One of the great things about this site is that people often bring products or research to our attention that we otherwise might have missed. This occurred yesterday in the comments section of Peter's recent post on Acai berry scams, when one of our readers brought up the use of Human Chorionic Gonadotropin (HCG) in the treatment of obesity. The website that we were provided smacks of weight loss gimmickry - notably the promise of an obesity "cure" and "near 100% success rate", but we thought it best to review the evidence before making a judgement one way or the other.
The use of HCG to treat obesity was first suggested by ATW Simeons in a 1954 Lancet paper. He reported that injection of HCG resulted in rapid mobilization of body fat stores and induced feelings of well-being. He also claimed that HCG reduced weakness and hunger during very low calorie diets (500kcal/day) and that HCG treatment could be used to prevent the protein and vitamin deficiencies which are a frequent side-effect of such low caloric intake. Finally, he suggested that HCG could be used to successfully treat a range of ailments ranging from diabetes and gout to ulcers and skin diseases. However, it is important to note that no actual study was performed - these were just subjective observations. Naturally, Simeons' observations spurred actual research into HCG.
Unfortunately for Simeons' pet theory, the vast preponderance of studies examining the effectiveness of HCG in the treatment of obesity found absolutely no effect. For example, a 1976 paper in the Journal of the American Medical Association performed a rigorously controlled, double-blind crossover study examining the effects of HCG on weight loss in obese individuals undergoing very low calorie diets. In a double-blind study, neither the patient, nor the physician, knows whether the patient is receiving HCG or a placebo. What were their results? Both groups lost a significant amount of weight (not surprising given subjects were only consuming 500 kcal/day), however there was no difference in weight loss between the HCG and placebo treatments.
However, sites which promote HCG such as the HCG Diet Info Blog claim that it doesn't matter if there was no difference in weight loss - HCG promotes fat loss, and preserves muscle mass. So both groups might have lost the same weight, but the HCG group might have lost more fat, and preserved more muscle than the other group. Luckily, the above paper examined this possibility as well, and report that there was no difference in fat loss between the HCG and placebo treatments. So, this study strongly suggests that HCG does not enhance fat loss, nor does it preserve muscle mass.
Ok, that's only one study, and to be fair there is one study by Asher and Harper which suggests that HCG might have some effect on weight loss. However, that is the only well designed study to show such a link, while numerous other studies have shown conclusive evidence that HCG does not enhance weight loss, reduce hunger, or increase the sense of well-being. For example, a meta-analysis in the British Journal of Pharmacology examining all of the research on HCG concluded that:
Interestingly, they report that most of the studies were of poor methodological quality, and of the 12 studies with the strongest methodologies and proper controls, 11 showed HCG to be utterly useless in inducing weight or fat loss. Additionally, they point out that the use of HCG is also unethical, given that "HCG is obtained from the urine of pregnant women who donate their urine idealistically in the belief that it will be used to treat... infertility". That's right - it comes from the urine of pregnant women!
That's not all. An editorial by John Ballin and Philp White in the Journal of the American Medical Assocation titled "Fallacy and Hazard" claims that "no rational basis exists for [HCG] use in weight reduction, except as placebo". Further "Weight loss under the Simeons regimen can be attributed solely to the semistarvation diet that is required", a diet which is so restricted as to raise safety concerns. Finally, they claim that way that Simeons weight clinics are run "pose serious questions for physicians who participate in them".
But if the evidence clearly suggests that HCG is completely useless in the treatment of obesity, why is HCG so popular? Well, it may have something to do with its inclusion in Kevin Trudeau's book "The Weight Loss Cure", which has been dissected by Dr Yoni Freedhoff and others in the past. For those of you who don't know Kevin Trudeau from late-night infomercials, watch an excellent piece by 20/20 here.
Interestingly, the best argument against the use of HCG therapy actually comes from the companies which peddle the product. For example, the disclaimer on the website of TrimYou, a company that certifies and promotes weight loss clinics adhering to the original Dr Simeons Diet Protocol reads thusly:
" The FDA has not approved HCG Therapy to lose weight. "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.""
Lijesen GK, Theeuwen I, Assendelft WJ, & Van Der Wal G (1995). The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. British journal of clinical pharmacology, 40 (3), 237-43 PMID: 8527285
UPDATE: Our friend Blake Hagen has an excellent post of his own on this same topic. You can read it here.
