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HCG Fat Loss >
Dr Simeons HCG Protocol >
The Nature of Obesity >
Three Basic Causes of Obesity >
The Treatment of Obesity >
HCG Diet Protocol
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HCG Diet Protocol Conclusion
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Unforeseen Interruptions of
Treatment
If an interruption of treatment
lasting more than four days is
necessary, the patient must increase
his diet to at least 800 calories by
adding meat, eggs, cheese, and milk
to his diet after the third day, as
otherwise he will find himself so
hungry and weak that he is unable to
go about his usual occupation. If
the interval lasts less than two
weeks the patient can directly
resume injections and the
500 calorie diet, but if the
interruption lasts longer he must
again eat normally until he has had
his third HCG injection.
When a patient knows beforehand that
he will have to travel and be absent
for more than four days, it is
always better to stop injections
three days before he is due to leave
so that he can have the three days
of strict dieting which are
necessary after the last injection
at home. This saves him from the
almost impossible task of having to
arrange the 500 calorie diet while
en route, and he can thus enjoy a
much greater dietary freedom from
the day of his departure.
Interruptions occurring before 20
effective injections have been given
are most undesirable, because with
less than that number of injections
some weight is liable to be
regained. After the 20th injection
an unavoidable interruption is
merely a loss of time.
Muscular Fatigue
Towards the end of a full course,
when a good deal of fat has been
rapidly lost, some patients complain
that lifting a weight or climbing
stairs requires a greater muscular
effort than before. They feel
neither breathlessness nor
exhaustion but simply that their
muscles have to work harder. This
phenomenon, which disappears soon
after the end of the treatment, is
caused by the removal of abnormal
fat deposited between, in, and
around the muscles. The removal of
this fat makes the muscles too long,
and so in order to achieve a certain
skeletal movement - say the bending
of an arm - the muscles have to
perform greater contraction than
before. Within a short while the
muscle adjusts itself perfectly to
the new situation, but under HCG the
loss of fat is so rapid that this
adjustment cannot keep up with it.
Patients often have to be reassured
that this does not mean that they
are “getting weak”. This phenomenon
does not occur in patients who
regularly take vigorous exercise and
continue to do so during treatment.
Massage
I never allow any kind of massage
during treatment. It is entirely
unnecessary and merely disturbs a
very delicate process which is going
on in the tissues. Few indeed are
the masseurs and masseuses who can
resist the temptation to knead and
hammer abnormal fat deposits. In the
course of rapid reduction it is
sometimes possible to pick up a fold
of skin which has not yet had time
to adjust itself, as it always does
under HCG, to the changed figure.
This fold contains its normal
subcutaneous fat and may be almost
an inch thick. It is one of the main
objects of the HCG treatment to keep
that fat there. Patients and their
masseurs do not always understand
this and give this fat a
working-over. I have seen such
patients who were as black and blue
as if they had received a sound
thrashing.
In my opinion, massage, thumping,
rolling, kneading, and shivering
undertaken for the purpose of
reducing abnormal fat can do nothing
but harm. We once had the honor of
treating the proprietress of a high
class institution that specialized
in such antics. She had the audacity
to confess that she was taking our
treatment to convince her clients of
the efficacy of her methods, which
she had found useless in her own
case.
How anyone in his right mind is able
to believe that fatty tissue can be
shifted mechanically or be made to
vanish by squeezing is beyond my
comprehension. The only effect
obtained is severe bruising. The
torn tissue then forms scars, and
these slowly contract making the
fatty tissue even harder and more
unyielding.
A lady once consulted us for her
most ungainly legs. Large masses of
fat bulged over the ankles of her
tiny feet, and there were about 40
lbs. too much on her hips and
thighs. We assured her that this
overweight could be lost and that
her ankles would markedly improve in
the process. Her treatment
progressed most satisfactorily but
to our surprise there was no
improvement in her ankles. We then
discovered that she had for years
been taking every kind of
mechanical, electric and heat
treatment for her legs and that she
had made up her mind to resort to
plastic surgery if we failed.
Re-examining the fat above her
ankles, we found that it was
unusually hard. We attributed this
to the countless minor injuries
inflicted by kneading. These
injuries had healed but had left a
tough network of connective
scar-tissue in which the fat was
imprisoned. Ready to try anything,
she was put to bed for the remaining
three weeks of her first course with
her lower legs
tightly strapped in unyielding
bandages. Every day the pressure was
increased. The combination of HCG,
diet and strapping brought about a
marked improvement in the shape of
her ankles. At the end of her first
course she returned to her home
abroad. Three months later she came
back for her second course. She had
maintained both her weight and the
improvement of her ankles. The same
procedure was repeated, and after
five weeks she left the hospital
with a normal weight and legs that,
if not exactly shapely, were at
least unobtrusive. Where no such
injuries of the tissues have been
inflicted by inappropriate methods
of treatment, these drastic measures
are never necessary.
Blood Sugar
Towards the end of a course or when
a patient has nearly reached his
normal weight it occasionally
happens that the blood sugar drops
below normal, and we have even seen
this in patients who had an
abnormally high blood sugar before
treatment. Such an attack of
hypoglycemia is almost identical
with the one seen in diabetics who
have taken too much insulin. The
attack comes on suddenly; there is
the same feeling of
light-headedness, weakness in the
knees, trembling, and unmotivated
sweating; but under HCG,
hypoglycemia does not produce any
feeling of hunger. All these
symptoms are almost instantly
relieved by taking two heaped
teaspoons of sugar.
