Should I do the HCG Diet?

taso42

Should I do the HCG Diet?

Acg67

HCG injections do nothing for weight loss and homeopathic drops do less than nothing

Stein et al. Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study. American Journal of Clinical Nutrition, Vol 29, 940-948

"HCG does not appear to enhance the effectiveness of a rigidly imposed regimen for weight reduction."

Lijesen et al. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. Br J Clin Pharmacol. 1995 Sep;40(3):237-43.

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

also see JAMA 236:2495–2497, 1976, American Journal of Clinical Nutrition 29:940–948, 1976, American Journal of Clinical Nutrition 12:230–234, 1963, S Afr Med J. 1990 Feb 17;77(4):185-9, West Journal of Medicine 127:461–463, 1977, Archives of Internal Medicine 137:151-155, 1977

MrsCon40

Human chorionic gonadotropin (hCG) is a hormone approved by the FDA for use in pre-pubertal boys to help aid normal sexual development, and in women to treat fertility problems. hCG is produced by the placenta and is also found in pregnant women’s urine. It is not approved for weight loss and has never been proven by credible peer reviewed science to cause weight loss. So how did hCG surface as a weight loss solution?

Back in the 1930’s, a physician named A.T.W. Simeons was using hCG for the standard reproductive medical conditions for which it was approved. He observed that some of his patients dropped weight while on the hCG injections. Thinking that perhaps the hCG was the cause, he administered the injections along with a dietary plan to overweight patients and noted weight loss. Please note that subsequent researchers repeated his clinical study and were never able to replicate any association between hCG and weight loss.

Since then, most independent, peer-reviewed studies have shown no difference in weight loss between subjects on a low-calorie diet who received hCG injections and subjects who received a placebo. In 1975, the FDA noted that hCG is not a weight loss drug. In 1995, the British Journal of Clinical Pharmacology published a summary of research showing no hCG related weight loss association. The American Society of Bariatric Physicians does not recommend hCG for weight loss as noted in a December 2009 position paper.

Flash forward to 2007 when Kevin Trudeau published his book “The Weight Loss Cure ‘They’ Don’t Want You to Know About“, in which he concocted a weight loss plan which included hCG injections. Trudeau has no professional training in medicine, health or science. He is widely known as a controversial businessman who has tangled with the law regarding false health claims related to his books and products. You’d think that common sense would dictate running the other way when this guy hawks anything. But, people are desperate and when they are promised rapid weight loss and an end to their misery, they’ll often line up to sign up.

What is involved with the hCG “diet”:

1) Daily injections of hCG, with online prices ranging from $30 to more than $600 for a month’s supply. One side effect is pregnancy, as hCG increases fertility among women.

2) 500 calories per day of highly restrictive food intake, including coconut oil. One tablespoon of coconut oil contains 13.6 g total fats, 11.8 g of which are artery clogging saturated fats, according to the U.S. Department of Agriculture National Nutrient Database for Standard Reference.

3) A range of body “flush and detox” regimens. Here’s my quote from a prior WebMD interview about this regimen. “All the flushes and cleanses are pure nonsense, unnecessary, and there is no scientific basis for these recommendations,” says nutrition and metabolism expert Pamela Peeke, MD, chief medical correspondent for Discovery Health channel. “Your body is well equipped with organs, such as the liver and kidneys, and the immune system, to rid itself of potential toxins and do an excellent job of cleansing itself without needing flushes or cleanses.“

Here are other concerns related to this “diet”:

1) You’re starving yourself. Your brain alone requires 600 calories per day to function optimally. By consuming only 500 calories per day, of course you’ll drop weight. But at what price? You’re cannibalizing your muscle mass, reducing your metabolism and consequently the effectiveness of your calorie burning. If I had you consume only 500 calories per day and then injected you with water, should I now call this the amazing water cure for weight loss? hCG has nothing to do with your weight loss. Starvation does.

2) It’s impossible to do. So you blame yourself (and not the author) when you cannot complete his plan. This is a core element of the scam. People who are overweight already feel guilty and are often filled with shame. After having laid down a lot of cash and not being able to successfully comply for a month or more, they figure “Oh well, just another diet I’ve failed at”.

