HCG Diet: Junk Science That Just Won't Go Away

While art, fashion and nightlife inspired by the past may be a "do," doowop-era fad diets are a don't. Specifically, I'm talking about one idea born in the 1950s that keeps coming back into fashion: the HCG diet.
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With the popularity of swanky nightclubs like The Edison and the Cicada Club retro is big in Los Angeles. But, while art, architecture, fashion and nightlife inspired by the past may be a "do" -- I'm going to say that doowop-era fad diets are a don't. Specifically, I'm talking about one lousy idea born in the 1950s that keeps coming back into fashion: the HCG diet.

No matter how many times scientific studies shoot down the effectiveness of this regimen, someone eagerly brings it back with expensive injections and unproven products. The diet originally was developed by A.T.W. Simeons, a British MD. He injected children with Frohlich's syndrome -- a condition characterized by obesity and slow development of reproductive organs -- with human chorionic gonadotropin. It's a hormone derived from the urine of pregnant women and known as HCG for short. This hormone stimulates the testes to produce testosterone, which helped the kids gain muscle mass and lose some of their fat (i.e. they went through puberty). For the next 20 years, he tried out the injections on overweight people without hormonal imbalances, while simultaneously putting them on a strict, 500-calorie-per-day diet of lean meat, leafy vegetables, fruit and two pieces of crisp bread. Unsurprisingly, these patients lost weight. Fans of the regimen boast they can lose up to a pound day.

It stands to reason that anyone who limits their food intake to a measly 500 calories daily will drop lots of weight -- which has nothing to do with that diet accompanied with a pricey hormone injection. That doesn't make it a good -- or safe -- idea. Further, the HCG diet claims that the hormone allows dieters to stick to minuscule meals without hunger pangs. However, many studies have since refuted this notion, with study patients both reporting ample urges to eat, as well as identical results between patients receiving the hormone and patients receiving placebo injections. The injections do keep the patients coming back to the doctor for the shots, a weigh in and a "wallet biopsy."

That hasn't sent this idea as out of fashion as the poodle skirt. Instead, the diet has evolved from injections to "homeopathic" products packaged as drops, pellets and sprays that indicate they contain HCG. The hormone is produced by the placenta during pregnancy and approved by the Food and Drug Administration as a prescription fertility treatment. In January, however, the FDA condemned these weight-loss products as fraudulent and illegal. One problem is that while these products label themselves as homeopathic, they are unrecognized as such by the FDA. (Homeopathy is an alternative medicine practice in which minute or diluted preparations of drugs are used to treat a condition.) As an oral preparation, the hormone would break down in the stomach, rendering it useless. As an injection, the hormone is approved only as a fertility treatment and treatment of undescended testicles -- not a weight loss aid.

There's good reason for that. Studies repeatedly have shown it doesn't work for weight loss. Dutch scientists analyzed eight uncontrolled and 16 controlled trials that measured HCG's effect in treating obesity and published their results in the British Journal of Clinical Pharmacology in 1995. Their analysis concluded there is no scientific evidence the hormone has any effect in treating obesity, that it does not bring about weight loss or redistribute fat. Further, the hormone fails to reduce hunger or spark a feeling of well-being.

The analysis also makes a point in remarking on the inappropriate use of the hormone in weight control since it is derived from pregnant women's urine, donated for the purpose of treating infertility.

A svelte physique is so prized and sought -- particularly in Los Angeles, the natural habitat of the beautiful and famous -- people will consider just about any bad idea to obtain it. It's mystifying that people will go to great lengths to buy only organic foods, shun junk food and yet repeatedly feed their minds with junk science. The Food and Nutrition Science Alliance, which includes the American Dietetic Association, the American Society for Clinical Nutrition, American College of Nutrition, and a number of other professional scientific societies, has developed a number of "Red Flags of Junk Science." The HCG diet raises many, including its:

  • Promises of a quick fix. Any diet that claims weight can be lost fast should raise a skeptical brow.
  • Claims that sound too good to be true. Claiming that an injection can make you feel spry and content on 500 calories daily falls in this category. Proponents also claim the shots "redistribute" fat or "target" specific problem areas of the body, fallacies to those who know medicine or science.
  • Statements refuted by reputable scientific organizations.
  • Lists of "good" and "bad" foods. Nutrition is a science. There shouldn't be a moral judgment placed on foods. Foods can be rich in nourishing nutrients, or poor in them.
  • Recommendations made to help sell a product.
  • Recommendations based on studies not peer reviewed. Anecdotes of success, as opposed to conclusions drawn from large clinical studies, could fall under this category.

As the medical community searches for tools to treat the growing obesity epidemic, there is a place for "very low" calorie diets, medically defined as diets consisting of 800 calories per day or less. These diets can be prescribed for those who are obese and need to lose large amounts of weight. But they are undertaken under physician supervision, with regular blood tests, blood pressure screenings and EKGs, among other screenings. Further, the food on these regimens often is prescribed, too, to ensure that patients get adequate nutrition from the calories they consume. This is accompanied by coaching in behavior modification and long-term strategies for weight control so the pounds don't just return when the very low calorie diet ends.

There's no quick fix in weight loss, and no miracle pill or injection that will erase the sensation of hunger. Weight and obesity often are complex health problems with a heavy dose of emotion attached to them; they can be hard for physicians and patients alike to confront. This is why fad diets and products like these make me angry: they prey on people who have a real health problem, offering them false, often expensive "solutions" that don't work and can cause harm. Before dialing the number on a late-night infomercial, turn to a doctor you trust or one of the many weight loss programs that have real science -- not junk science -- on their sides.

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