Medicine: Fat Faddists, Beware

If sales of diet books and enrollment in weight-loss programs are any indication, most of the more than 70 million Americans who are overweight are trying to slim down. But, the American Medical Association warns, weight-watchers should reduce with care. According to the A.M.A., two currently popular quick-loss plans offer more risks than lasting rewards.

One of the A.M.A.’s concerns is the treatment offered by Simeons Weight Clinics, a chain of “fat clubs” with branches throughout the U.S. The A.M.A. notes that Simeons clients are placed on a diet of 500 calories a day for 42 to 60 days. They are also given injections of a substance called human chorionic gonadotropin (HCG), which is extracted from the urine of pregnant women. The regimen’s proponents claim that HCG helps patients stick to their diets and burn up fats better.

Most of the patients who go through this routine do lose weight. But a commentary in the A.M.A. Journal notes that there is no evidence that HCG has any specific effect on fat metabolism or plays any special role in weight reduction. Furthermore, too much HCG may cause such unpleasant side effects as headache, restlessness and depression.

Any weight loss, the Journal states, is a result of the near-starvation diet, which can lead to a substantial and possibly hazardous protein loss.

The other fat fad to incur the displeasure of the A.M.A. is “staplepuncture,” which is based on the theory — so far unconfirmed — that there are “obesity nerve endings” in the ear. Doctors who practice the art place surgical staples in their patients’ ears and instruct them to wiggle the metal clips with their fingers whenever they feel like cheating on the 400-calorie-per-day diet that accompanies the treatment.

Deficient Diet. Dr. Robert Moser, editor of the A.M.A. Journal, does not doubt that staplepuncture patients are able to shed some poundage. But he rejects the idea that beyond serving as a reminder to those who are already well-motivated to reduce, the staples play a part in the loss. Instead, he attributes any reduction in weight to what he considers a dangerously deficient diet. But he admits that the staples do have at least one observable medical effect on some patients. They often cause ear infections.