Monday, January 11, 2010
University of Maryland medical expert warns that weight loss regime is still in use today
The death at age 38 of film and recording star Mario Lanza may have been related to a controversial weight loss program based on a hormone derived from the urine of pregnant women.
The diet was developed in the 1950’s and debunked in the 1960’s, but has undergone a recent revival and is touted on numerous Web sites. Lanza’s career in film, recording and live performance reached its height in the late 1940’s and through the 1950’s. His operatic voice and style inspired some of the world’s greatest singers, including the three tenors, Jose Carreras, Placido Domingo and Luciano Pavarotti.
“Mario Lanza was a massive overeater with major weight problems, which he attempted to correct through one crash diet after another,” says Philip A. Mackowiak, M.D., professor and vice chair of the Department of Medicine at the University of Maryland School of Medicine in Baltimore and founder of the school’s Historical Clinicopathological Conference, a yearly event devoted to the modern medical diagnosis of disorders that affected prominent historical figures. Dr. Mackowiak and Lanza biographer Armando Cesari have written an article that recounts the highs and lows of Lanza’s life in the January issue of The Pharos, the journal of Alpha Omega Alpha, the medical honorary society.
By the age of 22, Lanza, who was 5’7”, had ballooned to 260 pounds. In 1947, he signed a seven-year film contract with MGM after Louis B. Mayer heard him perform at a live concert. The contract required him to make movies for six months a year, leaving him free to appear in concerts the remaining months. Lanza would crash diet in order to look good on screen, going down to 169 pounds when making movies at the height of his career. He would then regain the weight during drinking and eating binges when he did not have to appear in front of the camera.
In 1957, two years before his death, Lanza entered a weight loss program that was developed by Dr. Albert T.W. Simeons of the Salvatore Mundi International Hospital in Rome. The diet included daily doses of the hormone human chorionic gonadotropin (hCG) and food intake of no more than 500 calories a day. A book written by an infomercial marketer in 2007 has sparked renewed interest in the diet.
hCG is made by the placenta during pregnancy and can be measured as a test for pregnancy. More is known now than in Lanza’s day about the qualities of the hormone. hCG has a structure similar to that of thyroid stimulating hormone. “If given in sufficient quantity and duration, it can induce a condition known as thyrotoxicosis,” says Dr. Mackowiak, who is also director of medical care at the VA Maryland Health Care System. “The body’s metabolism speeds up, causing sudden weight loss, a rapid or irregular heartbeat, sweating and irritability.”
It is not known whether Lanza was given enough hCG to cause thyrotoxicosis, but he lost an astonishing 30 pounds in his first nine days at the Salvatore Mundi International Hospital and another 44 pounds in the next three months, leaving him tired and drawn in appearance. “Such precipitous weight loss could not have resulted from a reduction in his intake of calories alone, but might have been possible if Lanza had been rendered thyrotoxic as a result of large doses of hCG,” says Dr. Mackowiak.
The hormone has been approved for treatment of some medical conditions, but the U.S. Food and Drug Administration (FDA) has not approved the use of hCG for weight loss. Utilizing hCG for weight loss is considered an “off label” use. Since 1975, the FDA has required labeling and advertising of hCG to state:
“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.”
Besides obesity, Mario Lanza’s health was complicated by other issues, says Dr. Mackowiak. By his mid-30’s, he suffered from hypertension, liver failure, coronary artery disease and thrombophlebitis of his right leg. He died suddenly in the morning of October 7, 1959. His medical records were meager and an autopsy was not performed. Dr. Mackowiak says Lanza’s death could have been due to any one of a number of disorders. He could have had a heart attack. He could have had a pulmonary embolism related to his phlebitis. “It is also possible,” says Dr. Mackowiak, “that he was thyrotoxic as a result of the hormone treatment. One of its consequences is a cardiac arrhythmia, which can result in sudden cardiac death.”
“Medical research looks toward the future to understand disease processes, improve patient care and develop cures,” says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine. “Knowledge of the past can help guide researchers toward the future. Dr. Mackowiak is a worldwide leader in analyzing the health of famous people in the past and applying the results of that analysis to the teaching of medical students, trainees and practitioners today.”
Dr. Mackowiak’s collaboration with Armando Cesari came after Mr. Cesari suggested Mario Lanza as a potential subject for one of Dr. Mackowiak’s Historical Clinicopathological Conferences. The two decided to write the article instead.