In the course of treatment the
possibility of such an attack is
explained to those patients who are
in a phase in which a drop in blood
sugar may occur. They are instructed
to keep sugar or glucose sweets
handy, particularly when driving a
car. They are also told to watch the
effect of taking sugar very
carefully and report the following
day. This is important, because
anxious patients to whom such an
attack has been explained are apt to
take
sugar unnecessarily, in which case
it inevitably produces a gain in
weight and does not dramatically
relieve the symptoms for which it
was taken, proving that these were
not due to hypoglycemia. Some
patients mistake the effects of
emotional stress for hypoglycemia.
When the symptoms are quickly
relieved by sugar this is proof that
they were indeed due to an abnormal
lowering of the blood sugar, and in
that case there is no increase in
the weight on the following day. We
always suggest that sugar be taken
if the patient is in doubt.
Once such an attack has been
relieved with sugar we have never
seen it recur on the immediately
subsequent days, and only very
rarely does a patient have two such
attacks separated by several days
during a course of treatment. In
patients who have not eaten
sufficiently during the first two
days of treatment we sometimes give
sugar when the minor symptoms
usually felt during the first three
days of treatment continue beyond
that time, and in some cases this
has seemed to speed up the euphoria
ordinarily associated with the HCG
method.
The Ratio of Pounds To Inches
An interesting feature of the HCG
method is that, regardless of how
fat a patient is, the greatest
circumference - abdomen or hips as
the case may be is reduced at a
constant rate which is
extraordinarily close to 1 cm. per
kilogram of weight lost. At the
beginning of treatment the change in
measurements is somewhat greater
than this, but at the end of a
course it is almost invariably found
that the girth is as many
centimeters less as the number of
kilograms by which the weight has
been reduced. I have never seen this
clear cut relationship in patients
that try to reduce by dieting only.
Preparing the HCG Solution
Human chorionic gonadotrophin comes
on the market as a highly soluble
powder which is the pure substance
extracted from the urine of pregnant
women. Such preparations are
carefully standardized, and any
brand made by a reliable
pharmaceutical company is probably
as good as any other. The substance
should be extracted from the urine
and not from the placenta, and it
must of course be of human and not
of animal origin. The powder is
sealed in ampoules or in
rubber-capped bottles in varying
amounts which are stated in
International Units. In this form
HCG is stable; however, only such
preparations should be used that
have the date of manufacture and the
date of expiry clearly stated on the
label or package. A suitable solvent
is always supplied in a separate
ampoule in the same package.
Once HCG is in solution it is far
less stable. It may be kept at
room-temperature for two to three
days, but if the solution must be
kept longer it should always be
refrigerated. When treating only one
or two cases simultaneously, vials
containing a small number of units
say 1000 I.U. should be used. The 10
cc. of solvent which is supplied by
the manufacturer is injected into
the rubber- capped bottle containing
the HCG, and the powder must
dissolve instantly. Of this solution
1.25 cc. are withdrawn for each
injection. One such bottle of 1000
I.U. therefore furnishes 8
injections. When more than one
patient is being treated, they
should not each have their own
bottle but rather all be injected
from the same vial and a fresh
solution made when this is empty.
As we are usually treating a fair
number of patients at the same time,
we prefer to use vials containing
5000 units. With these the
manufactures also supply 10 cc. of
solvent. Of such a solution 0.25 cc.
contain the 125 I.U., which is the
standard dose
for all cases and which should never
be exceeded. This small amount is
awkward to handle accurately (it
requires an insulin syringe) and is
wasteful, because there is a loss of
solution in the nozzle of the
syringe and in the needle. We
therefore prefer a higher dilution,
which we prepare in the following
way: The solvent supplied is
injected into the rubbercapped
bottle containing the 5000 I.U . As
these bottles are too small to hold
more solvent, we withdraw 5 cc.,
inject it into an empty
rubber-capped bottle and add 5 cc.
of normal saline to each bottle.
This gives us 10 cc. of solution in
each bottle, and of this solution
0.5 cc. contains 125 I.U. This
amount is convenient to inject with
an ordinary syringe.
Injecting HCG
HCG produces little or no
tissue-reaction, it is completely
painless and in the many thousands
of injections we have given we have
never seen an inflammatory or
suppurative reaction at the site of
the injection.
One should avoid leaving a vacuum in
the bottle after preparing the
solution or after withdrawal of the
amount required for the injections
as otherwise alcohol used for
sterilizing a frequently perforated
rubber cap might be drawn into the
solution. When sharp needles are
used, it sometimes happens that a
little bit of rubber is punched out
of the rubber cap and can be seen as
a small black speck floating in the
solution. As these bits of rubber
are heavier than the solution they
rapidly settle out, and it is thus
easy to avoid drawing them into the
syringe.
We use very fine needles that are
two inches long and inject deep
intragluteally in the outer upper
quadrant of the buttocks. The
injection should if possible not be
given into the superficial fat
layers, which in very obese patients
must be compressed so as to enable
the needle to reach the muscle.
Obviously needles and syringes must
be carefully washed, sterilized and
handled aseptically. It is also
important that the daily injection
should be given at intervals as
close to 24 hours as possible. Any
attempt to economize in time by
giving larger doses at longer
intervals is doomed to produce less
satisfactory results.
