It's a familiar story. She tried over and over to lose weight. Sometimes she succeeded, but it always came back.
And it seemed so unfair because she didn't want to get as skinny as a supermodel, just a healthy weight, 145 or 150 pounds.
Then Patti Dingler found the HCG Diet. She eats only 500 calories a day, and she and her husband have bumped up their walking regimen to five miles daily near their home in Wise County, Texas. Definitely a recipe for weight loss.
She shed 25 pounds in her first 30 days on the diet.
And after just the first week, "I felt 10 years younger," says Patti, 49, a contract specialist in the Federal Aviation Administration's Fort Worth office. "I had energy, and I breathed easier."
Most diet regimens allow about 1,200 calories a day for the average woman. Patti's getting far less. So how is she staving off hunger and fatigue?
Once or twice a day, she puts several drops of a nearly flavorless liquid under her tongue. She says it keeps her feeling good, mostly, although about one day in seven she is more tired than normal.
The important ingredient in those drops is a nonprescription, homeopathic form of HCG, or human chorionic gonadotropin. Naturally occurring HCG is a hormone that is produced in quantity during pregnancy. It's made by cells that form the placenta, which nourishes a fertilized egg after it attaches to the wall of the uterus.
Patti's form of HCG is the homeopathic, or "look-alike" version. Some people following the HCG diet use the actual hormone, prescribed by a doctor and injected with a syringe every day. Either way, plenty of people are willing to call HCG a godsend.
HCG for weight loss isn't new; it was first popularized in the 1950s by British physician Albert Simeons and enjoyed a resurgence in the '70s.
But lately it has made a huge comeback. It's on the Internet, billboards, TV and fliers you find on the windshield after you grab a pizza.
Patti's husband, Wes Dingler, is a believer. After some hesitation, he went on the diet, too.
"It was time for drastic measures," says Wes, a 45-year-old avionics manager. His doctor warned him that he was in danger of developing adult-onset diabetes. "I was on double cholesterol meds. The doctor said that on my next visit, if my blood sugar's still high, I'll have to go on insulin."
He started at 241 pounds and wants to get down to 175 pounds on his 5-foot-11 frame. "I'm dropping about a pound a day, 33 pounds already," he says.
The diet lays out a maintenance plan for the six weeks after discontinuing HCG. The dos and don'ts are similar to the 500-calorie diet: no processed foods, no starches or sugars, about 1,500 calories daily consisting mainly of fruit, vegetables, fish and chicken.
Wes and Patti like the idea that they'll keep eating healthy after they stop taking HCG. In fact, they like everything about the HCG diet.
Mainstream medicine has an entirely different view.
Most doctors' and dietitians' views can be summed up in three phrases: placebo, peril and put-it-back-on.
"I don't believe it to be efficacious. Either shots or drops, it's a placebo," says Craig Primack, a weight-loss doctor in Phoenix and a spokesman for the American Society of Bariatric Physicians. "Not many doctors commonly known as weight-loss doctors are using this."
The 500-calorie diet doesn't provide enough carbs or protein and will send the body into a state called ketosis. Ketosis is a natural appetite suppressant, Primack says, so he believes that is what banishes hunger, rather than HCG.
In ketosis, the body burns stored fat, but if it's extreme, it can lead to problems. The blood pH can change, making blood too acidic and essentially corrosive to internal organs.
"The short-term ketosis problem is bad breath," says Keri Gans, registered dietitian and spokesman for the American Dietetic Association. "Over an extended period, kidney stones and gallstones are common side effects, and also fatigue."
Injectable HCG is FDA-approved for some uses, but not for weight loss.
It was first used in the 1950s to boost testosterone production in boys who should be entering puberty but weren't, says Primack. It's also sometimes used to treat infertility and some cancers in men.
Doctors can legally prescribe a substance such as HCG for "off-label" use, such as weight loss, Primack says. Kenneth J. Heinrich, an ASBP spokesman and medical director of Physicians for Weight Loss in Chicago, says he knows of no obstetrician-gynecologists who recommend the homeopathic drops.
There's also controversy about just how dangerous off-label HCG injections can be, Heinrich says. "There are life-threatening effects, some say, but there are no studies documenting the frequency of adverse effects. The more common are headaches and excessive acne and hair growth."
HCG also can cause prostate problems in men, and, in women, it may bring on ovarian hyperstimulation syndrome, or excessive ovulation, he says.
Teenagers shouldn't use a very low-calorie diet at all unless they've reached their full growth, Heinrich says.
HCG dieters are setting themselves up for ultimate failure, Gans and Primack say.
"It's not a long-term solution to weight loss," says Gans. "There are not enough carbohydrates — that's the major fuel for our bodies."
Getting to the right weight is about eating healthy, she says, "eating plenty of fruits, vegetables and 'good carbs' like whole grains, oats, barley, quinoa, buckwheat, beans, other legumes — high-fiber carbs."
Primack agrees: "We live in a carb society. As soon as they're off the diet, most start gaining again."
Gans recommends losing much more slowly, 1 to 2 pounds a week . "The key is to not gain it back and wait for the next diet fad to come along."