The Hidden Dangers of The hCG Diet

My office gets calls each week, “Do you do the hCG Diet?”

This astounds me. hCG injections as an easy way to lose weight? Think again. It’s a scam, a fraud, a hoax, a deception.

I originally learned about the hCG diet when I studied as a Nutrition major at Cornell University. Human chorionic gonadotropin (hCG) is a hormone produced by the placenta during pregnancy. It’s the very same hormone, in fact, that turns the stick blue on a home pregnancy test. Dr. Albert T.W. Simeons first described the use of hCG as a treatment for obesity in a case series published in 1954 [1]. The Simeons Method consisted of a rigid diet of only 500 calories per day for forty days, along with the abstinence from using any medications or skin care products, and daily deep intramuscular injections of 125 units of hCG. The treatment became popularly known in 1957, when Harper’s Bazaar printed the story, “Slimming: A Roman Doctor’s Treatment” where Dr. Simeons claimed hCG would redistribute fat from the waist, hips and thighs, and his patients weren’t hungry as long as they took shots of hCG [2].
When diet clinics (run by other physicians, not Dr. Simeons) started popping up in the 1970’s offering “The Simeons Method” and “The hCG Diet”, people lost weight, but they lost their hair too [3]. When patients realized how unhealthy the diet was, they resumed eating. Their weight came back, but for at least a few unfortunate souls, their hair did not [4, 5].
Starvation itself leads to a reduced appetite [6]. The 500-calorie (semi-starvation) diet caused loss of protein from vital organs. When other physicians tried to replicate Dr. Simeons’ results in double-blind studies, they realized that the shots didn’t do anything, and that weight loss was due to the diet alone [7]. Study after study was published showing that the injections were just expensive placebos [8-13].

In 1976, the FTC ordered the diet clinics to stop their false and misleading advertising [14]. Though they couldn’t stop doctors from using hCG (the FDA allows hCG to be used for infertility treatments), it did make them disclose to every patient the following:

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.

Negative studies and government action reduced the use of hCG injections for weight control close to zero [15]. Why the recent resurgence in clinics advertising hCG shots and sublingual drops? Thank Kevin Trudeau and his 2007 book, The Weight Loss Cure They Don’t Want You to Know About [16].

Kevin Trudeau is a two-time convicted felon (impersonating a doctor and forging checks, and identity theft by stealing names and Social Security numbers, applying for credit cards and running up huge charges) who also happens to be one heck of a salesman [17]. His favorite marketing tool is the “infomercial,” a lengthy television advertisement that takes the form of a mock interview [18]. Through this medium Mr. Trudeau has sold various worthless products that he claimed could: cure numerous diseases, such as multiple sclerosis, cancer, substance abuse addictions, and arthritis (among many others); “hair farming” (a cure for balding); improve memory; and cause dramatic and permanent weight loss [19]. In 2004, the FTC won a permanent injunction prohibiting Mr. Trudeau from producing or disseminating infomercials with one narrow exception, for First Amendment reasons, he was still allowed to talk about his books [20].

Misleading commercial speech is entitled to no First Amendment protection however, so in 2007, the FTC charged Kevin Trudeau with violating a court order by misrepresenting the contents of the book [21]. In infomercials, Trudeau falsely claimed that the book’s weight-loss plan is easy to do, can be done at home, and ultimately allows readers to eat whatever they want. The hCG diet as described in his book, however, states that for the rest of your life, you can never use a microwave, never consume any chain restaurant food, avoid all artificial sweeteners, eat 100% organic food, exercise outside at least one hour a day, and among other things, periodically do colonic irrigation. In 2008, the Court ruled that his book was merely an advertisement for his website and newsletter, at a cost of $71 per month, that Trudeau had violated the previous order for making false claims, and ordered Trudeau to pay $37.6 million, the amount paid by consumers he defrauded [22].

The hCG diet is now being advertised everywhere as it is very lucrative for the physician and pharmacy to sell you worthless medication (that is often misbranded knockoffs from China and India) [23]. It still doesn’t work, but I guess the MIT study was right, expensive placebos are more convincing that cheap placebos [24]. The American Society of Bariatric Physicians (ASBP) has put forth a position statement that the hCG diet doesn’t work, is potentially dangerous, and isn’t recommended [25]. You might consider people that try the hCG diet to just be desperate to lose weight, but the state attorney would more likely classify them as victims of unscrupulous clinicians.

No one likes to be played for a fool. Dr. G. Michael Steelman, editor of the American Journal of Bariatric Medicine stated at the ASBP annual conference in November 2010, “This is going to explode, just like phen/fen [26].” I have to agree.

The State of Louisiana has already banned the use of hCG in the treatment of obesity [27]. I predict that in 2011, the FTC will come down on everyone and anyone advertising the hCG diet for violations of the Federal Trade Commission Act [28]. The FDA will send warning letters telling clinics and pharmacies that if they do not cease and desist from unsubstantiated claims, they will be subject to raids from the DEA for violating the Federal Food, Drug, and Cosmetic Act [29]. And the Florida medical board will reprimand any clinician offering hCG weight loss treatments for making deceptive, untrue, or fraudulent representations in or related to the practice of a profession or employing a trick or scheme in or related to the practice of a profession [30].