There are hardly any
contraindications to the HCG method.
Treatment can be continued in the
presence of abscesses, suppuration,
large infected wounds and major
fractures. Surgery and general
anesthesia are no reason to stop and
we have given treatment during a
severe attack of malaria. Acne or
boils are no contraindication; the
former usually clears up, and
furunculosis comes to an end.
Thrombophlebitis is no
contraindication, and we have
treated several obese patients with
HCG and the 500 calorie diet while
suffering from this condition. Our
impression has been that in obese
patients the phlebitis does rather
better and certainly no worse than
under the usual treatment alone.
This also applies to patients
suffering from varicose ulcers which
tend to heal rapidly.
Fibroids
While uterine fibroids seem to be in
no way affected by HCG in the doses
we use, we have found that very
large, externally palpable uterine
myomas are apt to give trouble. We
are convinced that this is entirely
due to the rather sudden
disappearance of fat from the pelvic
bed upon which they rest and that it
is the weight of the tumor pressing
on the underlying tissues which
accounts for the discomfort or pain
which may arise during treatment.
While we disregard even fair-sized
or multiple myomas, we insist that
very large ones be operated before
treatment. We have had patients
present themselves for reducing fat
from their abdomen who showed no
signs of obesity, but had a
large abdominal tumor.
Gallstones
Small stones in the gall bladder may
in patients who have recently had
typical colics cause more frequent
colics under treatment with HCG.
This may be due to the almost
complete absence of fat from the
diet, which prevents the normal
emptying of the gall bladder. Before
undertaking treatment we explain to
such patients that there is a risk
of more frequent and possibly severe
symptoms and that it may become
necessary to operate. If they are
prepared to take this risk and
provided they agree to undergo an
operation if we consider this
imperative, we proceed with
treatment, as after weight reduction
with HCG the operative risk is
considerably reduced in an obese
patient. In such cases we always
give a drug which stimulates the
flow of bile, and in the majority of
cases nothing untoward happens. On
the other hand, we have looked for
and not found any evidence to
suggest that the HCG treatment leads
to the formation of gallstones as
pregnancy sometimes does.
The Heart
Disorders of the heart are not as a
rule contraindications. In fact, the
removal of abnormal fat -
particularly from the heart-muscle
and from the surrounding of the
coronary arteries - can only be
beneficial in cases of myocardial
weakness, and many such patients are
referred to us by cardiologists.
Within the first week of treatment
all patients - not only heart cases
- remark that they have lost much of
their breathlessness.
Coronary Occlusion
In obese patients who have recently
survived a coronary
occlusion, we adopt the following
procedure in collaboration with the
cardiologist. We wait until no
further electrocardiographic changes
have occurred for a period of three
months. Routine treatment is then
started under careful control and it
is usual to find a further
electrocardiographic improvement of
a condition which was previously
stationary.
In the thousands of cases we have
treated we have not once seen any
sort of coronary incident occur
during or shortly after treatment.
The same applies to cerebral
vascular accidents. Nor have we ever
seen a case of thrombosis of any
sort develop during treatment, even
though a high blood pressure is
rapidly lowered. In this respect,
too, the HCG treatment resembles
pregnancy.
Teeth and Vitamins
Patients whose teeth are in poor
repair sometimes get more trouble
under prolonged treatment, just as
may occur in pregnancy. In such
cases we do allow calcium and
vitamin D, though not in an oily
solution. The only other vitamin we
permit is vitamin C, which we use in
large doses combined with an
antihistamine at the onset of a
common cold. There is no objection
to the use of an antibiotic if this
is required, for instance by
the dentist. In cases of bronchial
asthma and hay fever we have
occasionally resorted to cortisone
during treatment and find that
triamcinolone is the least likely to
interfere with the loss of weight,
but many asthmatics improve with HCG
alone.
Alcohol
Obese heavy drinkers, even those
bordering on alcoholism, often do
surprisingly well under HCG and it
is exceptional for them to take a
drink while under treatment. When
they do, they find that a relatively
small quantity of alcohol produces
intoxication. Such patients say that
they do not feel the need to drink.
This may in part be due to the
euphoria which the treatment
produces and in part to the complete
absence of the need for quick
sustenance from which most obese
patients suffer.
Though we have had a few cases that
have continued abstinence long after
treatment, others relapse as soon as
they are back on a normal diet. We
have a few “regular customers” who,
having once been reduced to their
normal weight, start to drink again
though watching their weight. Then
after some months they purposely
overeat in order to gain sufficient
weight for another course of HCG
which temporarily gets them out of
their drinking routine. We do not
particularly welcome such cases, but
we see no reason for refusing their
request.
Tuberculosis
It is interesting that obese
patients suffering from inactive
pulmonary tuberculosis can be safely
treated. We have under very careful
control treated patients as early as
three months after they were
pronounced inactive and have never
seen a relapse occur during or
shortly after treatment. In fact, we
only have one case on our records in
which active tuberculosis developed
in a young man about one year after
a treatment which had lasted three
weeks. Earlier X-rays showed a
calcified spot from a childhood
infection which had not produced
clinical symptoms. There was a
family history of tuberculosis, and
his illness started under adverse
conditions which certainly had
nothing to do with the treatment.
