Posted by: Chris Maloney | December 11, 2011

Why I Do Not Recommend HCG For Weight Loss.

The FDA has come down on the “homeopathic” versions of HCG, which were never homeopathic in any way.  But it has rekindled an interest in the diet, so here is the information again about why I do not recommend it, as well as the data. 

Hormone feedback cycles

Image via Wikipedia

Let me be clear.  Starving yourself for months on five hundred calories is extremely likely to lead to weight loss.  Taking HCG in addition to starving yourself (which has many long term side effects) has been shown not to help at all.  It may have very interesting side effects, as recorded on the chat rooms of body builders and in Timothy Ferriss‘ most recent book.   

The initial prospective studies on Simeon’s work were divided.  But when patients were divided into groups and some were given placebo, HCG failed to outperform placebo. 

Simeon’s mechanism of action for HCG does not hold up.  It is beyond me why Kevin Trudeau, who lost weight on the diet (starvation does equal short term weight loss) chose to promote this particular injectable rather than some of the newer ideas. 

I’m not promoting it, but it makes more sense to inject yourself with leptin than HCG.  We’ve got a positive prospective study to support it as well.  (Bottom of research). 

 

 

Br J Clin Pharmacol. 1995 Sep;40(3):237-43.

The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis.

Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G.

Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands.

Abstract

1. A meta-analysis was conducted to assess if there is scientific ground for the use of human chorionic gonadotropin (HCG) as adjunctive therapy in the treatment of obesity. 2. Published papers relating to eight controlled and 16 uncontrolled trials that measured the effect of HCG in the treatment of obesity were traced by computer-aided search and citation tracking. 3. The trials were scored for the quality of the methods (based on four main categories: study population, interventions, measurement of effect, and data presentation and analysis) and the main conclusion of author(s) with regard to weight-loss, fat-redistribution, hunger, and feeling of well-being. 4. Methodological scores ranged from 16 to 73 points (maximum score 100), suggesting that most studies were of poor methodological quality. Of the 12 studies scoring 50 or more points, one reported that HCG was a useful adjunct. The studies scoring 50 or more points were all controlled. 5. We conclude that there is no scientific evidence that HCG is effective in the treatment of obesity; it does not bring about weight-loss of fat-redistribution, nor does it reduce hunger or induce a feeling of well-being.

PMID: 8527285

West J Med. 1977 Dec;127(6):461-3.

Human chorionic gonadotropin (HCG) in the treatment of obesity: a critical assessment of the Simeons method.

Greenway FL, Bray GA.

Abstract

Injections of human chorionic gonadotropin (HCG) have been claimed to aid in weight reduction by reducing hunger, and affecting mood as well as aiding in localized (spot) reduction. We have tested these claims in a double-blind randomized trial using injections of HCG or placebo. Weight loss was identical between the two groups, and there was no evidence for differential effects on hunger, mood or localized body measurements. Placebo injections, therefore, appear to be as effective as HCG in the treatment of obesity.

PMID: 595585

JAMA. 1976 Nov 29;236(22):2495-7.

Chorionic gonadotropin in weight control. A double-blind crossover study.

Young RL, Fuchs RJ, Woltjen MJ.

Abstract

Two hundred two patients participated in a double-blind random cross-over study of the effectiveness of human chorionic gonadotropin (HCG) vs placebo in a wieght reduction program. Serial measurements were made of weight, skin-fold thickness, dropout rates, reasons for dropping out, and patient subjective response. There was no statistically significant difference between those receiving HCG vs placebo during any phase of this study (P greater than .1).

PMID: 792477

Geburtshilfe Frauenheilkd. 1987 May;47(5):297-307.

[Risk-benefit analysis of a hCG-500 kcal reducing diet (cura romana) in females].

[Article in German]

Rabe T, Richter S, Kiesel L, Runnebaum B.

Abstract

The British physician A.T.W. Simeons described in 1954 a new method for dieting. He combined a reduction diet (500 kcal per day) with daily injections of the pregnancy hormone human chorionic gonadotropin (hCG) (125 IU i.m.). According to Simeons the patient should not lose more weight during a 4-to-6 weeks’ diet than without hCG, but the injections should facilitate to maintain the diet and to lose body weight at specific parts of the body (e.g. hip, belly, thigh). After the first publication various studies conducted with male and female patients analysed the efficacy of the “Cura romana”. 10 of these studies showed positive and another 10 studies negative results with regard to hCG-related weight reduction. Two of these studies with positive results were double-blind studies (hCG vs. placebo). Most of them were reports on therapeutical experiences and were not controlled studies. According to these reports the body proportions normalized and the feeling of hunger was tolerable. Four out of 10 studies with negative results were controlled studies (hCG vs. control without hCG), whereas 6 were double-blind studies. These studies showed a significant weight reduction during dieting, but no differences between treatment groups in respect of body weight, body proportions and feeling of hunger. One of them is the only German study conducted by Rabe et al. in 1981 in which 82 randomised premenopausal volunteers had been dieting either with hCG or without hCG injections. In recent publications describing mostly well-documented double-blind studies authors largely reject hCG administration in dieting. Supporters of the hCG diet must prove the efficacy of this method in controlled studies according to the German Drug Law. Until then the opinion of the German steroid toxicology panel is still valid, that hCG is ineffective in dieting and should not be used (Bolt 1982 a, 1982 b).