3) It is unsustainable. This regimen is almost impossible to adhere to for more than a very short period of time. There are no healthy eating or physical activity behaviors to learn. Eventually you would have to enter the real world. And then, what do you do?

4) It’s unsafe. You cannot meet your baseline survival nutritional requirements on a starvation plan. You can seriously alter your healthy intestinal bacterial flora with repeated “cleanses and detox” regimens. This can lead to altered bowel function and inability to appropriately absorb food nutrients, which can then impair immune function.

Further, many of you have a lot of weight to remove. You may also have associated medical problems, including high blood pressure, elevated cholesterol and high blood sugar levels. You could also be on medications to treat these as well as mental conditions like depression and anxiety. When people buy into a diet scam like hCG, they usually don’t tell their medical team. Rapid weight loss, radically altered food consumption, cleanses and detox regimens can seriously affect your underlying mental and physical conditions and alter the clearance and blood level of medications you’re taking.

Don’t turn yourself into a science fair project. Beware of these radical scam approaches as they can deleteriously affect your health and wellbeing. In the best of all worlds, you’re working with credible health professionals to remove your excess weight.

5) You’re not breaking food addictions. The promise is that you’ll no longer be addicted to food and any abnormal eating behaviors. Credible research has clearly shown that starvation and useless injections are not the solution to food addictions. Behavioral modification, healthy eating practices and regular physical activity have clearly been shown to control food addictions.

6) You’re broke. Take a moment and add up the total costs of the books and products required. That’s why I’ve renamed this “diet” the High Cost Game scam.

Finally, there will always be an endless supply of frauds and scams created to prey on your desires to drop weight. To help guide you, here are the Food and Nutrition Science Alliances’ “Ten Red Flags of Junk Science“:

* Recommendations that promise a quick fix.
* Dire warnings of danger from a single product or regimen.
* Claims that sound too good to be true.
* Simplistic conclusions drawn from a complex scientific study.
* Recommendations based on a single study.
* Dramatic statements that are refuted by reputable scientific organizations.
* Lists of “good” and “bad” foods.
* Recommendations made to help sell a product.
* Recommendations based on studies published without peer review.
* Recommendations from studies that ignore difficulties among individuals or groups.

Always remember that if it sounds too good to be true, it is. Anything worth doing in your life requires time and effort to achieve and succeed. Run from false promises like the hCG scam. Stick with life-giving whole foods and physical activity. Now, that’s better living through your own chemistry.

http://blogs.webmd.com/pamela-peeke-md/2010/12/diet-scam-101-the-hcg-con.html

sweebum

Links to the studies I have for someone to incorporate:


American Journal of Clinical Nutrition: 1976

http://archinte.ama-assn.org/cgi/content/abstract/137/2/...

"Mean weight loss in the HCG-treated group was nearly identical to that achieved by women given the placebo."

Journal of the American Medical Association: 1977

http://www.ajcn.org/cgi/content/abstract/29/9/940

"Twenty of 25 in the HCG and 21 of 26 patients in the placebo groups completed 28 injections. There was no statistically significant difference in the means of the two groups in number of injections received, weight loss, percent of weight loss, hip and waist circumference, weight loss per injections, or in hunger ratings. HCG does not appear to enhance the effectiveness of a rigidly imposed regimen for weight reduction."

British Journal of Clinical Pharmacology: 1995

http://www.ncbi.nlm.nih.gov/pubmed/8527285?dopt=Abstract

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

South African Medical Journal: 1990

http://www.ncbi.nlm.nih.gov/pubmed/2405506?dopt=Abstract

Subjects receiving HCG injections showed no advantages over those on placebo in respect of any of the variables recorded. Furthermore, weight loss on our diet was similar to that on severely restricted intake.

WebMD: 2007 (Review of The Weight Loss Cure 'They' Don't Want You to Know About by serial conman Kevin Trudeau)

http://www.webmd.com/diet/features/weight-loss-c...

