Five hundred calories. That's less than one Quarter Pounder with cheese.
But that's what people on the hCG diet subsist on every day - and seemingly subsist on quite well.
The diet has been around for decades, but it's experienced a resurgence in popularity in recent years. If you ask around, you're bound to find someone in your social circle who's tried the plan.
The hCG diet uses human chorionic gonadotropin, a hormone that is produced in pregnant women. Dr. A.T.W. Simeons discovered in the 1950s that injections of the hormone helped those with weight issues metabolize fat when it was used as part of a weight-loss program that includes a structured calorie-restrictive diet.
The Food and Drug Administration hasn't approved hCG, but it isn't required to because it's classified as a supplement.
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The diet's not without controversy, however. Many doctors and dietitians say the 500-calorie-a-day diet would make anyone lose weight whether or not hCG is part of it.
Still, it's easy to find professionals who say hCG controls cravings and makes dieters feel full. Some offices say patients lose a half-pound to a pound a day on the hCG diet. Internet sites say people can lose 2 pounds a day.
Dr. Cynthia Thomson, a registered dietitian and associate professor in nutritional sciences at University of Arizona, does weight-loss research.
Thomson said scientific trials on the efficacy of hCG took place in the '50s and '60s, and no difference in weight loss was found whether the participants received hCG injections or a placebo.
"I think we need to test this in well-designed trials," Thomson said. "If they (medical professionals and manufacturers) want to make these claims, we should be evaluating these risks. Don't put something out there without putting it under scrutiny."
But ardent believers abound - because the diet worked for them.
Bobby Tenery started using hCG through Tucson Medical Weight Loss on Feb. 8, 2010, and lost 60 pounds in the first 30 days.
"It's changed my life," he said. "I flew on an airplane for the first time in five years. I'm a human being again."
Tenery, 51, has since lost a total of 220 pounds off his former 597-pound frame. He did it partly to be able to play with his 5-year-old twins, Max and Mia.
In the past couple of years, several offices in Tucson have begun offering hCG programs, which cost about $300 to $400 for the initial lab work and medical evaluation and $100 and up for four to six weeks of hCG. Group sessions could be an additional cost.
Dr. Suzanne Bentz, a board-certified bariatric specialist at Tucson Medical Weight Loss, has been treating obesity for 15 years. She started with an office in the Phoenix area and added one in Tucson two years ago.
Bentz has offered the hCG program at her Phoenix office for seven years and since the Tucson office opened.
She offers three basic programs: a basic calorie-counting, portion-control and exercise program with medications to control hunger and cravings; a meal- replacement program; and hCG.
Bentz said hCG is her most popular program.
"It's safe when done under the supervision of a qualified medical specialist with a medical grade hormone," Bentz said. "We're giving patients enough lean protein to conserve their muscle mass. That's the reason patients are able to follow that low-calorie diet; they find that they feel better, they're not hungry and have good energy levels."
Dr. Nicole Gullick has treated about 150 people with hCG at her East River Road office.
"A friend had used it and lost 80 pounds," she said. "I tried it myself. I could stand to lose 7 pounds, but it was 7 pounds that would not budge. I lost it, no problem, in about two weeks.
"There is almost a magical component to it."
Some experts contend the main reason people are losing weight is because of the calorie restrictions.
"If you're going to go on a 500-calorie diet, you'd better be under medical supervision because you're going to be deficient in almost every nutrient there is - and a multivitamin's not going to do it," said UA's Thomson.
"I think people need to realize that losing weight is never easy. You're talking of making lifestyle changes forever."
Dr. Donald Kwasman has headed Golden West Medical Center, which specializes in weight loss, since 1980.
"We don't use hCG because it doesn't work - it's a hoax," said Kwasman, 61. "I'm not convinced it's safe. There have been numerous studies to see if there was any credibility here. There wasn't.
"When I see people trying to lose weight with a 500-calorie diet, I see problems," he said. "There's nothing like diet and exercise."