Residual calcifications from an
early infection are exceedingly
common, and we never consider them a
contraindication to treatment.
The Painful Heel
In obese patients who have been
trying desperately to keep their
weight down by severe dieting, a
curious symptom sometimes occurs.
They complain of an unbearable pain
in their heels which they feel only
while standing or walking. As soon
as they take the weight off their
heels the pain ceases. These cases
are the bane of the rheumatologists
and orthopedic surgeons who have
treated them before they come to us.
All the usual investigations are
entirely negative, and there is not
the slightest response to anti-
rheumatic medication or
physiotherapy. The pain may be so
severe that the patients are obliged
to give up their occupation, and
they are not infrequently labeled as
a case of hysteria. When their heels
are carefully examined one finds
that the sole is softer than normal
and that the heel bone - the
calcaneus - can be distinctly felt,
which is not the case in a normal
foot.
We interpret the condition as a lack
of the hard fatty pad on which the
calcaneus rests and which protects
both the bone and the skin of the
sole from pressure. This fat is like
a springy cushion which carries the
weight of the body. Standing on a
heel in which this fat is missing or
reduced must obviously be very
painful. In their efforts to keep
their weight down these patients
have consumed this normal structural
fat.
Those patients who have a normal or
subnormal weight while showing the
typically obese fat deposits are
made to eat to capacity, often much
against their will, for one week.
They gain weight rapidly but there
is no improvement in the painful
heels. They are then started on the
routine HCG treatment. Overweight
patients are treated immediately. In
both cases the pain completely
disappears in 10-20 days of dieting,
usually around the 15th day of
treatment, and so far no case has
had a relapse though we have been
able to follow up such patients for
years.
We are particularly interested in
these cases, as they furnish further
proof of the contention that HCG
plus 500 calories not only removes
abnormal fat but actually permits
normal fat to be replaced, in spite
of the deficient food intake. It is
certainly not so that the mere loss
of weight reduces the pain, because
it frequently disappears before the
weight the patient had prior to the
period of forced feeding is reached.
The Skeptical Patient
Any doctor who starts using the HCG
method for the first time will have
considerable difficulty,
particularly if he himself is not
fully convinced, in making patients
believe that they will not feel
hungry on 500 calories and that
their face will not collapse. New
patients always anticipate the
phenomena they know so well from
previous treatments and diets and
are incredulous when told that these
will not occur. We overcome all this
by letting new patients spend a
little time in the waiting room with
older hands, who can always be
relied upon to allay these fears
with evangelistic zeal, often
demonstrating the finer points on
their own body.
A waiting-room filled with obese
patients who congregate daily is a
sort of group therapy. They compare
notes and pop back into the waiting
room after the consultation to
announce the score of the last 24
hours to an enthralled audience.
They cross-check on their diets and
sometimes confess sins which they
try to hide from us, usually with
the result that the patient in whom
they have confided palpitatingly
tattles the whole disgraceful story
to us with a “But don't let her know
I told you".
Concluding a Course
When the three days of dieting after
the last HCG injection are over, the
patients are told that they may now
eat anything they please, except
sugar and starch provided they
faithfully observe one simple rule.
This rule is that they must have
their own portable bathroom-scale
always at hand, particularly while
traveling. They must without fail
weigh themselves every morning as
they get out of bed, having first
emptied their bladder. If they are
in the habit of having breakfast in
bed, they must weigh before
breakfast.
It takes about 3 weeks before the
weight reached at the end of the
treatment becomes stable, i.e. does
not show violent fluctuations after
an occasional excess. During this
period patients must realize that
the so-called carbohydrates, that is
sugar, rice, bread, potatoes,
pastries, etc, are by far the most
dangerous. If no carbohydrates
whatsoever are eaten, fats can be
indulged in somewhat more liberally
and even small quantities of
alcohol, such as a glass of wine
with meals, does no harm, but as
soon as fats and starch are combined
things are very liable to get out of
hand. This has to be observed very
carefully during the first 3 weeks
after the treatment is ended
otherwise disappointments are almost
sure to occur.
Skipping a Meal
As long as their weight stays within
two pounds of the weight reached on
the day of the last injection,
patients should take no notice of
any increase but the moment the
scale goes beyond two pounds, even
if this is only a few ounces, they
must on that same day entirely skip
breakfast and lunch but take plenty
to drink. In the evening they must
eat a huge steak with only an apple
or a raw tomato. Of course this rule
applies only to the morning weight.
Ex-obese patients should never check
their weight during the day, as
there may be wide fluctuations and
these are merely alarming and
confusing.
It is of utmost importance that the
meal is skipped on the same day as
the scale registers an increase of
more than two pounds and that
missing the meals is not postponed
until the following day. If a meal
is skipped on the day in which a
gain is registered in the morning
this brings about an immediate drop
of often over a pound. But if the
skipping of the meal - and skipping
means literally skipping, not just
having a light meal - is postponed
the phenomenon does not occur and
several days of strict dieting may
be necessary to correct the
situation.
Most patients hardly ever need to
skip a meal. If they have eaten a
heavy lunch they feel no desire to
eat their dinner, and in this case
no increase takes place. If they
keep their weight at the point
reached at the end of the treatment,
even a heavy dinner does not bring
about an increase of two pounds on
the next morning and does not
therefore call for any special
measures. Most patients are
surprised how small their appetite
has become and yet how much they can
eat without gaining weight. They no
longer suffer from an abnormal
appetite and feel satisfied with
much less food than before. In fact,
they are usually disappointed that
they cannot manage their first
normal meal, which they have been
planning for weeks.