"Scientific studies have demonstrated that hCG injections do not cause weight loss, and regulatory actions by the Federal Trade Commission and Food and Drug Administration (FDA) have curbed their use in the United States," says Quack Watch.org owner and director Stephen Barrett, MD.

ninerbuff

Here's the best: If HCG extract is from a pregnant females urine, then why do pregnant women feel hungry?

CaptainGordo

Info regarding VLCD (Very Low Calorie Diets)

UCLA (http://rfoweightloss.med.ucla.edu/body.cfm?id=32)

"A VLCD is primarily for severely or morbidly obese individuals who must lose or wish to lose large amounts of weight as rapidly as possible in a safe manner. "

National Institutes of Health (http://win.niddk.nih.gov/publications/low_calorie.htm)

"VLCDs are designed to produce rapid weight loss at the start of a weight-loss program in patients with a body mass index (BMI) greater than 30 and significant comorbidities."

"Use of VLCDs in patients with a BMI of 27 to 30 should be reserved for those who have medical conditions due to overweight, such as high blood pressure."

"Many patients on a VLCD for 4 to 16 weeks report minor side effects such as fatigue, constipation, nausea, or diarrhea. These conditions usually improve within a few weeks and rarely prevent patients from completing the program. The most common serious side effect is gallstone formation. Gallstones, which often develop in people who are obese, especially women, are even more common during rapid weight loss. Research indicates that rapid weight loss may increase cholesterol levels in the gallbladder and decrease its ability to contract and expel bile. Some medicines can prevent gallstone formation during rapid weight loss. Your health care provider can determine if these medicines are appropriate for you"

"Studies show that the long-term results of VLCDs vary widely, but weight regain is common."

"In addition, VLCDs may be no more effective than less severe dietary restrictions in the long run. Studies have shown that following a diet of approximately 800 to 1,000 calories produces weight loss similar to that seen with VLCDs."

"For most people who are obese, their condition is long-term and requires a lifetime of attention even after formal weight-loss treatment ends. Therefore, health care providers should encourage patients who are obese to commit to permanent changes of healthier eating, regular physical activity, and an improved outlook about food"

WebMD (http://www.webmd.com/diet/guide/low-calorie-diets)

"Very low-calorie diets are generally safe when used under proper medical supervision in people with a body mass index (BMI) greater than 30. Use of VLCDs in people with a BMI of 27 to 30 should be reserved for those who have medical complications resulting from their obesity."

"To be healthy, we need a balance of foods from different food groups. It's quite difficult to get good nutrition in as few as 800 calories (even a dietitian would have trouble doing this), especially if one eats the same foods day after day."

"Also, once you go off the diet, you will likely regain your weight unless you change your lifestyle and commit to healthy eating, regular physical activity, and an improved outlook about food. By sticking to a long-term commitment, you can prevent your weight from drifting back up the scale."

CaptainGordo

When stacking Dr. Simeons' recommendations against the oodles of recommendations by reputable doctor and scientists, I would conclude that Dr. Simeon's protocol is quackery. Any doctors prescribing this are misled, and have not done their homework, as studies have proven it to be quackery. Nobody has been able to replicate Dr. Simeon's results, which would lead one to believe that it was an anomaly, other factors were present, or it was fraudulent.

"We conclude that there is no scientific evidence that HCG causes weight-loss, a redistribution of fat, staves off hunger or induces a feeling of well-being. Therefore, the use of HCG should be regarded as an inappropriate therapy for weight reduction, particularly because HCG is obtained from the urine of pregnant women who donate their urine idealistically in the belief that it will be used to treat an entirely different condition, namely infertility."

- British Journal of Clinical Pharmacology (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1365103/)

"Numerous clinical trials have shown HCG to be ineffectual in producing weight loss. HCG injections can induce a slight increase in muscle mass in androgen-deficient males. The diet used in the Simeons method provides a lower protein intake than is advisable in view of current knowledge and practice. There are few medical literature reports favorable to the Simeons method; the overwhelming majority of medical reports are critical of it. Physicians employing either the HCG or the diet recommended by Simeons may expose themselves to criticism from other physicians, from insurers, or from government bodies."

