This Informed Consent Form is intended to give fair notice of the requirements of clients seeking to participate in the HCG Diet Program at office affiliate that DBA OPTIONS MEDICAL WEIGHT LOSS, to fully disclose any risks associated with participation in the HCG Diet program, and to obtain written “Informed Consent” from the client to undergo treatment by health care professionals associated with the above stated clinics.
History of HCG for Weight Loss
Although the HCG diet has gained popularity in the past few years, the HCG diet dates to the 1950s. Columbia University explains that British doctor Albert T. Simeons was the first medical physician to experiment with HCG for dieting purposes. {1} Papers on the Simeons therapy have been published regularly since 1954. The Simeons therapy is a slimming therapy in which the patient, over a period of 3.5 to 6 weeks, keeps to a fat-free diet of 500 kilo-calories (kcal) day, as prescribed by Simeons. At the same time the patient receives daily an intramuscular injection of 125 International Units (iu) of human chorionic gonadotropin (HCG HCG is a hormone that occurs in the body in large quantities during pregnancy. It is obtained from the urine of pregnant women and is used to make a drug for the treatment of certain infertility problems Simeons developed the therapy on the basis of his experience of using HCG to treat young boys suffering from (Dystrophia adiposito- genitalis It is claimed that overweight patients who follow the Simeons therapy will a) lose weight quickly, b) not feel weak, c) not be hungry, and d) lose fat from those parts of the body where it tends to remain longest during normal dieting (i.e. stomach, hips, thighs, upper arms
The American FDA Requires the Following Disclaimer
“HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or ‘normal’ distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets”;
Allergic Responses and Important Information
{2} You should not use this medication if you have ever had an allergic reaction to HCG, or if you have:
- Early puberty (also called precocious puberty); or a hormone-related cancer (such as prostate cancer Before receiving HCG tell your doctor if you are allergic to any drugs or if you have:
- a thyroid or adrenal gland disorder;
- an ovarian cyst;
- premature puberty;
- cancer or a tumor of the breast, ovary, uterus, prostate, hypothalamus, or pituitary gland;
- undiagnosed uterine bleeding;
- heart disease;
- kidney disease;
- epilepsy;
- migraines; or
- asthma.
If you have any of these conditions, you may need a dose adjustment or special tests to safely use HCG.
{1} BR J Clin Pharmacol 1995; 40: 237-243 {2}Reference {https://www.drugs.com/hcg.html}