The hCG Diet

Or: How Making Money on Weight Loss Undermines the Medical Profession

A few months ago while at the Hazon Food Conference, I was approached by at least two people who wanted to know my opinion on the hCG diet. At the time I'd never heard about it, though I was familiar with hCG, or human chorionic gonadotropin, a hormone that surges in pregnant women, released into their urine - the very one, in fact, used to indicate pregnancy on the at-home test kits. My curiosity was piqued, and suddenly I started noticing hCG was everywhere. In my spam emails, on talk shows. One Google search for hCG diet yields over 5 million hits in 0.09 seconds.

Just a few days into my winter quarter classes, I learned about a group project in my Nutritional Supplementation class that would focus on a variety of supplements. I signed up for weight loss supplements and focused on hCG, among others. That provided me with the motivation to investigate this diet further. At the same time, my sister, taking a personal training course had to present on a fad diet too - her instructor assigned her hCG. We shared our findings and were shocked at what we discovered.

The hCG diet was born out of the work of Dr. ATW Simeons in the 1950s. The hormone, which is used (and approved) for treatment of infertility and hypogonadism, was found to help obese women lose weight when administered in conjunction with a 500 kcal/day diet. Ever since then the diet has had followers, despite repeated studies throughout the 1970s and 1990s that showed it held no validity whatsoever. Dr. Simeons believed that hCG injections helped reduce hunger and stimulated release of fat stores while the calorie restriction accelerated weight loss. Studies do not confirm his claims, but many medical professionals continue to use hCG, charging patients thousands of dollars to undergo treatment. HCG is also available online as homeopathic drops and creams, but the "gold-standard" requires a prescription and care from a licensed professional. Despite the FDA and JAMA's warnings about use of hCG for weight loss, just yesterday the New York Times printed an article about doctors using the hCG diet:

“From an anecdotal point of view,” Dr. Bissoon said, “physicians all around the country have seen people losing a tremendous amount of weight with this stuff, and you cannot afford to ignore that.”

Actually, you can. Anecdotal weight loss supplements via injection of sex hormones is not okay in a medical profession that relies on evidence-based research. It's true that patients have been losing weight, as anyone on a 5oo kcal/day diet would. This segment about success with the hCG diet on The Mike and Juliet Show is particularly amusing:

One site commented that the diet validated anorexia, by endorsing such low calorie dieting for significant periods of time. In fact, one woman interviewed for the article was a former anorexic who liked using hCG because she could lose weight and control her hunger without obsessing over food like she used to. But beyond that, I think Dr. Bissoon betrays something greater. When he says "You cannot afford to ignore that" he really means that he cannot afford to ignore that. As doctors struggle to find more ways to make money (see recent piece on psychiatrists' shift toward drug therapy), the hCG diet provides an easy way to make a few thousand dollars at a time. One cycle can cost patients between $1,000-1,500 a pop, and patients may return for up to four rounds.

What amazes me is how people - especially medical professionals - do not seem to be concerned with potential side effects, long term implications of taking pregnancy hormones and living on low calorie diets. I have not found any convincing reports from within the medical profession (allopathic or naturopathic), other than statements that it helps people lose weight. And that is perhaps the saddest reality of the diet. As we increasingly stigmatize obesity for being correlated with so many chronic diseases, we fail to address root causes and instead search for quick-fixes. After researching weight loss and ergogenic supplements this quarter I've learned that there are billions of dollars to be made, few products that show any efficacy and countless cases of false claims and contamination. In the quest to make more money, social and medical responsibility seem to have been tossed aside. The irony is that the recent resurgence of hCG is attributed to Kevin Trudeau's The Natural Weight Loss Cure "They" Don't Want You to Know About, who alleges that the FDA and pharmaceutical industry are conspiring to keep it a secret. Instead, his book supports professionals swindling people out of millions of dollars rather than helping them lose weight responsibly and sustainably.

The issues around obesity, size, public health, body image and eating disorders has become increasingly complicated. The more I delve into this field, the more I find that the real need lies in media literacy, education, critical thinking and self-awareness. Over the next few weeks I plan to focus more on these topics, that have been on my mind for a while and I invite your input to steer that conversation.