I’ve just completed a three week road trip, speaking dozens of times to doctor and student groups in Michigan and Oklahoma. A question that came up several times was what I thought about HCG injections and the “HCG diet” for weight loss. I promised the doctors I’d do a blog on the topic, so, here it is.
According to a report in Quack Watch, “Human chorionic gonadotrophin (HCG) is a hormone found in the urine of pregnant women. More than 50 years ago, Dr. Albert T. Simeons, a British-born physician, contended that HCG injections would enable dieters to subsist comfortably on a 500-calorie-a-day diet.
He claimed that HCG would mobilize stored fat; suppress appetite; and redistribute fat from the waist, hips, and thighs.
However, there is no scientific evidence to support these claims. Furthermore, a 500-calorie (semi-starvation) diet is likely to result in loss of protein from vital organs, and HCG can cause other adverse effects.”
Quack Watch goes on to say “At one time, HCG was the most widespread obesity medication administered in the United States. Some doctors liked it because it assured them of a steady clientele. Patients had to come in once a week for an injection.”
The LA Times reports about this fad by saying, “A long-ago discredited fad diet has been getting increased attention lately, thanks to Web chatter and the claims of a bestselling author. The so-called HCG diet’s recent popularity is a bit surprising — and not just because research suggests it doesn’t work.” The Times goes on to report:
Other currently popular diets call for cutting back on fat and sugar, consuming whole grains and lean meats, and even indulging in red wine. The HCG diet, in contrast, calls for eating just 500 calories a day while taking daily injections of human chorionic gonadotropin (HCG).
According to the hype, HCG suppresses the appetite and prevents dieters from feeling weak or woozy on the low-calorie diet. But as with any fad diet, consumers should be wary of such claims, says Kelly Brownell, professor of psychology, epidemiology and public health at Yale University in New Haven, Conn.
Over a number of years, when researchers rigorously compared the diet’s key ingredient — HCG injections — to a placebo, or dummy injection, they failed to produce evidence that the hormone was anything special.
In 1959, researchers in Israel reported that they had placed 45 patients on Simeons’ diet, giving half the patients HCG injections and the other half saline injections. The two groups both lost weight at the same rate — and all 45 participants complained of being constipated, hungry or weak.
In the early 1960s, researchers at UC San Francisco and at a U.S. Army Hospital in Fort Carson, Colo., came up with the same results. All three studies were published in the American Journal of Clinical Nutrition.
As a result of these, and other studies (citations below), in 1976, the FTC ordered a number of organizations and their officers to stop claiming that their HCG-based programs were safe, effective, and/or approved by the FDA for weight-control. Although the order did not stop the clinics from using HCG, it required that patients who contract for the treatment be informed in writing that:
THESE WEIGHT REDUCTION TREATMENTS INCLUDE THE INJECTION OF HCG, A DRUG WHICH HAS NOT BEEN APPROVED BY THE FOOD AND DRUG ADMINISTRATION AS SAFE AND EFFECTIVE IN THE TREATMENT OF OBSITY OR WEIGHT CONTROL. THERE IS NO SUBSTANTIAL EVIDENCE THAT HCG INCEASES 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-RESTRICTIVE DIETS.
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.
In the decades that have followed, researchers continued to study the diet and to show that the hormone added little to the low-calorie regimen.
In 1995, Dutch researchers reviewed the results of the 24 studies that had been conducted on the HCG diet. Just 12 of them were well-designed, the scientists found; of those, 11 reported that HCG was ineffective in treating obesity. The Dutch team published its results in the British Journal of Clinical Pharmacology.
Despite these decades of negative study findings, the HCG diet was given new life by bestselling author Kevin Trudeau’s 2007 book, “The Weight Loss Cure ‘They’ Don’t Want You to Know About.” Giving credit to Simeons, Trudeau recommended a multi-phase approach to weight loss, including a phase of daily HCG injections.
Trudeau has previously been targeted by the Federal Trade Commission for allegedly promoting unproven cancer cures, pain relievers and other products, and in 2004 was banned by the commission from appearing in infomercials selling products or services to the public. He said in a recent Chicago Tribune story that he wrote his latest book simply as a public service.
Regardless, the HCG diet continues to draw followers, with more and more online companies promising to supply the injections.
The shots can come at a significant cost: Online prices range from $30 to more than $600 for a month’s supply. And they have side effects. Simeons noted that his female patients often became pregnant while on the shots, and today, in fact, HCG is approved by the Food and Drug Administration as a fertility treatment.
Brownell says that any trendy diet should give consumers pause. “Research has not found fad diets to be safe, effective and permanent,” he says. “Consumers should be highly skeptical as the default.”
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