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Human Chorionic Gonadotropin (HCG) for Fat Loss: "Fallacy and Hazard"

Tuesday, April 07, 2009 Posted by Travis Saunders
Photo by Todd Huffman.
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:

"there is no scientific evidence that HCG is effective in the treatment of obesity; it does not bring about weight loss or fat redistribution, nor does it reduce hunger or induce a feeling of well-being."

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.”"



Enough said.




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Travis
Related Posts:
1. Hydroxycut Recall: best selling weight loss gimmick takes a fall
2. AcaiBurn: "the World's Most Extreme Weight-Loss Solution"?
3. Accelis: the Panacea for Obesity?


Lijesen, G.K., Theeuwen, I., Assendelft, W.J.J., & 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 Pharmacology, 40, 237-243.


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11 Response to "Human Chorionic Gonadotropin (HCG) for Fat Loss: "Fallacy and Hazard""

  1. Blake Said,

    Thanks for this. I wrote about this awhile ago. The HCG diet is complete garbage. Still not sure why so many people buy into it.

    Posted on April 7, 2009 at 1:44 PM

     
  2. Travis Saunders, MSc Said,

    Thanks for the comment Blake. I just read your own post on the topic, which was very nicely done. It's nice to see that we're not the only ones calling out that BS!

    For anyone looking for Blake's post on the topic, head to this URL:

    http://blakehagen.com/2008/12/hcg-injections-for-weight-loss-nope/

    Posted on April 7, 2009 at 4:19 PM

     
  3. Event Planning Said,

    To answer the question why so many people buy into it: Because it works. Period.

    All of the people losing tons of weight on HCG have read those same studies (many funded by Pharmaceutical companies) and it doesn't change the facts - 100's of thousands of people have done this HCG diet successfully, kept the weight off long-term, and had no side-effects.

    The only people that poo-poo the HCG diet are the ones that have never tried it and just regurgitate the same studies. Also, all websites promoting the HCG diet are required to put the FDA notice on their site because of those same studies.

    How many studies would it take proving it DOES work? There are already several showing the efficacy of HCG for weight loss. The study you cited that shows a link between fat loss and HCG clearly shows more research is needed.

    A physicians clinical observations are often discounted and referred to as anecdotal evidence, however if the physicians experience is consistently observed, it is often referred to as positive clinical outcome studies.

    I suggest that this is a more effective method to measure efficacy than the outmoded and ineffective double blinded, double crossover, placebo controlled study.

    Posted on April 8, 2009 at 11:54 AM

     
  4. Travis Saunders, MSc Said,

    Hi Event Planner,

    That's an interesting take on the evidence. You suggest that since one study by Asher and Harper showed HCG might be effective, more research is needed? Well nine well-controlled studies were performed after the Asher and Harper study, and none found any benefit of HCG beyond diet alone.

    It doesn't take any magic number of studies for me to believe something is effective, but I need to see it reported by more than one well-controlled study, especially when 9 others show it to be completely infeffective. The balance of evidence clearly shows that HCG has no effect on weight loss.

    In the end, I do agree completely that the HCG diet results in dramatic weight loss. I would expect nothing less when individuals are consuming only 500kcal/day. However, they don't lose any more weight when they are injected with HCG than they do on the diet alone.

    Travis

    Posted on April 8, 2009 at 12:23 PM

     
  5. Peter Janiszewski, PhD (Cand.), MSc Said,

    Event Planning,

    First, I find it rather interesting that you’d resort to criticizing studies for being “funded by pharmaceutical companies” when clearly you have vested financial conflicts of interest with regards to your stance on the (in)effectiveness of HCG diets.

