0 9.3 14.8 12.4 12.2 12.7 7.0 13.5

12.3 11.3 12.2 10.8 13.0 12.3 10.5 12.9

body loss

Loss, lb.

35

37

39 Mean

SEM

22

25

62.5

64.5

group

21 38 33 36 63

65

1 1 . 47u ±0.58

7.0

6.4 2.6 5.3 6.7 7.0 14.7

13.4 12.1 6.1 3.3

6.0 1.6 2.2 9.9 6.3 1.8 9.2 8.1 5.7

6. 77a ±0.83

O.585␣ ±0.044

0.313 0.417 0. 139 0.236 0.264 0.313 0.569 0.611 0.514 0.638 0.225 0.298 0.192

1 .062 0.493 0.257 0.333 0. 393 0.472 0.313

0.4031 ±0. 047

33 ␣28

64.5 36 63.5 32 64.5 28 62.25 36 70 36 64 36 68 36 64 36 65.5 36 66 33 62 35 63 35 66 36 62 36 62 36 65 32 64 36 62.5 28 64.5 22 60.25 36

66 36 64.5 36 62.5 27 61 35 62 36 64 36 58.5 36

27

36

141.5 135 11.25 222.5 20

␣ ␣

␣

67 60 67 64 64 67.5 13 674 65 36 67.5 36 629 ␣ 27 63 35

156.5 280 141.5 166.5 165.75 259.25 164.75 144.25 151

180 123

221.75

171.25 137.5 145.75

171.7

160.75

234.5

147 146.25 141.5 159.75 139 163.75 152.75 210 136.5 155 159.25 197 179.25 148 166.75 149 157.75 195.75

165.4

14.5

41.5

17.5

20.25

21 18.25 22.25 17.75 17 22 13.25 28.75 21 14.5 18.75

19. 96’ ± 1.63

11.25

15

3.75

8.25

9.50 11.25 20.5 22 18.5 12.75

4.5

9.25

2.5

4.25 17.75 9.25

3 13.75 12.75 I1.25

11 #{216}5a ±1.29

␣ ␣

␣ ␣ ␣ ␣ ␣

48 34 57 67 52 48 25 53 24 33 51 22 21 32 35

36 36 20 20 31

a Difference between the HCG and placebo groups, significant at P < 0.001. b Difference between the HCG and placebo groups, significant at P < 0.025.

per

injection

0.882

0.414

0.411 0.313 0.556 0.403

1.153 0.486 0. 563 0.636 0.521 0.636 0.493 0.472 0.611 0.414 0.799 0.750 0. 659 0. 521

Downloaded from www.ajcn.org by on May 14, 2007

TABLE 2 Blood pressure

HCG Placebo

Mean Systolic

final

blood

pressure Diastolic

72.5 ± 1.65 78.0 ± 2.50

Placebo

76.6’ ± 2.60␣ 23.4’ ± 3.30 ␣ 13.5’ ± 2.66 86.5’ ± 2.66

15.6 33.9 ␣4 6.1 24M 49.6 20␣

48.7’ ± 4.44 51.3a ± 4.44 30.0” ± 3.82 700” ± 3.82

␣-␣-

-␣

␣-␣----------␣ ------␣---------␣

EFFECT OF

Mean starting Systolic

HCG ON WEIGHT LOSS

blood pressure ␣ ␣ Diastolic ␣

215

120.7 ± 47#{216}a 77.4 ± 1.80 122.1 ± 2.87 ␣ 79.2 ± 2.16

115.1 ± 3.89 120.0 ± 2.92

Patients 2, 19, 25, 26, and 33 were excluded from analysis because final blood pressures were not obtained.

a SEM.

TABLE Percentage

HCG

3

of

well-being

Feeling None ␣ Little ␣ Some ␣ Much I Poor ␣ Fair ␣ Good ␣ Excellent 32.8 43.7 16.5 7.0 ␣ 0.5 13.0 63.2 23.3

all daily patient responses of hunger llunger

and feeling of ␣

Patients 13 and 16 were excluded from hunger analysis because these data were unavailable. (‘ Difference between HCG and placebo group, significant at P < 0.001. b SEM.

gram as there is no evidence in the literature that fats are absorbed through the skin. It does, however, seem possible that such ex- treme measures may have impressed the pa- Laxatives and other medications (with the

tients with the necessity of curtailing their dietary fat intake.

A number of physicians using HCG in this manner feel that once the HCG is mixed with diluent it must not be allowed to stand at room temperature and, even when refriger- ated, activity is uncertain after 1 week. In this study, each vial was refrigerated and used only 1 week after mixing. The material

exception of aspirin) were to be avoided if at all possible. Three patients received other medications. All were in the HCG group. One was on birth control pills (no. 2), one on estrogen (no. 1 5), and one on thyroid (no. 5). The patient on thyroid was retained in the study for the sake of completeness, although

the dosage of desiccated thyroid which the patient was taking prior to the start of the study was reduced from 2 grains to 1 grain on the I 2th day of the study. It is doubtful this change in dosage significantly affected the patient’s weight loss.