- American Society of Bariatric Physicians (http://www.asbp.org/resources/uploads/files/HCG Position Statement.pdf)

In 1976, the FTC ordered the Simeon Management Corporation, Simeon Weight Clinics Foundation, Bariatrics Management Corporation, C.M. Norcal, Inc., and HCG Weight Clinics Foundation 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 (Federal Trade Commission Decisions. Complaint in the matter of Simeon Management Corporation et al. Order, opinion etc., in regard to alleged violation of Secs. 5 and 12 of the Federal Trade Commission Act. Docket 8996. Complaint, Oct 15, 1974. Final Order April 29, 1976.).

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.

_GlaDOS_

The FDA and FTC are now making efforts to remove HCG products from the market, claiming the drug is not approved for marketed use. In fact, there are no HCG drugs approved by the FDA for weight loss.

FDA Release:

http://tinyurl.com/85ap9ym

"Deceptive advertising about weight loss products is one of the most prevalent types of fraud,” said David Vladeck, director of the FTC’s Bureau of Consumer Protection. “Any advertiser who makes health claims about a product is required by federal law to back them up with competent and reliable scientific evidence, so consumers have the accurate information they need to make good decisions.”


The Endocrine Society has agreed with the FDA, and has issued a fact sheet on the myths, facts, and dangers of HCG and a 500 calorie per day diet:

Fact Sheet:

http://tinyurl.com/6nwd6wx

CaptainGordo

Read the experience of an MFP member: http://www.myfitnesspal.com/topics/show/338789-looking-for-peeps-who-did-hcg-diet-with-bad-results

myofibril

This is a position statement from the American Society of Bariatric Physicians on HCG

History

Human Chorionic Gonadotropin (HCG) is a hormone normally secreted by the trophoblastic cells of the placenta during pregnancy. It was first described as a treatment for obesity in conjunction with a very low calorie diet by Dr. A. Simeons in 1954 [1]. The Simeons method consisted of a rigid diet of about 500 calories per day combined with 125 units of HCG injected six days per week for 8 weeks. For each of the two meals permitted daily, patients were instructed to select one item from each of four food groups, protein, vegetable, bread, and fruit. For protein servings patients were told to select from the following list: 3.5 ounces of meat, 3.75 ounces of fish, 4 ounces of Hoop cheese, or 6 egg whites. The latter two choices were to be selected occasionally [2]. The protein intake on the Simeons diet therefore ranged from about 45 to 50 grams per day. The Simeons method was very popular in the 1970s and advocates claimed that the method had numerous advantages including rapid weight loss with minimal hunger, no weakness, and dramatic loss of fat in the stomach, hips, thighs, and upper arms.

After a series of clinical trials disputing the effectiveness of the Simeons Method it fell from favor, but popular demand for HCG in the treatment of obesity has recently resurfaced in the United States. HCG is currently available for injection and as sublingual tablets.

Discussion

Although there were a few early studies in agreement with Simeons recommendations [2-3], a number of subsequent studies produced evidence that the HCG in the Simeons method was ineffectual and that the weight loss was entirely due to the diet [4-7]. A meta-analysis review in 1995 of prior studies concluded that there is no scientific evidence that HCG is effective in the treatment of obesity [8]. The meta-analysis found insufficient evidence supporting the claims that HCG is effective in altering fat-distribution, hunger reduction or in inducing a feeling of well-being. The authors stated “…the use of HCG should be regarded as an inappropriate therapy for weight reduction…” In the authors opinion, “Pharmacists and physicians should be alert on the use of HCG for Simeons therapy. The results of this meta-analysis support a firm standpoint against this improper indication. Restraints on physicians practicing this therapy can be based on our findings.” PubMed and Google Scholar searches (on December 2, 2009) revealed no favorable reports on the Simeons method since the 1995 meta-analysis.

On the other hand, no significant harmful effects of HCG injections have been described in the medical literature.