    Second, decisions in science and medicine cannot be based on subjective anecdotal interpretation but on rigorously performed scientific research. We are, after all, in an era of evidence-based medicine. What you propose should be used as an indicator of treatment efficacy may have been acceptable some centuries ago, but not today. As such, decisions regarding associations between risk factors and disease outcomes, as well as efficacy of various treatments, etc. are based on the PREPONDERENCE of available high-quality evidence. Hence, a ratio of null-to-significant findings of 100:1 for any given treatment would lead to the conclusion that the treatment is ineffective. Hence, given that the PREPONDERENCE of high-quality research does not indicate any usefulness of HCG protocols, it is appropriately deemed to be useless. Any alternative interpretation is simply erroneous.

    Posted on April 8, 2009 at 1:01 PM

     
  6. Fat Loss Chronicles Said,

    People who have lost weight on HCG are falling into a trap-- they believe that the falling number on the scale tells them everything they need to know.

    Not so.

    I was very skeptical about HCG when my sis-in-law did it and lost weight. I told her rapid weight loss will cause you to lose muscle. All she cared about was what the scale said.

    So I became a guinea pig, and tried the HCG Diet.

    I documented EVERYTHING on my blog daily, including body fat percentages.

    http://fatlosschronicles.blogspot.com

    Yes, I lost almost 20 pounds. However, 41% of that weight lost was from lean body mass! That is a starvation diet percentage.

    Just because the scale tells you that you lost weight does not automatically equate to losing fat.

    The HCG Diet is not what it claims.

    Posted on April 19, 2009 at 12:26 PM

     
  7. Anonymous Said,

    Okay so this lady i work with is taking hcg and when she told me i listen to what she had to say then on my own started researching hcg. So, what i have come up with is that hcg pretty much is a scam and very unhealthy i have read nothing but bad reviews on hcg. I told her that she could get the same results from exercise and dieting or just eating healthier food but of course she don't listen. Also when i tell her that its unhealthy she gets very offensive i have given up on talking to her about it i guess when people are just stupid. She's lost like 25 pounds so far but i beleave she could have taken sugar pills and 500 cals a day and did the same.

    Posted on April 21, 2009 at 11:11 AM

     
  8. Jazzy Said,

    no wonder manny ramirez used this .. hehehehe

    Posted on May 7, 2009 at 4:50 PM

     
  9. nutrprofe Said,

    HCG injections were popularized by Simeons starting in the early 1960's. All data shows that it is an expensive placebo. Remember that placebos can be effective. People getting saline injections and told to follow 500-calorie diets also lose weight.
    HCG injections have continued because they are profitable for bariatric physicians. They are relatively harmless, at least, compared to other treatments used by bariatric physicians such as high doses of thyroid and amphetamines (especially phentermine), often in combination.

    Posted on July 7, 2009 at 4:47 PM

     
  10. Travis Saunders, MSc Said,

    I ask this out of ignorance as much as anything else - do bariatric physicians commonly give their patients high doses of thyroid hormone and amphetamines?

    As a non-physician, that doesn't sound like the ideal treatment strategy.

    Posted on July 7, 2009 at 5:44 PM

     
  11. Anonymous Said,

    Ok- I fell into this trap. I wanted to loose weight and a co-worker (a nurse,at that) did it and lost 20 lbs. So I thought, "why not". Yes, I have been losing a pound a day,(6,so far)but I find myself hungrier now than I was before I started this diet and I definately do not have a "feeling of well-being" as sights have suggested I would. I find I have less energy now than I did before. Also, the diet states that you SHOULD NOT exercise. Well, I miss my 4 mile walks and walking my 2 labs. So, I have made the decision to go off this diet and just start making smarter food choices and get my butt back out there walking.

    Posted on September 6, 2010 at 12:46 PM

     

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We are PhD students in the School of Kinesiology and Health Studies at Queen's University in Kingston, Ontario. Our research focuses on the relationships between obesity, physical activity, and health risk. This blog is our attempt to consider the many "cures" for obesity that we read about on a daily basis. Enjoy.

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The opinions expressed here belong only to Peter and Travis and do not reflect the views of any organization. Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.

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