The HCG diet has been around for decades but as we roll into 2020, it’s still a popular diet across the internet and social media.
The HCG diet is an extreme low-calorie diet that proponents claim will make you lose weight fast (1-2 lbs or 0.5 to 1kg per day) but without feeling hungry or losing muscle.
While this might sound appealing, the HCG diet is not risk-free and there are some red flags of which you should be aware.
Therefore, the purpose of this article is to cut through the hype, provide a level-headed look at the HCG diet, scientific evidence, what you can reasonably expect, risks and side effects, and a final recommendation.
What is HCG?
HCG stands for human chorionic gonadotropin and is the hormone produced by women during pregnancy.
Some pregnancy tests detect HCG, but it is also produced by some cancerous tumors so it’s always best to consult your doctor if your HCG levels are elevated.
What is the HCG diet?
In the 1950s, British physician Dr. Albert T. Simeons used HCG injections for the treatment of obesity.
He suggested that the addition of HCG to a reduced-calorie diet might help dieters improve adherence, reduce hunger cravings during food restriction, and promote fat loss.
The Simeons HCG protocol entailed:
- Daily injections of 125 international units (IU) of HCG six times per week for a total of 40 injections.
- A diet of 500 calories per day broken up into two daily meals.
HCG scientific research
In the early to mid 1970s, HCG diet studies started surfacing in peer-reviewed medical journals.
Initial optimism for the HCG diet as an obesity therapy was tempered by subsequent, more robust clinical studies which found no demonstrable benefit.
Asher and Harper (1973)
In a 1973 study published in the American Journal of Clinical Nutrition, Asher and Harper found that women receiving 125 IU injections of HCG six days per week for six weeks while consuming a 500 calorie per day diet lost more weight, had less hunger, and experienced greater well-being than women receiving placebo injections.
Stein, Julis, et al (1976)
In a 1976 study published in the American Journal of Clinical Nutrition, Stein and colleagues replicated the Asher-Harper study protocol and found no statistically significant difference in weight loss, percent of weight loss, waist and hip circumference, weight loss per injection, or hunger ratings between women receiving HCG injections versus a placebo injection.
Shetty and Kalkhoff (Feb 1977)
In a February 1977 study published in the Archives of Internal Medicine, Shetty and Kalkhoff compared six hospitalized obese women on 500 calorie diets receiving daily intramuscular injections of 125 IU of HCG for 30 days to five obese women on an identical diet receiving placebo injections.
They found no differences between groups for weight loss, triceps skinfold thickness, circumference measurements of the chest, waist, hips, and thighs, plasma and urine substrates, electrolytes, and hormone levels.
They concluded that the HCG injections offered no advantage over calorie restriction in promoting weight loss.
Miller and Schneiderman (Mar 1977)
In a March 1977 randomised double-blind crossover study in the Journal of Family Practice, Miller and Scheiderman found no significant difference in mood, hunger, or missed injections, and no apparent difference in adherence to diet between HCG and a placebo saline injection.
Interestingly, they did find that subjects were able to lose more weight in the first four weeks compared to the last four weeks in the study no matter what injection was used, suggesting a placebo effect or a Hawthorne effect (the awareness they were being studied).
Greenway and Bray (Dec 1977)
In a 1977 randomised double-blind study published in the Western Journal of Medicine, Greenway and Bray found no significant difference between groups in weight loss, hunger, mood, or body measurements and concluded that HCG injections were no more effective than a placebo injection.
Birmingham and Smith (1983)
- “HCG has no known effect on fat mobilization, appetite, or sense of hunger, or body fat distribution
- HCG has not been demonstrated to be effective adjunctive therapy for obesity
- There is no evidence that it increases weight loss beyond that resulting from caloric restriction
- There is no evidence that it causes a more attractive or “normal” distribution of fat
- There is no evidence that it decreases the hunger and discomfort associated with calorie-restricted diets
- Adverse effects may include headache, irritability, restlessness, depression, fatigue, edema, precocious puberty, gynecomastia, pain at injection site
Bosch, Venter, et al (1990)
In a 1990 double-blind, placebo-controlled study published in the South African Medical Journal, Bosch and colleagues found obese women on a 1200 calorie (5000 kJ) diet, receiving daily intramuscular HCG or placebo injections for six weeks showed no differences in weight loss, hunger, body circumference, or blood measures. They concluded there was no rationale for the HCG diet in the treatment of obesity.