Losing more Weight
An ex-patient should never gain more
than two pounds without immediately
correcting this, but it is equally
undesirable that more than two lbs.
be lost after treatment, because a
greater loss is always achieved at
the expense of normal fat. Any
normal fat that is lost is
invariably regained as soon as more
food is taken, and it often happens
that this rebound overshoots the
upper two lbs. limit.
Trouble After Treatment
Two difficulties may be encountered
in the immediate post-treatment
period. When a patient has consumed
all his abnormal fat or, when after
a full course, the injection has
temporarily lost its efficacy owing
to the body having gradually evolved
a counter regulation, the patient at
once begins to feel much more hungry
and even weak. In spite of repeated
warnings, some over-enthusiastic
patients do not report this.
However, in about two days the fact
that they are being undernourished
becomes visible in their faces, and
treatment is then stopped at once.
In such cases - and only in such
cases - we allow a very slight
increase in the diet, such as an
extra apple, 150 grams of meat or
two or three extra breadsticks
during the three days of dieting
after the last HCG injection.
When abnormal fat is no longer being
put into circulation either because
it has been consumed or because
immunity has set in, this is always
felt by the patient as sudden,
intolerable and constant hunger. In
this sense, the HCG method is
completely self-limiting. With HCG
it is impossible to reduce a
patient, however enthusiastic,
beyond his normal weight. As soon as
no more abnormal fat is being
issued, the body starts consuming
normal fat, and this is always
regained as soon as ordinary feeding
is resumed. The patient then finds
that the 2-3 lbs. he has lost during
the last days of treatment are
immediately regained. A meal is
skipped and maybe a pound is lost.
The next day this pound is regained,
in spite of a careful watch over the
food intake. In a few days a tearful
patient is back in the consulting
room, convinced that her case is a
failure.
All that is happening is that the
essential fat lost at the end of the
treatment, owing to the patient's
reluctance to report a much greater
hunger, is being replaced. The
weight at which such a
patient must stabilize thus lies 2-3
lbs. higher than the weight reached
at the end of the treatment. Once
this higher basic level is
established, further difficulties in
controlling the weight at the new
point of stabilization hardly arise.
Beware of Over-Enthusiasm
The other trouble which is
frequently encountered immediately
after treatment is again due to
over-enthusiasm. Some patients
cannot believe that they can eat
fairly normally without regaining
weight. They disregard the advice to
eat anything they please except
sugar and starch and want to play
safe. They try more or less to
continue the 500 calorie diet on
which they felt so well during
treatment and make only minor
variations, such as replacing the
meat with an egg, cheese, or a glass
of milk. To their horror they find
that in spite of this bravura, their
weight goes up. So, following
instructions, they skip one meager
lunch and at night eat only a little
salad and drink a pot of unsweetened
tea, becoming increasingly hungry
and weak. The next morning they find
that they have increased yet another
pound. They feel terrible, and even
the dreaded swelling of their ankles
is back. Normally we check our
patients one week after they have
been eating freely, but these cases
return in a few days. Either their
eyes are filled with tears or they
angrily imply that when we told them
to eat normally we were just fooling
them.
Protein Deficiency
Here too, the explanation is quite
simple. During treatment the patient
has been only just above the verge
of protein deficiency and has had
the advantage of protein being fed
back
into his system from the breakdown
of fatty tissue. Once the treatment
is over there is no more HCG in the
body and this process no longer
takes place. Unless an adequate
amount of protein is eaten as soon
as the treatment is over, protein
deficiency is bound to develop, and
this inevitably causes the marked
retention of water known as hunger-
edema.
The treatment is very simple. The
patient is told to eat two eggs for
breakfast and a huge steak for lunch
and dinner followed by a large
helping of cheese and to phone
through the weight the next morning.
When these instructions are followed
a stunned voice is heard to report
that two lbs. have vanished
overnight, that the ankles are
normal but that sleep was disturbed,
owing to an extraordinary need to
pass large quantities of water. The
patient having learned this lesson
usually has no further trouble.
Relapses
As a general rule one can say that
60%-70% of our cases experience
little or no difficulty in holding
their weight permanently. Relapses
may be due to negligence in the
basic rule of daily weighing. Many
patients think that this is
unnecessary and that they can judge
any increase from the fit of their
clothes. Some do not carry their
scale with them on a journey as it
is cumbersome and takes a big bite
out of their luggage-allowance when
flying. This is a disastrous
mistake, because after a course of
HCG as much as 10 lbs. can be
regained without any noticeable
change in the fit of the clothes.
The reason for this is that after
treatment newly acquired fat is at
first evenly distributed and does
not show the former preference for
certain parts of the body.
Pregnancy or the menopause may annul
the effect of a previous treatment.
Women who take treatment during the
one
year after the last menstruation -
that is at the onset of the
menopause - do just as well as
others, but among them the relapse
rate is higher until the menopause
is fully established. The period of
one year after the last menstruation
applies only to women who are not
being treated with ovarian hormones.
If these are taken, the
pre-menopausal period may be
indefinitely prolonged.