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nterestingly, the best argument against the use of HCG therapy actually comes from the companies which peddle the product. For example, the disclaimer on the website of
I have used this & lost 27 lbs using HCG sublingually-it really does work; it worked for me. It 'uses' your stored body fat to supply the rest of the caloric need for the day besides the 500 cals you eat. So, for each his own I say
Say what you want but I have lost over 40 lbs using HCG. I am not hungry, I am not weak, I am having NO adverse reactions. And when I stabilize, as is part of the protocol, I am able to eat normal healthy foods in adequate amounts. I do not starve myself with restricted calories or low fat in order to maintain my new weight. HCG absolutely does work and there are thousands of us out there to prove it; many of whom have tried every other diet on the planet with no success.
In modern life, we are concerned not only our health, even our bodies ,Especially fast food as our main food, our bodies began to gain weight, which not only seriously effect our work, but also effect our health. I was an obeser before I troubled deep fat,.when I started to lose weight , I became aware of weight loss is a difficult thing. But since I took the pruduct zi xiu tang, I no longer anxious,now I have successfully reduced by 20 pounds, my friend, if you are still upset about obesity, please try my method, I really hope we do not trouble.
As a physician I would almost beleive you if I did not lose 22 lb in 21 days and maintained it afterwards.
The fact is, there is something in hcg as well as obesity itself that we all, I repeat WE - healthcare professionals - dont know and undestand.
Bring in "evidence- based medicine" data here. for me the fact is I lost weight,very sugnificant lsot, and all 4 people I recommended this diet lost weight too.
No shit you lost weight. The diet calls for 500 cals a day. for all you that lost weight with this diet, good luck trying to keep it off. If its to good to be true, it most likely is. I lost over 40 lbs twice on diets, gained it back plus some every time. the problem with getting "on" a diet, is that you always get "off". Why don't you do the healthier and harder thing and change your lifestyle.
Someone in our area was promoting HCG. So just for kicks, since I could stand to loose a few pounds, I followed the diet but without using the HCG. I lost an average of 2 lbs a day just like the program suggested without feeling hungry. I think the body naturally makes up for the needed calories. I lost 13 lbs total over the course of 7 days. Vic said 'he maintained it.' Because of my lifestyle of meetings and lunches, over a course of a few weeks, it came back. The trick is to learn how to eat healthy and stay away from fast food and sugars. My opinion is that the HCG doesn't do anything that the body doesn't already do.
I tried hcg and I had tried many things before i tried pills you name a diet a tried it but this to me has been the best thing ever I lost weight in places that I couldn't before
and I felt wonderful I felt so good I asked my doctor if it could be used regularly I had been depressed for a long time this made me want to live again I don't know why I just know that it did wonders for me. I lost 27 pounds I stopped 6 months ago and I'm going to start again in a week I would definitely recommend it to a friend.
Am I the only one who sees (quite clearly) that the weight loss has NOTHING to do with hCG? If you restrict your normally 1500-2000 calorie diet to 500 calories, OF COURSE you're going to lose weight. Why?! Because you're bloody starving yourself! The whole concept is a scam and incredibly unhealthy. Try the same diet without the hCG and it will yield the same results!! Change your diet to a more healthy 1500 calories, even as low as 1200 (depending on your life style) and get a good long walk in every day. THAT is the way to lose weight.
While it's true that the weight loss has nothing to do with hCG per se, (I've been on calorie restriction diets before without the use of it), The idea behind its use has more to do with accessibility of the appropriate fat stores, and assisting the body in making those fat stores available to constantly use as fuel in lieu of the missing calories from the diet. Of course the weight can return in cases of resuming poor dietary habits, that is ostensibly the result of the hypothalamic switch being flipped back into weight gain mode. I think one of the best pieces of evidence of its efficacy (re: resetting the hypothalamic activity) is the fact that once the hCG is out of your system (three days after discontinuing), you can resume a normal caloric intake (per the protocol instructions) and not only not instantly gain weight, but actually continue to lose a bit more.
Having said all that, this diet is certainly not safe for everyone, and it should be undertaken with caution under the supervision of a competent physician.