In the meantime, what does my receptionist say when prospective patients ask whether we offer the hCG diet? “We’ve looked at it, we’ve studied it, we’ve compared the data, and we get better results without the added cost of hCG.”

To learn about one of my patient’s run-in’s with this diet, read my article, Case of The hCG Diet Hoax.

[1] Simeons AT. The action of chorionic gonadotrophin in the obese. Lancet. 1954
Nov 6;267(6845):946-7. [2] Fraser L. Ten Pounds in Ten Days – A Sampler of Diet Fads and Abuse. In Fraser L. Losing It: False Hopes and Fat Profits in the Diet Industry. New York, NY: Plume; 1998. [3] Blackburn GL, Bistrian BR, Hoag C. Letter: Hair loss with rapid weight loss. JAMA. 1976 Jul 19;236(3):252. [4] Dulloo AG, Jacquet J, Girardier L. Poststarvation hyperphagia and body fat overshooting in humans: a role for feedback signals from lean and fat tissues. Am J Clin Nutr. 1997 Mar;65(3):717-23. [5] Goette DK, Odom RB. Alopecia in crash dieters. JAMA. 1976 Jun 14;235(24):2622-3. [6] Andik I, Donhoffer S, Moring I, Szentes J. The effect of starvation on food intake and selection. Acta Physiol Hung. 1951;2(3-4):363-8. [7] Sohar E. A forty-day-550 calorie diet in the treatment of obese outpatients. Am J Clin Nutr. 1959 Sep-Oct;7:514-8. [8] Frank BW. The use of chorionic gonadotrophin hormone in the treatment of obesity. A double-blind study. American Journal of Clinical Nutrition 1964;14:133–136. [9] 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. [10] Young RL, Fuchs RJ, Woltjen MJ. Chorionic Gonadotropin in Weight Control: A Double-Blind Crossover Study. JAMA 1976; 236:2495-2497. [11] 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. [12] 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. [13] 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. Br J Clin Pharmacol. 1995;40:237-243. [14] 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. [15] Barrett, Stephen. HCG Worthless as Weight-Loss Aid. http://www.dietscam.org/reports/hcg.shtml Accessed November 21, 2010. [16] Trudeau K. The Weight Loss Cure They Don’t Want You to Know About. Birmingham, AL: Alliance Publishing; 2007. [17] Warner, M. After Jail and More, Salesman Scores Big With Cure-All Book. NY Times. August 28, 2005. [18] Wikipedia – “Kevin Trudeau”. http://en.wikipedia.org/wiki/Kevin_Trudeau accessed November 21, 2010. [19] Barrett, S. Kevin Trudeau Found In Contempt of Court Again. http://www.casewatch.org/ftc/enforcements/trudeau/book/contempt.shtml accessed November 21, 2010. [20] Kevin Trudeau Banned from Infomercials For Three Years, Ordered to Pay More Than $5 Million for False Claims About Weight-Loss Book. October 6, 2008. http://www.ftc.gov/opa/2008/10/trudeau.shtm accessed November 21, 2010. [21] Central Hudson Gas & Elec. Corp. v. Pub. Serv. Comm’n, 447 U.S. 557, 562-63 (1980). [22] Judge Orders Kevin Trudeau to Pay More Than $37 Million for False Claims About Weight-Loss Book. http://www.ftc.gov/opa/2009/01/trudeau.shtm accessed November 21, 2010. [23] Barrett, S. Illegal HCG Seized at Naturopathic Clinic. http://www.casewatch.org/doj/marschall/warrant_application.shtml accessed November 21, 2010. [24] Waber RL, Shiv B, Ariely D. Commercial Features of Placebo and Therapeutic Efficacy. JAMA. 2008;299(9):1016-1017. [25] American College of Bariatric Physicians. Position statement: Use of HCG in the treatment of obesity. Approved Dec 2009. [26] Steelman GM. hCG: A Debate. American Society of Bariatric Physicians. 60th Annual Obesity & Associated Conditions Symposium. New Orleans, LA. November 10-14th, 2010. [27] Louisiana Statutes. Chapter 69. Prescription, Dispensation, and Administration of Medications. Subchapter A. Medications Used in the Treatment of Obesity. §§6901-6913. [28] Federal Trade Commission Act 15 U.S.C §§ 41-58. [29] Federal Food, Drug, and Cosmetic Act 21 U.S.C. § 301 et seq. [30] Florida Statutes 456.072 (a)(m)(n)(gg); 457.109 (d)(k)(n); 458.331 (d)(k)(n)(o)(q)(u)(ee)(qq); 459.015 (d)(r)(t)(y)(ii)(ss); 460.413 (d)(k)(n)(p)(s); 468.518 (g)(h)(m)(n); 465.016 and 465.024.

Dr. Kenneth Woliner is a board-certified family physician in private practice in Boca Raton. He can be reached at Holistic Family Medicine, LLC, 9325 Glades Road Suite #104, Boca Raton, Florida 33434 or via the phone at (561) 314-0950 or via e-mail at knw6@cornell.edu.