Late teenage girls who suffer from
attacks of compulsive eating have by
far the worst record of all as far
as relapses are concerned.
Patients who have once taken the
treatment never seem to hesitate to
come back for another short course
as soon as they notice that their
weight is once again getting out of
hand. They come quite cheerfully and
hopefully, assured that they can be
helped again. Repeat courses are
often even more satisfactory than
the first treatment and have the
advantage, as do second courses,
that the patient already, knows that
he will feel comfortable throughout.
Plan of a Normal Course
250 I.U. of HCG daily (except during
menstruation) until 42 injections
have been given.
Until 3rd HCG injection forced feeding.
After 3rd HCG injection, 500 calorie
diet to be continued until 72 hours
after the last injection.
For the following 3 weeks, all foods
allowed except starch and sugar in
any form (careful with very sweet
fruit).
After 3 weeks, very gradually add
starch in small quantities, always
controlled by morning weighing.
CONCLUSION
The HCG plus diet method can bring
relief to every case of obesity, but
the method is not simple. It is very
time consuming and requires perfect
cooperation between physician and
patient. Each case must be handled
individually, and the physician must
have time to answer questions, allay
fears and remove misunderstandings.
He must also check the patient
daily. When something goes wrong he
must at once investigate until he
finds the reason for any gain that
may have occurred. In most cases it
is useless to hand the patient a
diet-sheet and let the nurse give
him a "shot".
The method involves a highly complex
bodily mechanism, and even though
our theory may be wrong the
physician must make himself some
sort of picture of what is actually
happening; otherwise he will not be
able to deal with such difficulties
as may arise during treatment.
I must beg those trying the method
for the first time to adhere very
strictly to the technique and the
interpretations here outlined and
thus treat a few hundred cases
before embarking on experiments of
their own, and until then refrain
from introducing innovations,
however thrilling they may seem. In
a new method, innovations or
departures from the original
technique can only be usefully
evaluated against a substantial
background of experience with what
is at the moment the orthodox
procedure.
I have tried to cover all the
problems that come to my mind. Yet a
bewildering array of new questions
keeps arising, and my
interpretations are still fluid. In
particular, I have never had an
opportunity of conducting the
laboratory investigations which are
so necessary for a theoretical
understanding of clinical
observations, and I can only hope
that those more fortunately placed
will in time be able to fill this
gap.
The problems of obesity are perhaps
not so dramatic as the problems of
cancer, or polio, but they often
cause life long suffering. How many
promising careers have been ruined
by excessive fat; how many lives
have been shortened. If some way
-however cumbersome - can be found
to cope effectively with this
universal problem of modern
civilized man, our world will be a
happier place for countless fellow
men and women.
GLOSSARY
ACNE - Common skin disease in
which pimples, often containing pus,
appear on face, neck and shoulders.
ACTH - Abbreviation for adrenocorticotrophic hormone. One of
the many hormones produced by the
anterior lobe of the pituitary
gland. ACTH controls the outer part,
rind or cortex of the adrenal
glands. When ACTH is injected it
dramatically relieves arthritic
pain, but it has many undesirable
side effects, among which is a
condition similar to severe obesity.
ACTH is now usually replaced by
cortisone.
ADRENALIN -
Hormone produced by
the inner part of the Adrenals.
Among many other functions,
adrenalin is concerned with blood
pressure, emotional stress, fear and
cold.
ADRENALS - Endocrine glands.
Small bodies situated atop the
kidneys and hence also known as
suprarenal glands. The adrenals have
an outer rind or cortex which
produces vitally important hormones,
among which are Cortisone similar
substances. The adrenal cortex is
controlled by ACTH. The inner part
of the adrenals, the medulla,
secretes adrenalin and is chiefly
controlled by the autonomous nervous
system.
ADRENOCORTEX -
See adrenals.
AMPHETAMINES
- Synthetic drugs
which reduce the awareness of hunger
and stimulate mental activity,
rendering sleep impossible. When
used for the latter two purposes
they are
dangerously habit-forming. They do
not diminish the body's need for
food, but merely suppress the
perception of that need. The
original drug was known as
Benzedrine, from which modern
variants such as Dexedrine, Dexamil,
and Preludin, etc., have been
derived. Amphetamines may help an
obese patient to prevent a further
increase in weight but are
unsatisfactory for reducing, as they
do not cure the underlying disorder
and as their prolonged use may lead
to malnutrition and addiction.
ARTERIOSCLEROSIS
- Hardening of
the arterial wall through the
calcification of abnormal deposits
of a fatlike substance known as
cholesterol.
ASCHHIEIM-ZONDEK
- Authors of a
test by which early pregnancy can be
diagnosed by injecting a woman's
urine into female mice. The HCG
present in pregnancy urine produces
certain changes in the vagina of
these animals. Many similar tests,
using other animals such as rabbits,
frogs, etc. have been devised.
ASSIMILATE
- Absorb digested
food from the intestines.
AUTONOMOUS
- Here used to
describe the independent or
vegetative nervous system which
manages the automatic regulations of
the body.
BASAL METABOLISM
- The body's
chemical turnover at complete rest
and when fasting. The basal
metabolic rate is expressed as the
amount of oxygen used up in a given
time. The basal metabolic rate (BMR)
is controlled by the thyroid gland.