Except for receiving the study injections, the subjects were treated in a manner similar to that used in treating HH’s regular pa- tients receiving HCG. At any given time, the study patients constituted only a small portion of the patients receiving injections at HH’s office.

was

injected cold. HH saw the patients only at the time of

the initial and final visits. His office assistants, who were quite enthusiastic about the pro- gram, saw the patients 6 days each week. Patient charts were reviewed periodically by HH and his assistants during the course of treatment. The patients had 125 IU HCG (or equivalent placebo) injected deep im in the buttocks on each visit, with the exception that no injections were given to a few patients on the days they experienced heavy men- As we concur with Albrink (10) that all

strual flow. The patients were required, how- ever, to report 6 days each week whether or not an injection was received.

Downloaded from www.ajcn.org by on May 14, 2007

216 ASHER AND

starting patients should be included in the analyses rather than only those completing treatment, we have included all starting pa- tients.

HARPER

weight, we felt including a few males in each group was undesirable. A large enough series of males needs to be studied so the results in males can be analyzed in a statistically mean- ingful way.

Fleigelman and Fried (1 1) injected 50 IU HCG daily intraperitoneally for 7 days into rats. Controls received 0.2 ml saline. The

The placebo used in our study was as nearly like the HCG preparation as possible with only the HCG itself missing. Thus, the HCG and placebo preparations should have been essentially indistinguishable on the basis rats were killed after 7 days. The levels of

of appearance or the local sensation of the patient who received the injections.

three enzymes involved in linking glycolysis to the esterification and synthesis of fatty acids were assessed. There was an 85%,

In addition to the study reported here, we have also completed a double-blind study 35 % , and 48 % reduction in the adipose tis-

sue levels of alpha-glycero-phosphate dehy- Simeons’ programs modified to varying de- drogenase (AGPD), lactic dehydrogenase

grees. Three of these physicians had had little (LDH), and glucose-6-phosphate dehydro- or no experience with the use of HCG in genase (G6PD), respectively. Liver levels of weight reduction. None of their programs ap- G6PD and muscle levels of AGPD were proached the rigidness of the program con- also significantly reduced. These enzymes sidered in detail in this report. For instance, play significant roles in directing lipid syn- one physician allowed some patients to ad- thesis. If these reductions in enzyme levels minister their own HCG injections at home. are in turn responsible for a decrease in the One physician at times gave injections three rate of fatty acid synthesis, a possible enzy- times/week and one gave injections five matic basis for the finding in our present times/week. study is suggested.

Physicians were allowed to use diets of The extraction method used in preparing their own choosing, as these patients were HCG from pregnant human urine is similar seen in the course of their regular practice. to the extraction method used for the prepa- None of these four physicians insisted on the ration of urogastrone, a hormone inhibiting

involving patients of four physicians using

patient’s absolute attention to detail in con- trast to the physician whose practice is re- ported here. This is particularly true in re- gard to the restriction of fat intake.

gastric secretion (1 2, 1 3). These authors re- port HCG preparations cause inhibition of gastric secretions even when the gonadotro- phal activity of HCG preparations is de-

The dropout rate was high in all practices stroyed. Ghosh (14) reported different activ- involved in the initial study. When weight ity rates for gonadotrophic and antisecretory loss was analyzed for each practice, there effects in rats when two purified gonadotro- was no significant difference between the phin preparations were assayed. In addition, HCG and placebo groups in any practice. van Hell et al. (15) have presented evidence Combined data from all four practices re- that HCG preparations may be fractionated vealed 28 patients were on HCG and 32 on into a number of HCG components differing the placebo. The mean number of visits in from each other in biological potency, elec-

the HCG group was 18.0 and 18.5 in the placebo group (36 visits possible).

preparations in regard to weight the mean weight loss in the HCG group was could be related to a specific HCG fraction

6.8 lb and 6.5 lb in the placebo group. This or fractions, or to urogastrone, or other un- difference in weight loss was not significant. known urine components extracted by this Thus, it appears that insistence on strict method. If this were the case, such “fat mo- adherence to details is correlated with sue- bilizing” activity levels might vary considera-

When all starting patients were analyzed,

reduction

bly in different preparations and batches of In these four studies and the study pre- HCG. This might in part explain the varia-

cess (even in the placebo group).

bility in results in various reports where HCG cause males tend to lose larger amounts of has been used.

sented here only females were included. Be-

trophoretic mobility, and sialic acid It is conceivable that the activity

content. of HCG

Downloaded from www.ajcn.org by on May 14, 2007

EFFECT OF HCG

Another possible explanation of negative results might be the loss of activity of HCG with time after mixing especially if not re- frigerated. It is probable in most studies that an individual patient received injections from a single vial which, after mixing, would be a minimum of 6 weeks old by the time of the final injection.

ON WEIGHT LOSS 217

after reconstitution with bacteriostatic water, and should not be used longer than 1 week. Patients selected should be sufficiently over- weight to assure they will not reach their desired weight before the termination of the study.

The 500- supplementation

calcium to

to 550-kcal eating plan needs of certain items such as

make it nutritionally complete.

