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.
However, in a letter to the editor in the same journal, Hirsch and Van Itallie pointed out methodological flaws that challenged the validity of Asher and Harper’s results (view PDF).
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)
In a 1983 review published in the Canadian Medical Association Journal, Birmingham and Smith Birmingham and Smith (PDF here) reviewed the scientific evidence up to that point and concluded that:
- “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)
In a 1995 meta-analysis (a combined statistical analysis) published in the British Journal of Clinical Pharmacology, Lijesen and Theeuwen (PDF here) evaluated the body of HCG research and concluded:
- 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.
Dr Oz has been rightfully criticized in recent years for peddling bogus weight loss remedies. with numerous calls for his resignation for promoting quackery.
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.
Tuesday 31st of May 2022
My experience with the HCG diet has been completely positive. I lost 30 lbs on my first round - 10 lbs was water weight as it was gone within days of starting, and I always had problems with puffy feet and ankles. The rest was quite visibly off of my chest, stomach and butt. My rosacea is much less inflamed, my energy is up, and I am rarely hungry, though I eat because I must! I have Chronic Fatigue Syndrome, but have been able to do yard work without needing Advil after to control the muscle and joint pain I normally get.
My diet is monitored by a ND, I self inject the prescription HCG, I also take high quality vitamins and drink at least 2 Litres of water. I do light exercise, and get a great night’s sleep. During my first three week maintenance Keto/Paleo period I used My Fitness Pal to make sure I was within the correct macros and calories, and I gained one pound. I enjoyed the food so much more than before, and the idea of eating junk food just was not exciting.
I feel doing it unmonitored and with likely low quality HCG is a risk, but if it’s done correctly it can make a major shift in a person’s relationship with food, and provide a leg up to better health.
Saturday 12th of February 2022
I recently joined an HCG website and considered starting the diet and drops. Thank you for all the information and research in the article I just read! 500 calories a day is terrifying and hard to believe sustainable for anyone. I was horrified to read online comments saying it was perfectly safe being on the diet pregnant or nursing! OMG! Untruths like this are life threatening . . .
Sam D Giarrizzo
Saturday 27th of November 2021
My friend and I did a 40 day hcg diet 20 years ago and we both lost approx 40 lbs each and it was easy. Ive always wondered if it was a lose of weight do to the low calories so i will b trying again
Dr Bill Sukala
Saturday 27th of November 2021
Remember that losing weight is one thing, but keeping it off is another. One of the main physiological limitations of the HCG diet is that it is not sustainable over the long-term. Anyone can starve themselves on any low calorie diet, but once you come off it, that's when the real fight begins in keeping it off.
Tuesday 29th of June 2021
I am an older woman with Hashimotos Thyroiditis who has tried both the HCG diet injection protocol and also the starvation diet protocol (!) without HCG. And while I appreciate the precautionary tales here, you are incorrect in your statement that a person will lose the same amount of weight without the injections. HCG does - as it states - dramatically increase the amount of weight loss for me and for other women I know. It also stops intense hunger pains.
Hypothyroid sufferers live with the inability to lose weight without dramatically less calorie intake and many alternative weight loss plans lead to long months or years of effort during which time it is easy to lose hope and enthusiasm. I found that a few rounds of HCG - with a rest period of 6 weeks in between during which time I increased my calorie intake and worked towards adopting a more healthy diet going forward - has helped me to reach my weight loss goal much more quickly and maintain it.
I can't say it would be for everyone, because changing eating habits is key to long-term maintenance. But that is the same with any diet. The HCG diet is still around after all of these years because it works, especially for those of us for whom weight loss is far more difficult than the norm. My Endocrinologist - as with most doctors - had a fit when she found out, but her advice to me for years to decrease my calorie intake and increase my cardio resulted in only a few lost pounds. And the fallacy that thyroid replacement hormones work well and that you don't gain weight just by looking at food and that you can't possibly feel so fatigued that you can't get out of bed some days is still being touted by doctors. So I have to accept that this would be my lot in life forever? I don't think so. All of my blood test results are greatly improved, my potential fatty liver issue has resolved and I have the energy to exercise more.
Dr Bill Sukala
Friday 2nd of July 2021
The desire to believe in something can be very powerful. If you believe that eating 500 calories is easier with an hcg injection, then good for you. What matters most isn't losing weight, but keeping it off. See how you're feeling after a year or two on 500 calories.
Friday 28th of August 2020
I’m another who feels I should add to those who’ve actually DONE the diet. I discovered it before the huge surge, spent hours reading what was available & sent it to my mum’s friend - who’s a RN in the emergency ward- to see what she thought. My mother was the reason I was researching, having been failed for decades by doctors who had no time to investigate her weight gain, preferring to blame her for it. This also happened when she had a heart attack- the doctor in charge made no effort to hide his disgust at her weight & nearly killed her. Betty (my mum’s friend), was furious. Why? Because she’d spent decades watching obese people die, suffer, get ill, be mistreated, be amputated. Before talking to my mum, we both tried it, as she’d had so many disappointments, if we were wrong, we didn’t want to do that to her. I lost 28 lbs in 30 days, ending up at 150lbs. Was it easy? No, & I agree with you wholeheartedly on the scammy marketing practices used to sell product. Was I hungry? No, not at all. I was working full time in a busy restaurant when I started. By the 3rd week, I could feel some issues with fatigue, but adding an extra 100g of protein when necessary solved my energy levels. Dr Simeon was clear that you should feel GOOD on it, and I think my exercise levels required the additional protein. What AMAZED me, utterly, totally and completely, was that I ended at 150 lbs, and at that weight, my pear shape was SUBSTANTIALLY changed. I’ve been an athlete. A few years prior to the diet I was at my fittest, at 138lbs with a 6 pack & very strong. But at 150, my thighs and hips had never been so slim & proportional in my entire life. Ever. I think your article is very well written. Much of my mum’s problems were rooted in the “scientifically proven” low fat high carb ethos from the 70s-90s. She’s now in a home with dementia caused by pernicious anemia which she couldn’t get injections for, because it was “scientifically proven” that sublingual was good enough. Thank you for allowing comments to be posted, as it’s important that both sides are aired. Frankly, scientific studies be damned, this diet is astounding. Oh- my mum lost 90lbs in 120 days. Her health improved dramatically- the $1000/month we were spending on her meds got cut to $200. Something I’m sure the drug companies funding these studies aren’t keen on having happen.
Dr Bill Sukala
Monday 31st of August 2020
Hi Lola, Thanks for taking the time to leave a comment. Can I ask...
1) You lost 28 pounds of what in 30 days? 2) Mum lost 90 pounds of what in 120 days?