In was in the 1930s that Dr. Albert T. W. Simeons brought the world the human chorionic gonadotropin (HCG) diet. After scores of unsuccessful controlled trials, the enthusiasm surrounding the HCG diet largely diminished. But in 2007 it was resurrected trom the rubbish bin of science and it wasn’t long before the hysteria rekindled and the same fad reared its ugly head once more.
Yet the first trials to look at the efficacy of the HCG diet coming out negative were already conducted in 1959 by Dr. Carne. He performed two, both feeding the subjects 500 calories a day. In the first trial he administered the intervention group with HCG (as per the dose prescribed by Simeon's himself) via intramuscular injection. The control group were given a placebo (saline) solution. After six weeks, there was no significant weight-loss difference between the two groups (1).
Carnes' second trial was arguably even important than his first because it did not even use HCG. The study involved choosing random subjects and in addition to their 500 calorie/day diet, he gave some the placebo injections and some just the diet alone. The subjects of course thought the injections were HCG. Something amazing happened that would later come to firmly validate the uselessness of the HCG diet. Carnes found that those in the placebo group lost significantly more weight (nearly 5 pounds more at the end of the 6 week period). The study paper extensively accounts how subjects in the placebo group constantly spoke about the "benefit" they felt and how this was the only diet that seemed to work for them (1). This is unequivocally the placebo-effect. It's very real and is entirely what HCG is about.
It took another 33 years before another trial was published. Dr.Craig put subjects on a 550 calorie diet with either saline or HCG injections. Again, there was no significant difference in weight-loss observed between groups (2).
Another study of the same fashion emerged in 1964 where researchers placed subjects on either a placebo or HCG injection. Researchers however did not conform to the traditional 500 calorie a day diet, instead prescribing 1000 calories a day, stating it would increase dietary adherence. Again, there was no significant variations in weight-loss between intervention and control groups (3).
The 'Supportive' Doesn't Support Anything
HCG proponents love to remind us that powerful organizations such as the FDA collude with medical journals to prevent the publishing of supportive studies or some such nonsense. If these people had bothered to review the scientific literature they would know that in fact supportive studies have been published. But how convincing are they?
Two trials purportedly found results that supported the HCG diet. The first trial was performed by Harper and Asher. At the start of the study the researchers were quick to dismiss all other previous trials because they failed to follow Simeon's 'exact' protocols. Their study sought to correct these 'errors'. They put 2 groups of subjects on diets consisting of 500-550 calories and gave one group either HCG injections or the placebo. Those in the HCG group lost nearly twice more weight than the placebo group (9).
Since this study was an aberration, another group of researchers sought to replicate the results in a much more closely controlled trial with more participants. The exact same protocol was used in this study as was used in the Harper and Asher trial. Although in this study there was no statistically significant difference in weight-loss between groups (10). The findings of Harper and Asher were not validated and thus cannot be taken as legitimate support for the HCG diet.
Moreover, in their paper, Harper and Asher also make a fleeting comment about a previous trial they conducted that failed to find any greater weight loss in the HCG group. Suspiciously this study was never published. Finally, doubt needs to be raised about the objectivity of the researcher, Harper, who was already using the HCG diet in his practise prior to conducting the trial, making confirmation bias a very probable reality. In holism, too many questionable factors arise when looking at the this study. But most importantly, the findings seen were not replicated by another group of researchers.
The second trial investigated patients assigned a 500 calorie a day diet receiving either placebo or saline injections as per the usual study designs. But again, the study was riddled with discrepancies that cannot be ignored. Firstly, the entire paper is woefully reported with failure to elucidate randomization procedures, the ages of 40 subjects are missing, and the results of 23 subjects are excluded from the final analysis. Secondly, statistical significance was mostly dependant on outliers; the majority of the subjects in both the placebo or HCG group differed only slightly in weight-loss (11).
Dangers And Some Common Sense
In a 2012 review of the toxicology of weight-loss agents, it was reported that adverse side-effects of HCG use may include hypotension, hypoglycemia, constipation, fatigue and a possible concern regarding increased thrombosis risk with intramuscular injections of HCG (12). Trials have not been of sufficient length to ascertain any long-term health risks. Regardless, it is beyond comprehension why anyone would choose to inject themselves with an alien substance that imparts absolutely no benefit to weight-loss and may potentially be dangerous.
HCG - The Fad That Keeps On FailingA meta-analysis published in 1995 (13) concluded:
(...) there is no scientific evidence that HCG causes weight-loss, a redistribution of fat, staves off hunger or induces a feeling of well-being.That's right, folks, the HCG diet is another dismal diet failure which has been debunked time and again in controlled trials. Everyone that claims to have lost weight on the diet actually lost weight because they were eating at a caloric deficit, the HCG injections did absolutely nothing. The only thing they were experiencing was the placebo-effect. We can only hope that the HCG diet stays in the trash-pile where it belongs with all the other miserable diet failures that have come and gone over the decades. Stick to the time-tested and scientifically verified basics and reap the rewards!Pictures courtesy of Lauren Nelson and the U.S. Army Research, Development and Engineering Command.