The diet employed in the Simeons method provides a daily protein intake below that recommended by the RDA for most patients. The caloric intake of the Simeons diet is similar to that of a VLCD but the protein intake is lower than that prescribed for VLCDs in current use. Indeed, in the last few years several well-known researchers have produced evidence that most adults benefit from protein intakes well above the minimum RDA and that intakes higher than the minimum RDA improve weight loss during caloric restriction diets [9-10]. A further criticism of the Simeons diet is that the amounts of protein per serving recommended do not reach 30 grams, the threshold dose required for initiation of muscle protein synthesis [11-14]. Although the required amount of daily protein intake is still controversial, most bariatric practitioners will agree that caloric restriction diets should provide more than the minimum recommended by the RDA.

Recent studies indicate that HCG injections in men, especially men with testosterone deficiency, can produce a slight gain in muscle mass, thought to be due to rises in testosterone levels [15]. The doses in the latter study were 250 units twice weekly. However, no studies have been reported of muscle mass changes in patients before and after weight loss with the Simeons method. Therefore one cannot assume that weight loss with the Simeons method will result in a net gain in muscle mass.

There are no reports in the medical literature regarding the effectiveness of sublingual HCG.

Summary

Numerous clinical trials have shown HCG to be ineffectual in producing weight loss. HCG injections can induce a slight increase in muscle mass in androgen-deficient males. The diet used in the Simeons method provides a lower protein intake than is advisable in view of current knowledge and practice. There are few medical literature reports favorable to the Simeons method; the overwhelming majority of medical reports are critical of it. Physicians employing either the HCG or the diet recommended by Simeons may expose themselves to criticism from other physicians, from insurers, or from government bodies.

Conclusions

It is the position of the American Society of Bariatric Physicians that:

1. The Simeons method for weight loss is not recommended.

2. The Simeons diet is not recommended.

3. The use of HCG for weight loss is not recommended.

References

1. Simeons A. The action of chorionic gonadotropin in the obese. Lancet 1954; 2: 946-947.

2. Asher WL, Harper HW. Effect of human chorionic gonadotrophin on weight loss, hunger, and feeling of well-being. Am J Clin Nutr 1973; 26: 211-218.

3. Lebon P. Treatment of overweight patients with gonadotropin: follow-up study. J Am Geriat Soc 1966; 14: 116-125.

4. Greenway FL, Bray GA. Human chorionic gonadotropin (HCG) in the treatment of obesity: a critical assessment of the Simeons method. West J Med 1977; 127: 461-463. PMCID: 1237915.

5. Stein M, Julis R, Peck C, Hinshaw W, Sawicki J, Deller J, Jr. Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study. Am J Clin Nutr 1976; 29: 940-948.

6. Young RL, Fuchs RJ, Woltjen MJ. Chorionic Gonadotropin in Weight Control: A Double-Blind Crossover Study. JAMA 1976; 236: 2495-2497.

7. Bosch B, Venter I, Stewart RI, Bertram SR. Human chorionic gonadotrophin and weight loss. A double-blind, placebo-controlled trial. S Afr Med J 1990; 77: 185-189.

8. Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G. 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 1995; 40: 237-243. PMCID: 1365103.

9. Layman D. Dietary guidelines should reflect new understandings about adult protein needs. Nutrition & metabolism 2009; 6: 12.

10. Layman DK. Protein quantity and quality at levels above the RDA improves adult weight loss. J Am Coll Nutr 2004; 23: 631S-636S.

11. Paddon-Jones D, Rasmussen BB. Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care 2009; 12: 86-90.

12. Paddon-Jones D, Short KR, Campbell WW, Volpi E, Wolfe RR. Role of dietary protein in the sarcopenia of aging. Am J Clin Nutr 2008; 87: 1562S-1566.

13. Paddon-Jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-Plantenga M. Protein, weight management, and satiety. Am J Clin Nutr 2008; 87: 1558S-1561.

14. Symons TB, Sheffield-Moore M, Wolfe RR, Paddon-Jones D. A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects. J Am Diet Assoc 2009; 109: 1582-1586.

15. Liu PY, Wishart SM, Handelsman DJ. A Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Recombinant Human Chorionic Gonadotropin on Muscle Strength and Physical Function and Activity in Older Men with Partial Age-Related Androgen Deficiency. J Clin Endocrinol Metab 2002; 87: 3125-3135.

This position is ASBP Board-approved and accurate as of November 2010. It will be reviewed and updated if further research is warranted.