CALORIE - The physicist's
calorie is the amount of heat
required to raise the temperature of
1 cc. of water by 1 degree
Centigrade. The dietician's Calorie
(always written with a
capital C) is 1000 times greater.
Thus when we speak of a 500 Calorie
diet this means that the body is
being supplied with as much fuel as
would be required to raise the
temperature of 500 liters of water
by 1 degree Centigrade or 50 liters
by 10 degrees. This is quite
insufficient to cover the heat and
energy requirements of an adult
body. In the HCG method the deficit
is made up from the abnormal
fat-deposits, of which 1 lb.
furnishes the body with more than
2000 Calories. As this is roughly
the amount lost every day, a patient
under HCG is never short of fuel.
CEREBRAL
- Of the brain.
Cerebral vascular disease is a
disorder concerning the blood
vessels of the brain, such as
cerebral thrombosis or hemorrhage,
known as apoplexy or stroke.
CHOLESTEROL
- A fatlike
substance contained in almost every
cell of the body. In the blood it
exists in two forms, known as free
and esterified. The latter form is
under certain conditions deposited
in the inner lining of the arteries
(see arteriosclerosis). No clear and
definite relationship between fat
intake and cholesterol-level in the
blood has yet been established.
CHORIONIC
- Of the chorion,
which is part of the placenta or
after-birth. The term chorionic is
justly applied to HCG, as this
hormone is exclusively produced in
the placenta, from where it enters
the human mother's blood and is
later excreted in her urine.
COMPULSIVE EATING
- A form of
oral gratification with which a
repressed sex-instinct is sometimes
vicariously relieved. Compulsive
eating must not be confused with the
real hunger from which most obese
patients suffer.
CONGENITAL
- Any condition which
exists at or before birth.
CORONARY ARTERIES
- Two blood
vessels which encircle the heart and
supply all the blood required by the
heart-muscle.
CORPUS LUTEUM
- A yellow body
which forms in the ovary at the
follicle from which an egg has been
detached. This body acts as an
endocrine gland and plays an
important role in menstruation and
pregnancy. Its secretion is one of
the sex hormones, and it is
stimulated by another hormone known
as LSH, which stands for luteum
stimulating hormones. LSH is
produced in the anterior lobe of the
pituitary gland. LSH is truly
gonadotrophic and must never be
confused with HCG, which is a
totally different substance, having
no direct action on the corpus
luteum.
CORTEX
- Outer covering or rind.
The term is applied to the outer
part of the adrenals but is also
used to describe the gray matter
which covers the white matter of the
brain.
CORTISONE
- A synthetic
substance which acts like an adrenal
hormone. It is today used in the
treatment of a large number of
illnesses, and several chemical
variants have been produced, among
which are prednisone and triamcinolone.
CUSHING
- A great American brain
surgeon who described a condition of
extreme obesity associated with
symptoms of adrenal disorder.
Cushing's Syndrome may be caused by
organic disease of the pituitary or
the adrenal glands but, as was later
discovered, it also occurs as a
result of excessive ACTH medication.
DIENCEPHALON
- A primitive and
hence very old part of the brain
which lies between and under the two
large hemispheres. In man the diencephalon (or hypothalamus) is
subordinate to the higher brain or
cortex, and yet it ultimately
controls all that happens inside the
body. It regulates all the endocrine
glands, the autonomous nervous
system, the turnover of fat and
sugar. It seems also to be the seat
of the primitive animal instincts
and is the relay station at which
emotions are translated into bodily
reactions.
DIURETIC
- Any substance that
increases the flow of urine.
DYSFUNCTION
- Abnormal
functioning of any organ, be this
excessive, deficient or in any way
altered.
EDEMA
- An abnormal accumulation
of water in the tissues.
ELECTROCARDIOGRAM
- Tracing of
electric phenomena taking place in
the heart during each beat. The
tracing provides information about
the condition and working of the
heart which is not otherwise
obtainable.
ENDOCRINE
- We distinguish
endocrine and exocrine glands. The
former produce hormones, chemical
regulators, which they secrete
directly into the blood circulation
in the gland and from where they are
carried all over the body. Examples
of endocrine glands are the
pituitary, the thyroid and the
adrenals. Exocrine glands produce a
visible secretion such as saliva,
sweat, urine. There are also glands
which are endocrine and exocrine.
Examples are the testicles, the
prostate and the pancreas, which
produces the hormone insulin and
digestive ferments which flow from
the gland into the intestinal tract.
Endocrine glands are closely inter
dependent of each other, they are
linked to the
autonomous nervous system and the
diencephalon presides over this
whole incredibly complex regulatory
system.
EMACIATED
- Grossly
undernourished.
EUPHORIA
- A feeling of
particular physical and mental well
being.
FERAL
- Wild, unrestrained.
FIBROID
- Any benign new growth
of connective tissue. When such a
tumor originates from a muscle, it
is known as a myoma. The most common
seat of myomas is the uterus.
FOLLICLE
- Any small bodily cyst
or sac containing a liquid. Here the
term applies to the ovarian cyst in
which the egg is formed. The egg is
expelled when a ripe follicle bursts
and this is known as ovulation (see
corpus luteurn).
FSH
- Abbreviation for
follicle-stimulating hormone. FSH is
another (see corpus luteum) anterior
pituitary hormone which acts
directly on the ovarian follicle and
is therefore correctly called a
gonadotrophin.
