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Dieters take a jab at fat with injections for weight loss

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Dr. Jyotindra Shah gives a weight-loss patient a lipotropic vitamin shot at Amari, his Scarsdale, N.Y., wellness clinic. He also offers hCG shots and drops. (Photograph by Alexandra Horowitz)

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Dr. Jyotindra Shah uses injectable hCG (center), sublingual hCG drops (left) and lipotropic vitamin shots (right) at Amari, his Scarsdale, N.Y., wellness clinic. (Photograph by Alexandra Horowitz)

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Dr. Jyotindra Shah uses injectable hCG (center), sublingual hCG drops (left) and lipotropic vitamin shots (right) at Amari, his Scarsdale, N.Y., wellness clinic. (Photograph by Alexandra Horowitz)

Almost every morning last month, Leigh Cordiner, a Floridian living in the U.S. Virgin Islands, stuck a syringe into her thigh muscle and injected herself with a hormone extracted from a pregnant woman’s urine.

And so far, she said, it’s helped her lose 15 of the 25 pounds she’s hoping to shed.

She’s using a small dose of human Chorionic Gonadotropin, hCG, which pregnant women’s placentas produce to stimulate progesterone production. It’s the hormone detected in a pregnancy test, and its medicinal uses, as far as the Food and Drug Administration is concerned, are infertility treatments and testosterone stimulation in men.

But for $450, a Lake Mary, Fla., wellness clinic sold her 18 syringes and a supply of hCG to take at home as a weight loss supplement, an off-label use of the substance. Cordiner and other patients who use it then stick to a specific 500-calorie diet. Tthey say the hCG gives them energy and controls their hunger.

“Yeah, it’s a little weird,” said Cordiner, 48, who doesn’t think she could maintain the restrictive diet without hCG. “I’m not completely comfortable with it. But, you know, I’m comfortable enough to inject it into myself.”

Cordiner’s diet, which was first popular in the 1960s and 1970s, was developed in the 1950s by British doctor Albert T. Simeons and includes daily hCG injections. After years of obscurity, however, the plan has become popular again, thanks mostly to Kevin Trudeau’s 2007 book, “The Weight Loss Cure ‘They’ Don’t Want You To Know About,” a controversial diet book based on Simeons’ work that appeared on every major bestseller list last year.

Word of mouth has added to the diet’s buzz.

“I’m getting thousands of calls a day now,” said Noka Nolan, owner of Native Healing Ways, a chain of hCG weight loss clinics in Tennessee and South Carolina. “I’ve got people coming down from everywhere.”

Business is so good, said Nolan, 66, that she opened a location in Greer, S.C., as a business for her granddaughter, Natasha Highlander.

Sales of hCG “are off the roof,” said Pharmacist in Charge of Central Drugs Compounding Pharmacy Nayan Patel.

The company that makes the preparation he distributes, Abraxis Pharmaceutical Products, is “always on a back-order, but I have to keep it in stock at all times,” he said.

Highlander said the company she orders hCG from, Ferring Pharmaceuticals, put a hold on sales last year.

Both APP and Ferring declined to comment, although both said using hCG for weight loss is off-label.

Yet, even with demand so high, doctors aren’t eager to make noise about prescribing hCG. Some weight loss clinics are hostile to media coverage. Several hung up on a reporter, and one doctor said he did not prescribe hCG for weight loss despite the advertisements for it on his clinic’s Web site.

“The use of hCG is at best controversial,” said Dr. Michael Steelman, past chairman of the American Society of Bariatric Physicians and who practices in Oklahoma City. Doctors, he said, “should be very reluctant to try it” without knowledge of the very-low-calorie diets that accompany the program of shots because they can have “significant metabolic consequences.”

No peer-reviewed study on the effectiveness of hCG for weight loss has shown it to be effective, and the Federal Trade Commission has taken court action against Trudeau for misrepresenting his diet on TV. He has also been convicted of credit card fraud and larceny in an unrelated case.

And how the substance is supposed to work is shrouded in mystery: Simeons claimed hCG worked by changing the hypothalamus’s activity to regulate hunger and redistribute fat stores more attractively, but one clinic contacted said it worked by burning an extra 2,000 calories a day and another said it cleansed the liver.

But some in the medical community think hCG is worthless as a diet aid.

“hCG is never the right choice, and if it were up to me I would take away the license of anyone who prescribes it on the basis of bad judgment,” said Dr. Stephen Barrett, a retired Pennsylvania psychiatrist who runs the consumer health advocacy sites Quackwatch.com and Dietscam.org. “If something hasn’t been demonstrated to work, how ethical is it to try to commercialize it and capitalize it?”

But customers are buying more than hCG in weight loss clinics and online. Lipotropic injections--doses of B12, B100 and other vitamins--promise to give dieters more dieting stamina. Nolan and Highlander, who say the shots give patients energy boosts and healthier livers, include them as part of every diet package they sell.

“More people are asking” for the lipotropic shots,” said Dr. Jyotindra Shah, who runs a weight loss clinic in Scarsdale, N.Y. He said more pharmacies are trying to sell it to him now than five years ago, and that, based on patients he has observed, he believes it enhances fat loss. “I got good results, so I continue using it,” he said. Like hCG, lipotropic shots are not approved by the FDA for weight loss.

Shah is also sending patients home with Releana, a new sublingual form of hCG patients hold under their tongues for several minutes instead of injecting. He hasn’t seen any evidence that hCG would help women lose weight, he said, but he’s “trying it out” anyway.

Steelman said the substances aren’t inherently dangerous in most people, and their effectiveness may just be placebo effect. “As somebody once said, it’s fine to use a placebo as long as you use one that works,’” he said.

For Cordiner, hCG has been a “wonder drug” that she said “helps you help yourself” lose weight. She said she intends to use Weight Watchers to maintain her weight loss.

But some supplement-friendly dieters draw the line at trying hCG. “I could not restrict myself to that level no matter what I’m injecting,” said Lisa Shannon, 30, of Brooklyn, N.Y. She’s at a plateau in her diet, she said, “but I’m not calling my doctor saying, ‘give me hCG!’”

Shannon found sustaining weight loss was impossible without realistic lifestyle changes. “You didn’t get fat overnight,” she said. Losing weight “takes effort. Anything worth doing takes effort.”

E-mail: alh2146@columbia.edu