Lijesen, Theeuwen, et al (1995)
- Most studies were of poor methodological quality (scores ranged from 16 to 73 points baed on a 100 point scale. Higher points meant better quality)
- Of the 12 studies that scored 50 or more points, only one reported that HCG was useful
- There is no scientific evidence that HCG is effective in the treatment of obesity
- HCG does not bring about weight loss or fat redistribution
- HCG does not reduce hunger or induce a feeling of well-being
For a more detailed breakdown of the scientific evidence, you can read Joe Cannon’s HCG research review here.
HCG diet for weight loss
Will you lose weight on the HCG diet?
My short answer is: yes, but… And it’s a big BUT.
You are only allowed to eat 500 calories a day and, well, that’s pretty much starving yourself.
Proponents of the diet claim you’ll lose 1-2 pounds (0.5 to 1 kg) per day, but this is simply unsafe and unsustainable.
Safe, healthy fat loss is about 1-2 pounds per week, not per day.
Any quick “weight loss” on the bathroom scale will likely be in the form of water, stored carbohydrate (called glycogen), and muscle.
You will lose some body fat, but not as much as you’re expecting. The severe calorie restriction will likely induce your body’s famine reaction, make you hold onto your body fat, and possibly make it more difficult to lose weight on future attempts.
Moreover, the scientific evidence for the HCG diet shows that weight loss was due to severe calorie restriction rather than anything to do with the HCG injections.
And there were no differences in hunger between those receiving HCG or a placebo.
HCG side effects & risks
Expect to lose muscle – and lots of it the longer you’re on the diet.
A major drawback to eating 500 calories per day is that you will “lose weight” but a lot of that will be valuable, metabolism-stoking muscle.
This sort of regimen cannot be sustained indefinitely and, when you go back to eating normally, your reduced muscle (lower metabolism) will leave you more susceptible to weight regain (yo-yo dieting).
A 500 calorie diet is a very low energy intake and should be supervised by a responsible bariatric physician or university-qualified dietitian (not a self-styled “nutritionist” on Instagram).
In fact, it’s about 700 calories less than what would be considered a nutritionally deficient diet in terms of the main macronutrients (carbohydrate, protein, fat) and vitamins and minerals.
Some HCG vendors sell B-complex vitamins while you’re on the diet, but this is sort of like band-aid to a train crash.
If you have health issues, see your doctor first before considering the HCG diet.
Because the diet is so low in energy, there may be collateral side effects.
Side effects include dehydration which can contribute to cardiac arrhythmias and electrolyte imbalances.
And if you’re not eating enough food, you may fatigue faster than usual, feel irritable, or have feelings of anxiety and depression.
HCG false claims
Despite significant evidence that the HCG diet has no effect on weight loss or hunger, this has not stopped unscrupulous marketers from selling HCG.
You can easily buy HCG online in the United States, Canada, United Kingdom, Australia, and New Zealand, with numerous websites (including Amazon and eBay) pushing it as a weight loss cure-all.
Most HCG sellers use heavily biased, expertly-written marketing copy to push on your pain points and insecurities to give you that (false) sliver of hope that it “might” work (news flash: it doesn’t).
Protect yourself with these related articles:
- Interactive bullshit detector for health products
- 37 Bullshit health marketing phrases you should ignore
- Want to be healthy? Then stop chasing golden unicorns
- 13 Permanent fat loss principles: the “secret” is no secret
- SkinnyFit Detox Review: A Detox from Toxic Marketing
Have a look at the HCG ad below, complete with a “doctor-ish” looking guy with a stethoscope. Let’s break it down together:
Note that this advertisement refers to the HCG drops and not the injections which would need to be administered by a medical professional.
“No prescription required”
“No prescription required” capitalises on the narrative that it’s not a “poisonous pharmaceutical.”