GLANDS
- See endocrine.
GONADOTROPHIN
- See corpus luteum, follicle and FSH.
Gonadotrophic literally means sex
gland-directed. FSH, LSH and the
equivalent hormones in the male, all
produced in the anterior lobe of the
pituitary gland, are true
gonadotrophins. Unfortunately and
confusingly, the term gonadotrophin
has also been applied to the
placental hormone of pregnancy known
as human chorionic gonadotrophin (HCG).
This hormone acts on the
diencephalon and can only indirectly
influence the sex-glands via the
anterior lobe of the pituitary.
HCG
- Abbreviation for
human chorionic gonadotrophin
HORMONES
- See endocrine.
HYPERTENSION
- High blood
pressure.
HYPOGLYCEMIA
- A condition in
which the blood sugar is below
normal. It can be relieved by eating
sugar.
HYPOPHYSIS
- Another name for
the pituitary gland.
HYPOTHESIS
- A tentative
explanation or speculation on how
observed facts and isolated
scientific data can be brought into
an intellectually satisfying
relationship of cause and effect.
Hypotheses are useful for directing
further research, but they are not
necessarily an exposition of what is
believed to be the truth. Before a
hypothesis can advance to the
dignity of a theory or a law, it
must be confirmed by all future
research. As soon as research turns
up data which no longer fit the
hypothesis, it is immediately
abandoned for a better one.
LSH
- See corpus luteum.
METABOLISM
- See basal
metabolism.
MIGRAINE
- Severe half-sided
headache often associated with
vomiting.
MUCOID
- Slime-like.
MYOCARDIUM
- The heart-muscle.
MYOMA
- See fibroid.
MYXEDEMA
- Accumulation of a mucoid substance in the tissues
which occurs in cases of severe
primary thyroid deficiency.
NEOLITHIC
- In the history of
human culture we distinguish the
Early Stone Age or Paleolithic, the
Middle Stone Age or Mesolithic and
the New Stone Age or Neolithic
period. The Neolithic period started
about 8000 years ago when the first
attempts at agriculture, pottery and
animal domestication made at the end
of the Mesolithic period suddenly
began to develop rapidly along the
road that led to modern
civilization.
NORMAL SALINE
- A low
concentration of salt in water equal
to the salinity of body fluids.
PHLEBITIS
- An inflammation of
the veins. When a blood-clot forms
at the site of the inflammation, we
speak of thrombophlebitis.
PITUITARY
- A very complex
endocrine gland which lies at the
base of the skull, consisting
chiefly of an anterior and a
posterior lobe. The pituitary is
controlled by the diencephalon,
which regulates the anterior lobe by
means of hormones which reach it
through small blood vessels. The
posterior lobe is controlled by
nerves which run from the
diencephalon into this part of the
gland. The anterior lobe secretes
many hormones, among which are those
that regulate other glands such as
the thyroid, the adrenals and the
sex glands.
PLACENTA
- The after-birth. In
women, a large and highly complex
organ through which the child in the
womb receives its nourishment from
the mother's body. It is the organ
in which HCG is manufactured and
then given off into the mother's
blood.
PROTEIN
- The living substance
in plant and animal cells.
Herbivorous animals can thrive on
plant protein alone, but
man must have some protein of animal
origin (milk, eggs or flesh) to live
healthily. When insufficient protein
is eaten, the body retains water.
PSORIASIS
- A skin disease which
produces scaly patches. These tend
to disappear during pregnancy and
during the treatment of obesity by
the HCG method.
RENAL
- Of the kidney.
RESERPINE
- An Indian drug
extensively used in the treatment of
high blood pressure and some forms
of mental disorder.
RETENTION ENEMA
- The slow
infusion of a liquid into the
rectum, from where it is absorbed
and not evacuated.
SACRUM
- A fusion of the lower
vertebrate into the large bony mass
to which the pelvis is attached.
SEDIMENTATION RATE
- The speed
at which a suspension of red blood
cells settles out. A rapid settling
out is called a high sedimentation
rate and may be indicative of a
large number of bodily disorders of
pregnancy.
SEXUAL SELECTION
- A sexual
preference for individuals which
show certain traits. If this
preference or selection goes on
generation after generation, more
and more individuals showing the
trait will appear among the general
population. The natural environment
has little or nothing to do with
this process. Sexual selection
therefore differs from natural
selection, to which modern man is no
longer subject because he changes
his environment rather than let the
environment change him.
STRIATION
- Tearing of the lower
layers of the skin owing to rapid
stretching in obesity or during
pregnancy. When first formed striae
are dark reddish lines which later
change into white scars.
SUPRARENAL GLANDS
- See
adrenals.
SYNDROME
- A group of symptoms
which in their association are
characteristic of a particular
disorder.
THROMBOPHLEBITIS
- See
phlebitis.
THROMBUS
- A blood-clot in a
blood-vessel.
TRIAMCINOLONE
- A modern
derivative of cortisone.
URIC ACID
- A product of
incomplete protein-breakdown or
utilization in the body. When uric
acid becomes deposited in the
gristle of the joints we speak of
gout.
VARICOSE ULCERS
- Chronic
ulceration above the ankles due to
varicose veins which interfere with
the normal blood circulation in the
affected areas.
VEGETATIVE
- See autonomous.
VERTEBRATE
- Any animal that has
a back-bone.
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