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The HCG diet: Don’t fall for the hype

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A controversial diet that was first popularized in the 1950s has seen a surge in public interest in recent years. The HCG diet, which combines hormone injections with a low-calorie diet, has made a huge comeback in the US, and there are now hundreds
of websites dedicated to promoting its effectiveness.

However, despite all of its spectacular claims, there’s little proof that the diet actually works. Worse, it may even be seriously bad for your health.

What’s it all about?

HCG stands for ‘human chorionic gonadotrophin’, a hormone that is produced by the placenta during pregnancy and excreted in the urine of pregnant women. The HCG diet combines daily injections of this hormone with severe calorie restriction-followers are allowed only 500 calories a day. Supposedly, this regime will allow you to lose one to two pounds every day, and without feeling hungry, weak or irritable.

The use of HCG for weight loss was first proposed more than 50 years ago by British physician Dr Albert T. Simeons. He claimed that the hormone, when coupled with a low-calorie diet, caused the body of obese individuals to preferentially burn stored fat-and especially fat from the stomach, hips and thighs.
According to Simeons, the HCG diet is more effective than a low-calorie diet on its own because the hormone suppresses appetite and improves mood, thereby increasing the likelihood that the dieter will stick to the stringent regime. In fact, in a report published in 1954 in the peer-reviewed medical journal The Lancet, Simeons reported that he had treated 500 obese patients and found that those who had followed the HCG weight-loss plan for 40 days had managed to lose 20 to 30 pounds without feeling weak or excessively hungry (Lancet, 1954; ii: 946; Harv Womens Health Watch, 2010; 17: 8).
Since then, HCG injections have been used as a weight-loss aid with amazing commercial success (Can Med Assoc J, 1983; 128: 1156-7). Yet-and, astonishingly, in spite of Dr Simeons’ scientific report-there is no reliable evidence to show that the HCG diet truly works.

Where’s the proof?

Numerous studies have been published attempting to either substantiate or disprove Simeons’ theory of the effectiveness of HCG for weight reduction. These have included well-designed, randomized controlled trials (RCTs-the ‘gold standard’ of clinical-trial evidence) comparing HCG injections with saline injections (as the placebo for comparison). In almost every study, HCG has proved to be ineffective. In other words, any resulting weight loss was entirely due to sticking with the low-calorie diet.

In one critical review by two researchers from the Pennington Biomedical Research Center in Baton Rouge, LA, it was found that weight loss was identical between two groups of dieters whether they received HCG or a placebo. More-over, there were no differences in terms of hunger, mood and body measurements (West J Med, 1977; 127: 461-3).

More recently, a meta-analysis (pooled analysis) of 24 relevant studies in the scientific literature concluded that there is no scientific evidence to support the claim that HCG can cause weight loss, redis-tribute fat, reduce hunger or create feelings of wellbeing (Br J Clin Pharmacol, 1995; 40: 237-43).

On the other hand, there is one RCT that reported positive findings with HCG. Published in 1973 by two US-based physicians, one of whom was the executive director of the American Society of Bariatric Physicians, the study involved 40 women who had received either HCG injections-a total of 36 injections, unless their ideal weight was achieved prior to this-or a placebo, and who followed a diet of 500-550 calories a day.
The results showed that the HCG group lost significantly more weight than the placebo group.

What was important, however-given the main beneficial claims of taking the hormone-was that, according to their responses to a questionnaire, the women given HCG said they were less hungry and generally felt better compared with the controls (Am J Clin Nutr, 1973; 26: 211-8).

Nevertheless, the study has since been heavily criticized (Am J Clin Nutr, 1973; 26: 1039-41), and a team of researchers who tried to replicate the study failed to find any differences in the number of injections received, weight loss, percentage of weight loss, hip and waist circumferences, weight loss per injections or hunger ratings between those taking HCG and those given a placebo while dieting.

For this reason, the researchers concluded that “HCG does not appear to enhance the effectiveness of a rigidly imposed regimen for weight reduction” (Am J Clin Nutr, 1976; 29: 940-8).

Homeopathic HCG

Despite the lack of any scientific evidence that the HCG diet works, it continues to be promoted as a miracle weight-loss cure, and it now appears to be more popular than ever. Much of this new-found popularity may be because HCG is now available in the form of homeopathic drops and sprays, which are meant to be taken orally-far more convenient and acceptable than an injection.

Nevertheless, no scientific tests of homeopathic HCG have yet been published, but it may be safe to assume that it is not likely to be any more effective than the injected hormone.

Ultimately, the HCG diet doesn’t live up to its claims, and reports suggest that it could even be dangerous. The extremely low caloric intake alone is likely to be bad for your health, but there’s also the questionable safety of the HCG injections themselves (see box above).
As usual, if it sounds too good to be true, it usually is.

Joanna Evans

HCG side-effects

The reported adverse effects of the HCG diet (Can Med Assoc J, 1983; 128: 1156-7) include:

o headache
o irritability
o restlessness
o depression
o fatigue
o oedema (water retention)
o pain at the injection site
o gynaecomastia (breast enlargement in men).

Treatment with HCG has also been linked to:
o early puberty
o blood clots
o fluid accumulation in the lungs and abdominal cavity
o ovarian overstimulation syndrome, involving oedema, cyst formation
and intra-abdominal haemorrhage
o multiple pregnancy, with an increased prevalence of prematurity,
abortion, perinatal death and preeclampsia.


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