Friday, August 24, 2012

Weight loss programs I wish would go away #2: The HCG diet.

SkepticRD had the good fortune to have a good science-based education and do a dietetic internship where I was taught to look at new research and new treatments with a critical eye.  Once I graduated I had the idea that anyone who survived the rigors of obtaining their health care degree/license/registration would have that same critical eye and be aware of how their own body worked.  I don't think that delusion lasted for more than a month once I overhead what other other health care people were telling their patients and even what I saw them try to do for themselves when it came to what I call "Food and Diet Woo."  Here in Skepticville one of "things people who should know better but don't" are doing is the HCG diet.

First, a little history, as this plan is not new but a recirculation of something that's been around for about 50-60 years.   Apparently a German endocrinologist by the name of ATW Simeons was the first use to the hormone human chorionic gonadotropin (HCG) to help people lose weight after publishing his book in 1954.  I noticed that it was difficult to get information on this person from a reliable internet source (which should be a red flag there) but apparently he either noticed the weight loss side effects when either a) treating adolescent males with low testosterone, or b) he noticed that women living in third world countries were still giving birth to "healthy" babies even though they were on "starvation diets."  He then formulated a regimen combining weekly injections of HCG with a 500 calorie a day diet and a new weight loss plan was formed.  This plan enjoyed a resurgence around 2007 when Kevin Trudeau published his book "The weight loss cure they don't want you to know about.

As I mentioned before, the fact that it was hard to find reliable information on the author of this plan, although his 50 page booklet on obesity is free for download for your reading pleasure.  Once again, the fact that it was hard to find reliable websites that contained information on him was one red flag, another red flag was the story about the starving women giving birth to supposedly healthy babies.  The impact of poor nutrition during pregnancy has been fairly well established (Link) so I would be curious to see how healthy these children were.  The third red flag was that the supplement was done in conjunction with a very low calorie diet, which would help people lose weight anyway even if it wasn't very pleasant to follow.  Fourth, the title of Kevin Trudeau's book, which speaks of conspiracy theories and persecution is one of the major red flags in the Baloney Detection Kit.

Then of course there is the question, "Is there any evidence that this works?"  Stephen Barrett, MD over at and has already compiled a pretty extensive list of studies that say "no." (Link)  One of things that I worry about is the long term consequences.  First of all, it is very hard to meet your protein and fat needs to maintain your lean body mass and cell wall integrity on that low of a calorie diet.  Possible, but difficult.  Second of all, what about maintaining weight loss in the long term?  Losing weight can be quite easy actually; it's keeping it off that's the problem.  In order to keep that weight off you need to find a program you can live with most of the time, and preferably a way of eating where you actually enjoy what you eat!  Third, we don't know too much about the long term consequences of playing with this type of hormonal treatment.  Of course, HCG is a "natural" hormone that helps women who have infertility, but there are other "natural" hormones that our bodies produce that can have devastating consequences when out of balance, like insulin for instance.

There is also (always!) the cost of the program.  Apparently some insurance programs will cover injections but you are still paying a co-pay.  And if you really want to waste your money you can buy the "herbal" or "homeopathic" version. There are many articles on why homeopathy is junk science, but here's favorite by SkepticHero Dr. Harriet Hall.  And even if there is actually enough HCG in something, this type of hormone is what we call a polypeptide hormone which will be broken down in your stomach and rendered useless.  Just like insulin has to be given via injection for it to work, this type of hormonal treatment requires injections as well.

Take home message--not enough evidence to support the HCG diet for long term weight loss.  And unless you want to dissolve away your money, don't use the herbal formulation.

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