It's been a while since I wanted to write a piece about HCG diets. I've had several patients coming to me recently asking for advice as to whether it would be a good thing for them to do in order to lose weight. I have seen a lot of interest for HCG diets not only among my patients, but even among my peers. A couple of years ago, a former residency colleague called me to ask for advice regarding a practice opportunity where he was offered a lucrative position by one of the HCG diet firms. They needed a physician to authorize and give more credence to their weight loss program, and in return he was to receive very generous benefits, including a promise to drive a Mercedes Benz before the year was over.
The HCG weight loss craze is perhaps the most recent in a series of diet fads. At any given time in recent history, there was at least one famous offer on the table for those looking at massive weight loss - from Atkins to Hoodia, to Acai berry, and now to homeopathic HCG.
For those who are not familiar with the details, the HCG diet plan promises rapid and substantial weight loss for those who use HCG homeopathic supplements. They are told that HCG is a natural hormone that will change their metabolism so that they will find it a lot easier to lose the fat around the waist and other unwanted areas. They claim there is ample scientific support for this.
What is not so apparent at first look, but is presented as an absolutely necessary ingredient once you become interested, is that a very low calorie diet is also a requirement - 500 calories a day is typically recommended.
I wanted to discuss here a few issues related to the HCG diet plan. First, I will look at the claims related to HCG's effect on body fat and metabolism. Second, I will discuss the role the 500 calories a day diet plays in the actual weight loss that happens, as well as the risks of such a very low calorie diet. Finally, I will present some concluding thoughts.
What Is HCG?
HCG is, indeed, a naturally occurring hormone in pregnant women. In fact, it is the hormone that turns the urine pregnancy tests positive quite early after conception, when it is produced by the embryo. Later in pregnancy, HCG is made in generous amounts by the placenta. HCG plays several important roles during pregnancy. Early on, it promotes progesterone secretion from the corpus luteum (a structure that is left in the ovary after the egg is released at ovulation). Progesterone is very important in preparing the uterus for implantation of the egg and subsequent development of the fetus. Later, HCG appears to play an important role in sheltering the fetus against his mother's immune system. It has also been suggested that HCG is responsible for morning sickness. Finally, there is evidence that HCG plays a role in cellular/tissue growth.
HCG is very similar in structure to LH, a pituitary hormone present in both men and women. LH is important in triggering the ovulation in females, and in males it stimulates testosterone production. Because of this similarity, and because HCG is easy to extract from the urine pregnant women, HCG is oftentimes used in fertility treatments.
Another important thing to remember is that HCG is a glycoprotein. More on that later.
What Is The HCG Diet?
The diet plan that is promoted with the HCG package is a very low calorie diet, about 500 calories a day. The average adult needs anywhere between 1,600-2,000 calories a day. That same average adult loses a pound of body weight for every 3,500 calories in deficit. The HCG diet averages a deficit of 1,100 to 1,500 calories a day, which causes people to lose 2-3 lbs a week. The weight loss is typically more pronounced in the beginning, for metabolic reasons.
For most who try it, the rapid rate of weight loss in the early phases of the HCG diet plan is the main attraction. After all, the sooner the excessive weight is gone, the better. Or so it seems...
Later on, during what is oftentimes called a maintenance phase, the caloric intake is increased to allow for a closer to normal diet.
Is There Any Scientific Evidence Showing HCG Causes Weight Loss
The short answer is no, absolutely none. The promoters use testimonials, "expert" statements and anecdotal evidence, rather than scientific studies/sources to back up their claims.
But there is a more direct answer to this question. HCG is a glycoprotein made up of 244 amino acid residues, plus some oligosaccharide chains bound to the peptide molecule. No normal adult human can absorb intact glycoproteins. They get annihilated (in terms of their function) by the stomach acid, and then broken down inside the intestine into 244 individual amino acids and individual sugar molecules, and these "pieces" is what we absorb. While it may not amount to much nutritionally (especially if the producer used the homeopathic method of infinitesimal dilutions), it can be very safely stated that there is absolutely no trace of active, functional HCG absorbed from these HCG supplements. This is the reason why fertility treatments with HCG are given by injection.
Even with other methods of administration - such as sprays, or sublingual forms, the absorption issue is there. HCG is such a large molecule that it is practically impossible for it to pass through the skin or mucosal barriers intact, in any significant amount.
There are promoters of HCG for weight loss who advocate injectable administration, and while this would ensure it makes it into the body intact, evidence for HCG causing weight loss independent of the very low calorie diet is lacking.
The heavy-lifting, in fact ALL the weight loss that occurs in people enrolled in HCG diet plans is caused by the very low calorie diet, as explained above. You can look at it this way: HCG is the trick these companies use to steal your money. Nobody would pay this much just for being told to semi-starve themselves on 500 calories a day. Amazingly, though, people would easily dent their savings accounts for a placebo.
HCG Diet Dangers
There are several serious reasons for concern that should give pause to anybody ready to try the HCG diet plan:
- Very low calorie diets are unhealthy. Malnutrition/vitamin and essential nutrient deficiencies are a real risk for those trying them. It is practically impossible to meet nutritional needs with diets with less than 800 calories a day. HCG diet promoters often recommend use of vitamin and mineral supplements, and while these can help, they are not a sufficient substitute for a healthy, adequate diet.
- Very low calorie diets cause gallstones. I have seen a number of patients who developed gallstones after an aggressive diet very low in calories. Gallstone surgery is no small deal, even in the days of laparoscopic procedures.
- HCG diets slow metabolism. These diets cause the body to go into a sort of hibernation mode, slowing down metabolic processes to a degree that is takes a lot more effort to lose weight in the future.
- HCG diets are not sustainable. While they usually cause significant weight loss, these diets are so aggressive that they are difficult to follow even on the short-term. What I invariably see is people getting excited about the HCG diet, suffering through several weeks of semi-starvation, losing pounds usually in the double digits and boasting to everybody - including to me - about it, and then going gradually, or sometimes right away, to their old habits of unhealthy eating and sedentary life. And often before their next appointment, they have gained all the weight back, and then some. This yo-yo is not at all healthy for the human body. These people would be better off if they didn't diet at all.
- HCG diets are expensive. Wasting money on diet fads is not news anymore, but it still stings when it happens to you...
One of the things that puzzles me regarding the whole HCG weight loss craze is why people don't use their common sense. Women gain weight during pregnancy. Some women gain more than 30 lbs. If HCG, the hallmark hormone of pregnancy, had any effect on weight, it would most likely be weight gain. I know some say that HCG causes morning sickness, but even with morning sickness, most pregnant women gain weight.
I just hope what I wrote above will help those who are willing to use their common sense avoid wasting their money and endangering their health by trying the HCG diet fad.
If I could have another wish, I wish the HCG fad would go away. But I know wishes like these are not granted easily. So I guess I will settle for seeing the HCG weight loss fad fade into the confusing background noise of questionable, yet still popular weight loss plans that work for a while, only to disappoint later, like so many other diet fads have done in the past. I could settle to see the HCG plan buried in a place where people who would rather not change their lifestyle go to pick their alternatives from. But I know you are different - you made it to the end of the article, after all - and you would look for something better. Congratulations!
Dr. Gily Ionescu MS, MD.