HCG - WHAT IS IT?
You might have heard about "The HCG-diet" for weight loss and read the 1962 book by Dr A. T.W.Simeons. His diet included HCG and a pretty austere program of 500 kcal/day.
HCG (human Chorionic Gonadotropin) is a hormone produced in high amounts in pregnancy, supporting fetal growth and cell development. All humans produce low levels of HCG, probably contributing to hormonal control of body composition. In men it may trigger testosterone production. Women produce testosterone as well, but in about 1/10 the amount of men. The effects of testosterone in all humans are anabolic and androgenic, meaning it contributes to leanness, i.e. muscle mass, bone strength, energy, sexual development energy and increased libido. Aging and chronic illness may lower testosterone, which again may lead to higher body fat, lower energy and slower weight loss. For unclear reasons, lower doses of HCG make most parsons feel full on very little food.
If you are considering HCG for weight loss you should know this:
- HCG is approved by the FDA only for use in fertility treatment. It is currently used in weight loss, constituting "off label use". This means the local medical community sees benefit from a drug and uses it for a condition where it helps without harming the patient. Given in smaller doses of 100-500 units per day it produces an unexplained appetite-suppressant effect, allowing a person to do a program of severe calorie restriction (some 500/day), lose fat mass quickly and feel full. The body cannot do strenuous exercise in this calorie range, but will still give up weight. HCG is often given as daily injections, but it works perfectly well given by mouth in the context of a good eating program.
- HCG promotes testosterone-mediated preservation of lean body mass. A study suggests that HCG promotes fat loss from certain areas of the body (contouring effects).
- The American Society of Bariatric Physicians conducted a large study on HCG and reported that HCG itself does not cause side effect, including those seen with appetite suppressants (jitteriness, sleeplessness, and personality changes). The Very Low Calorie Diet (VLCD) used in the original "Simeons diet" was lacking in modern understanding of nutrition, and carried risk of hair loss, dry skin, eczema, gall stones and a host of deficiencies. For this reason the article recommends a HCG-weight loss program be supervised by a physician with special training in the use of the modern VLCD to avoid side effects.
- HCG does not teach or change eating habits. It only has a permissive effect, granting the patient and the doctor the respite to work on change while seeing quick results without the side effects or frustration that might wear down the patient in long term weight loss programs.
- I am already seeing patients who lost and gained it all back on HCG. Teaching you how to maintain your weight loss should start in the first meeting with your weight loss doctor – HCG or not. In the end, that is where the problem was to begin with! If you live in the Bay Area and you think you are a candidate for HCG, or have questions about this, you may call us in San Francisco at 415-989-1007, or in Oakland at 510-444-0322.
References:
- Simeons ATW. The Action of Chorionic Gonadotropins in the Obese. Lancet 1954;946-47
- Liu PY, Wishart SM et al. "A Double - Blind, Placebo-Controlled, Randomized Clinical Trial of Recombinant Human Chorionic Gonadotropin on Muscle Strength and Physical Function and Activity in Older Men with Partial Age-Related Androgen-Deficiency". J Clin Endocrin 2002; 87(7):3125-35
- Feste JR, Clark M. A Retrospective Analysis of 140 Patients Treated with hCG and a Calorie Restricted Diet. Am J Bariatric Soc 2011;26(1):8-11
- Belluscio DO, Ripamonte L et al. "Utility of an Oral Presentation of hCG (Human Chorionic Gonadotropin) for the Management of Obesity: A Double Blind Study", abstract, The Original Internist, December 2009.