PMID: 3609673

S Afr Med J. 1990 Feb 17;77(4):185-9.

Human chorionic gonadotrophin and weight loss. A double-blind, placebo-controlled trial.

Bosch B, Venter I, Stewart RI, Bertram SR.

Department of Medical Physiology and Biochemistry, University of Stellenbosch, Parowvallei, CP.

Abstract

Low-dose human chorionic gonadotrophin (HCG) combined with a severe diet remains a popular treatment for obesity, despite equivocal evidence of its effectiveness. In a double-blind, placebo-controlled study, the effects of HCG on weight loss were compared with placebo injections. Forty obese women (body mass index greater than 30 kg/m2) were placed on the same diet supplying 5,000 kJ per day and received daily intramuscular injections of saline or HCG, 6 days a week for 6 weeks. A psychological profile, hunger level, body circumferences, a fasting blood sample and food records were obtained at the start and end of the study, while body weight was measured weekly. Subjects receiving HCG injections showed no advantages over those on placebo in respect of any of the variables recorded. Furthermore, weight loss on our diet was similar to that on severely restricted intake. We conclude that there is no rationale for the use of HCG injections in the treatment of obesity.

PMID: 2405506

JAMA. 1999 Oct 27;282(16):1568-75.

Recombinant leptin for weight loss in obese and lean adults: a randomized, controlled, dose-escalation trial.

Heymsfield SB, Greenberg AS, Fujioka K, Dixon RM, Kushner R, Hunt T, Lubina JA, Patane J, Self B, Hunt P, McCamish M.

Weight Control Unit, St Luke’s-Roosevelt Hospital, New York, NY 10025, USA. SBH2@Columbia.edu

Comment in:

JAMA. 2000 Mar 22-29;283(12):1567-8.

Abstract

CONTEXT: The protein hormone leptin is important to the homeostatic regulation of body weight. Treatment with exogenous leptin may affect weight loss.

OBJECTIVE: To determine the relationship between increasing doses of exogenous leptin administration and weight loss in both lean and obese adults.

DESIGN: A randomized, double-blind, placebo-controlled, multicenter, escalating dose cohort trial conducted from April 1997 to October 1998.

SETTING: Four university nutrition and obesity clinics and 2 contract clinical research clinics.

PARTICIPANTS: Fifty-four lean (body mass index, 20.0-27.5 kg/m2; mean [SD] body weight, 72.0 [9.7] kg) and 73 obese (body mass index, 27.6-36.0 kg/m2; mean [SD] body weight, 89.8 [11.4] kg) predominantly white (80%) men (n = 67) and women (n = 60) with mean (SD) age of 39 (10.3) years.

INTERVENTIONS: Recombinant methionyl human leptin self-administered by daily morning subcutaneous injection (0 [placebo], 0.01, 0.03, 0.10, or 0.30 mg/kg). In part A, lean and obese subjects were treated for 4 weeks; in part B, obese subjects were treated for an additional 20 weeks. Lean subjects consumed a eucaloric diet to maintain body weight at the current value, and obese subjects were prescribed a diet that reduced their daily energy intake by 2100 kJ/d (500-kcal/d) from the amount needed to maintain a stable weight.

MAIN OUTCOME MEASURES: Body weight, body fat, and incidence of adverse events.

RESULTS: Weight loss from baseline increased with increasing dose of leptin among all subjects at 4 weeks (P = .02) and among obese subjects at 24 weeks (P = .01) of treatment. Mean (SD) weight changes at 4 weeks ranged from -0.4 (2.0) kg for placebo (n = 36) to -1.9 kg (1.6) kg for the 0.1 mg/kg dose (n = 29). Mean (SD) weight changes at 24 weeks ranged from -0.7 (5.4) kg for the 0.01 mg/kg dose (n = 6) to -7.1 (8.5) kg for the 0.30 mg/kg dose (n = 8). Fat mass declined from baseline as dose increased among all subjects at 4 weeks (P = .002) and among obese subjects at 24 weeks of treatment (P = .004); more than 95% of weight loss was fat loss in the 2 highest dose cohorts at 24 weeks. Baseline serum leptin concentrations were not related to weight loss at week 4 (P = .88) or at week 24 (P = .76). No clinically significant adverse effects were observed on major organ systems. Mild-to-moderate reactions at the injection site were the most commonly reported adverse effects.

CONCLUSIONS: A dose-response relationship with weight and fat loss was observed with subcutaneous recombinant leptin injections in both lean and obese subjects. Based on this study, administration of exogenous leptin appears to induce weight loss in some obese subjects with elevated endogenous serum leptin concentrations. Additional research into the potential role for leptin and related hormones in the treatment of human obesity is warranted.

PMID: 10546697

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