Sept. 30, 2009 12:00

Weighing the pros and cons: A look into the HCG diet craze


The waiting area is filled nearly to capacity. Deep blue wallpapered walls surround the small room. The inhabitants of the chairs all sit quietly, only disturbing the silence with occasional flips of magazine pages. A nurse opens a door to the left and calls a name and an empty chair finally opens up, only to be filled a few moments later.

It’s not the waiting room of your local family doctor’s office flooded with patients waiting for a flu shot, but the waiting room of the Weight Loss and Wellness Clinic office in Clemmons and it functions like a well-oiled machine. Patients move from nurse to physcian to pharmacist all in one visit, and can purchase everything from their doctor’s visit for the day (which isn’t covered by insurance providers) to high-protein, doctor-approved snack bars.

This weight-loss clinic offers HCG (Human Chorionic Gonadotropin) injections and diet program first introduced by Dr. Albert T. Simeons over 50 years ago.

While the US Food and Drug Administration has only approved the HCG injections as a fertility drug, it is still legal to use the hormone for weight loss based on off-label usage laws.

“The FDA approval for HCG use is for an extremely high dose and is given in a muscular injection which has significant risks. We use 35 units versus 5,000 units in a safer delivery form,” Dr. Michael P. Girouard, owner of the Weight Loss and Wellness Clinics, said.

Dr. Girouard says that the HCG injections are effective on 80 percent of his patients. He believes that the HCG is allowing the breakdown of the triglycerides in fat cells and allowing the fat to release from the cells and be metabolized.

Today Dr. Girouard offers his version of the program to his weight-loss patients in all three of his office locations and is enjoying great success as his patient roster continues to grow and word of his practice spreads. However, there are still skeptics that say there are flaws and obvious explanations as to why this is not the next miracle weight-loss solution.

“I don’t think the HCG is approved or effective in and of itself but you follow the diet they give and you’re going to lose weight on that,” Dr. Steve Bissette, a physician at Maplewood Family Practice in Winston-Salem, said. “You’re going to lose a pound a week on that kind of calorie count, if not more.”

Dr. Girouard’s weight-loss plan features a rotating diet of 600 to 800 calories a day for two weeks followed by a week of 1,000 to 1,200 calories a day with protein calories not counting towards your daily total. This diet is high in protein and stresses that patients partake in minimal amounts of carbohydrates, starches and fatty foods and liquids, especially alcohol.

Dr. Girouard says that over half of his patients start the program with a diet that he calls the Casey diet. It is named after one of his former patients who lost 70 pounds in two months. The diet consists of a protein shake for breakfast, a diet-frozen dinner for lunch and dinner and a piece of fruit or sugar-free Jell-O before bed.

Dr. Girouard says that patients are discouraged from consuming excess amounts of milk because of its estrone content, bananas because of an enzyme that prevents the body from losing fat, high-calorie fruits like raisins, grapes and figs and foods with high oil content like olives and avocadoes. He also advises patients to stay completely away from sugary liquids like sweet tea and soft drinks.

“I tell my patients, ‘Don’t waste your calories on your liquids because they will leave your system quickly, go have two Krispy Kremes instead of those two Coca-Colas because those are going to last you longer,’” Girouard said.

The appetite suppressant Phentermine is prescribed to be taken no more than once daily at a maximum of 75 milligrams and the optional 35 to 70 units a week of HCG injections are prescribed to be used anywhere from once a week to twice a week based upon the patient’s individual results and desires. The injections are provided in a month’s supply and can be administered by the patient at home or the patient can go to the clinic and have a physician administer the shot.

The Phentermine is prescribed to fight off the stings of hunger while on the very restrictive diet. Dr. Girouard believes that the drug helps patients to change their eating habits “Appetite suppressants are like an anesthetic agent; they take away the pain of hunger.” Dr. Girouard said. “If you can keep away the pain of hunger then you can get people eating smaller portions of food and making different choices of food comfortably.”

The appetite suppressant is used for four consecutive months with a month off as suggested by the FDA. Dr. Girouard says that most of his patients experience a small weight gain during this time.