The claim of “natural weight loss” doesn’t really mean much but it plays on your fear of “chemicals” (BTW, water is a chemical too!).
“Lose 1-2 pounds” of WHAT?
The claim you can lose 1-2 pounds (~0.5 to 1 kg) per day is deceptive and misleading. It is not physiologically possible to lose this much BODY FAT in 24 hours. Crash diets are unhealthy and can set you back in the long-term.
Homeopathic remedies are diluted to such a level that none of the original substance exists. So in essence, you’re paying for homeopathic HCG but by definition there is no HCG in it. In any event, it’s still a false claim.
Check out Joe Cannon’s unbiased homeopathic HCG drops review for more information.
No loyalty amongst thieves
“Same results as in an HCG clinic” is competition bashing meant to lower your guard and make you think it’s “easy” to lose weight without the hassle of going to a clinic.
Increase energy levels?
“Proven to increase your energy levels” is a false claim. No scientific evidence supports this.
Converts fat into nutrients?
“HCG converts fat into nutrients without loss of muscle” is a false or, at least, stupid claim. Converts fat into what nutrients? Name them, HCG marketers!
Legal action against HCG marketers
In 2011, the US Food and Drug Administration banned the sale of HCG products and declared them fraudulent and illegal.
In 2013, the Federal Trade Commission (FTC) came down on several HCG marketers for making false claims exactly like those in the above image.
The FTC maintains that Kevin Write and his companies, HCG Platinum and Right Way Nutrition, LLC, promised consumers that HCG Platinum liquid drops will cause fast and significant weight loss similar to that of the endorsers in their advertisements.
Disturbingly, they sold their products through major trusted retail outlets like GNC, Rite Aid, and Walgreens.
This might make you assume HCG is safe and effective since it’s sold in big name pharmacies.
HCG Dr Oz Effect
The HCG diet even appeared on the Dr Oz show.
In one of his segments, he gave airtime to a woman pusher her brand of HCG diet.
She claimed to have conducted “research” but it was neither published nor peer-reviewed in a scientific journal.
The only “evidence” was that she appeared on the Dr Oz show, and that’s no evidence at all.
Sublingual HCG drops
Sublingual HCG drops are sold online, but there is no evidence they cause fat loss or help preserve muscle mass.
Marketers selling HCG drops puff up outdated claims by Dr. Simeons and conveniently neglect to mention that all early research was based upon HCG injections.
In the image below, the advertiser falsely claims that HCG drops are “clinically proven” (which means nothing) and will make you lose 1-2 pounds per day.
They also try to deceive you by making it look like it’s FDA approved. Being listed or registered with the FDA is NOT the same as being FDA approved.
The HCG diet easy?
Purveyors of the HCG diet would have you believe it’s easy, but at 500 calories per day, it’s anything but easy.
At such a low energy intake, you are likely to find it difficult to comply with the diet.
You are also unlikely to meet your basic nutrition needs (i.e., carbohydrate, fat, protein, vitamins, minerals) unless you’re supplementing.
There are, however, extreme cases where a doctor might put a morbidly obese person on a strictly monitored very low calorie diet (VLCD).
But this is a rare situation where the goal is to shed weight as quickly as possible, even if unhealthy, to reduce disease risk.
HCG diet cost
Because HCG injections are not covered by insurance, you’d be personally liable for all doctor’s visits and injections.
An initial consultation could set you back between $100 and $200, plus another $10 to $15 for each HCG injection.
Depending on how much weight you lose (or don’t lose), you may incur additional costs for ongoing office visits and injections.
There are also numerous shady website that will sell you the injections online for a few hundred dollars, but you are seriously taking a gamble with your health.
Does the HCG diet work?
In a word: No.
Yes, you will lose weight because you’re starving yourself. Period.
Despite its popularity, the preponderance of scientific evidence shows HCG injections have no effect on hunger, weight loss, or weight loss maintenance beyond making healthy lifestyle changes.
HCG diet marketing is bogus and biased. It is specifically designed to confuse and fool you into buying into the hype. Regulatory action has been taken against HCG sellers for making false claims.
Bottom line: The HCG diet should be dismissed as an unhealthy fad that will only leave you lighter in the wallet.