Summary

Twenty kcal diets

female

receiving human

patients on 500- to 550- daily injections of 125

However, ments were

Whether loss using

injections long-term objective such would involved

in the interest not included

of simplicity, supple-

lu of (HCG) tients placebo were

chorionic were compared with

gonadotrophin 20 female pa-

diets receiving in both groups daily injections

careful restriction It is interesting

valuable assistance

the long-term single or multiple are better than results of weight

on 500- injections.

to 550-kcal Patients

examination. be the case

seems doubtful work vigorously with

of eating pat-

(unless this). mean weight, mean weight significantly starting weight. daily patient no hunger” was significantly

continued to the patient in the re-education

had a loss per

significantly injection,

greater and lost a

terns. The strict

must follow

of their

intake

of dietary on strict attention to all de-

requirement meticulously

that the the various

of the Whether necessary mains to a minimal The emphasis tails may at least motivate the patient to more

of his daily food intake.

program seems certain aspects

aspects almost ritualistic.

for success when be seen. Proponents

of this ritual are HCG is used re-

than in vestigation weight indicated.

the loss,

[␣

greater in placebo group. 0’ the influence

hunger, and

the HCG group Additional in- of HCG on

well-being seems

to note that HH’s patients a placebo lost more on the average than either the HCG or placebo pa-

who were given tients of the other four practitioners (11.05

1.

2. 3. 4.

5.

6.

SIMEONS, A. T. W. The action of chorionic gonadotrophin in the obese. Lancet 2: 946,

1954.

SIMEONS, A. T. W. Chorionic gonadotropin in

in

the present study. results of weight courses of HCG the usual dismal

reduction needs

It unless the physician

generally insist fats is necessary.

and 6.5 lb, respectively). It that HCG used in a casual

lb versus therefore program of weight reduction, as it often is in a general practice, is of no value. The fact

6.8 appears

that in a tients is in itself interesting. logical impact of which the patient believes in is important.

4: 36, 1956. gonadotrophin in

HH’s placebo 6-week period do on other

patients lost more weight

pa-

It is hoped other investigators will repeat

this study. The insistence on strict adherence

than most diets and/or

physicians’ medications

Certainly, receiving a

the psycho- daily injection

to a low fat, low calorie eating plan seems 230, 1963.

critical. Ideally, each or seven individual make blinding more study. Each vial should be kept refrigerated

7. FRANK, B. W. The use of chorionic gonadotro-

patient should have six

pin hormone double-blind

in the treatment of obesity. A study. Am. I. C/i,z. Nutr. 14: 133,

weekly vials complete

that would than in this

1964. 8. LEBON, P. Treatment of overweight patients

patient

instructed 6 days each week for a total of 36 injections

desired weight The HCG group

was achieved lost significantly

prior to more

to return for

greater mean percentage The percentage of affirmative

responses indicating “little or and “feeling good to excellent”

We wish to of Lynne Stone out the details of the study on a daily basis.

References

acknowledge the who was responsible for carrying

geriatrics. J. Am. Geriat. Soc. SIMEONS, A. T. W. Chorionic the obese. Lancet 1: 47, 1962. GUSMAN, H. A. Chorionic gonadotropin in obesity. Further clinical observations. Am. J. Clin. Nutr. 22: 686, 1969.

CARNE, S. The action of chorionic gonadotro- phin in the obese. Lancet 2: 1282, 1961. CRAIG, L. S., R. E. RAY, S. H. WAXLER AND H. MADIGAN. Chorionic gonadotropin in the treat- ment of obese women. Am. J. Clin. Nuir. 12:

Downloaded from www.ajcn.org by on May 14, 2007

218

ASHER AND

Geriat.

HARPER

secretory substance: urogastrone. Arc/i. Bio-

with chorionic gonadotropin.

J. Am.

chem. 25: 133, 1950. 9. SoNAR, E. A forty-day-550 calorie diet in the 13. PERERA, B. A. V., AND V. M. ROSENOER. The

Soc. 14: 116, 1966.

treatment of obese outpatients. Am. I. Clin.

phins. Brit. I. Pharmacol. 20: 534, 1963. 10. ALBRIN␣, M. J. Chorionic gonadotropin and 14. GHOSH, M. N. Inhibition of acid gastric secre-

obesity. Am. J. Clin. Nutr. 22: 681, 1969. tion in the rat by chorionic gonadotrophin. J. 11. FLEIGELMAN, R., AND G. H. FRIED. Metabolic P/zysiol. 147: 585, 1959.

effects of human chorionic gonadotropin in 15. VAN HELL, H., R. MATTHIJSEN AND J. D. H. rats. Proc. Soc. Exptl. Biol. Med. 135: 317, HOMAN. Studies on human chorionic gonado-

Nutr. 7: 514, 1959.

1970. 12. Hun␣, J. W., E. A. RISLEY AND R. H. BARNES.

Preparation and properties of purified anti-

trophin. I. Purification and some physico- chemical properties. Ada Endocrinol. 59: 89,

1968.

relation between urogastrone and gonadotro-

Downloaded from www.ajcn.org by on May 14, 2007