One difference between Dr. Girouard’s weight-loss clinic and some others is that he doesn’t require his patients to get a full blood workup before starting the diet and medications.

“There is nothing in a blood workup that would change my treatment, diagnosis or outcome so why would I charge her the extra money?” Dr. Girouard said. “Blood work looks good but it’s not necessary so there’s no reason for me to pad my billfold by doing something that’s unnecessary.”

Dr. Bissette feels that a blood workup is a good step to take before starting a program like the HCG diet as well as making sure your family doctor is informed that you’re starting on the program.


According to, in 1954 Dr. Simeons published a report stating that HCG, a hormone found in the urine of pregnant women, could be used to aid in weight loss. Dr. Simeons believed that patients could be placed on a 500-calorie daily diet while receiving the HCG injections and feel better and less hungry than someone who went on the diet without the injections.

Since Dr. Simeon’s proposal, scientists continue to conduct surveys to determine whether his findings are in fact valid.

A study done by the American Journal of Clinical Nutrition in 1973 reported that when two groups placed on a 500-calorie diet, the group receiving the HCG injections “lost significantly more weight, had a significantly greater mean weight loss per injection and lost a significantly greater mean percentage of their starting weight.” The HCG patients were also found to experience little or no hunger and felt good to excellent while on the diet.

A study conducted by the Journal of the American Medical Association found that “there was no statistically significant difference between those receiving HCG versus placebo during any phase of the study.

Most research and scientific studies have concluded that there is no scientific link between the HCG injections and weight loss, that the injections create a more attractive or proportionate distribution of fat or that they decrease the feeling of hunger when paired with a low calorie diet.

Several patients would beg to differ.


Cassie M. Spencer has been struggling with her weight for most of her life. Her main goal in a weight-loss program was to become healthier as she dropped the pounds.

“I have tried the Atkins diet, cutting calories, eating healthier and exercising and none of it worked,” Spencer said. “I would always lose five pounds and then gain it back.”

While working as a registered nurse in the emergency department of Wake Forest University Baptist Medical Center Spencer heard success stories about the HCG weight loss plan from her coworkers. She started Dr. Girouard’s program at the beginning of April this year.

“I have to eat a high-protein and low-calorie diet, exercise at least three to four times a week and watch my sugar and caffeine intake,” Spencer said.

Since starting the diet Spencer has dropped from a size 14 to a size six and she has lost 30 pounds. She says that over the past six months she has experienced no side effects and even managed to lose weight during her month off from the program, something that is uncommon among most of the program’s patients.

Spencer has stopped taking the appetite suppressant and is now maintaining her diet and exercise and continuing with the HCG injections, which she also plans to stop taking at the end of October.

“I just want to maintain my weight loss, stay healthy and active once I go off the diet,” Spencer said.


Nicole Sizemore started the weight loss plan with Dr. Darryl B. Rhyne in February this year after experiencing mediocre to no results with programs like GNC and Weight Watchers. She heard about the diet from her friends and co-workers who were already seeing results.


Once patients cease the appetite suppressants and HCG injections and go back to a typical calorie intake they tend to start gaining weight once more. The hope of the weight loss doctors is to have treated the patient’s eating habits long enough that they can make healthier choices and maintain their weight loss with minimal weight gain after the program. However, if the patient starts packing on the pounds once more, the clinics are there to start them back on the program and remove them once more.


The Sept. 16 cover story, “Secrets of the trade: The business of elections in Greensboro,” erroneously stated the district seat sought by Greensboro City Council candidate Jim Kee. In fact, Kee is running for the District 2 seat. We regret the error.

Left: Dr. Girouard in Winston-Salem offers the HCG program. Inset: Dr. Steve Bissette believes that the HCG weight loss plan is effective only because of the low-calorie diet and that the injections create a placebo effect.

Costs of the diet: For Dr. Girouards office: First visit: $140-$160 (which includes office visit, a month supply of appetite suppressants and one month of injections) Injections: $10 a piece Four week follow-up visits: $105-$120

Also in From The Cover

Also from Lindsay Craven