Human chorionic gonadotropin (hCG) for weight loss?
Most clinicians and many lay readers may question the reason for a post human chorionic gonadotropin (hCG) for obesity when the scientific question of its efficacy has long ago been decisively put to rest. Regrettably, there are still those who promote HCG injections for weight loss. Consider a paper published in the British Journal of Clinical Pharmacology back in 1995 in which the authors conducted a meta-analysis of earlier trials including 8 controlled and 16 uncontrolled studies:
"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."
What did the authors determine from the data presented?
"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."
German investigators reported their examination of the available science in a paper published in in 1987 in the journal Geburtshilfe und Frauenheilkd. The authors state:
"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 noting that early descriptions of positive effects were "reports on therapeutical experiences and were not controlled studies," they go on to state:
"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."
A few years later investigators published a paper in the South African Medical Journal reporting that...
"In a double-blind, placebo-controlled study, the effects of HCG on weight loss were compared with placebo injections."
They examined the effects of daily intramuscular injections of saline or HCG, 6 days a week for 6 weeks, on forty obese women, all on the same diet. They also conducted a psychological profile, evaluated hunger level, measured body circumferences, took fasting blood samples and maintained food records while measuring body weight weekly. What did their data show?
"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."
Canadian researchers came to a similar conclusion in a paper published in the Canadian Medical Association Journal. The authors state:
"It has recently come to our attention that a number of practitioners are still using daily deep intramuscular injections of human chorionic gonadotropin (HCG) as an adjunct in the management of obesity. We condemn, in terms that cannot possibly be misconstrued, such use of HCG."
After reviewing the evidence available at the time (1983) and listing several serious potential side-effects hypercoagulability and thromboembolism, they go so far as to assert:
"Because HCG is "therapy" in the management of obesity has been thoroughly discredited and thus rejected by the majority of the medical community, any practitioner whose patients experience undesirable side effects as a consequence of such therapy may face civil and even criminal liability."
American scientists had demonstrated the ineffectiveness of hCG for weight reduction in a double-blind study published back in 1976 in The American Journal of Clinical Nutrition. They undertook a duplication of the original study which first suggested there may be of benefit:
"Our investigation was designed to retest the hypothesis of the efficacy of human chorionic gonadotropin (HCG) on weight reduction in obese women in a clinic setting. We sought to duplicate the Asher-Harper study (1973) which had found that the combination of 500 cal diet and HCG had a statistically significant benefit..."
Their study cohort included fifty-one women between the ages of 18 and 60 who participated in a 32- day randomized and double-blind comparison of HCG versus placebo. Each patient was given the same diet as prescribed in the Asher-Harper study. Laboratory studies were also performed at the beginning and end of the study. What did they find?
"There was no statistically significant difference in the means of the two groups in number of injections received, weight loss, percent of weight loss, hip and waist circumference, weight loss per injections, or in hunger ratings. HCG does not appear to enhance the effectiveness of a rigidly imposed regimen for weight reduction."
A paper published more recently in the journal Obesity Reviews notes the discredited status of hCG for weight loss while commenting on the larger problem of the commercial marketing of ineffective weight loss programs:
"The increasing prevalence of obesity has been mirrored by a parallel increase in the number of commercial weight loss programmes. Research evaluating these programmes is meagre, however, compared to the numbers treated....Evaluation of commercial weight loss programmes usually progresses from testimonials, often by famous people who were successful, to uncontrolled studies of past participants evaluated either by the programme itself or by an outside entity."
The authors further state:
"The gold standard, however, is a scientifically rigorous, controlled study of the programme conducted by an independent entity. Such a study, published in a peer-reviewed journal, can gain credibility for a programme, as it did with Slim Fast, if the results are positive, or herald the end of the programme, as it was with Simeons human chorionic gonadotropin injection clinics."
The author of an essay recently published in the West Virginia Medical Journal presents his position under the title of "There they go again"--hCG and weight loss." He regrets that the availability of medications on the internet exposes patients to ineffective treatments and unsafe products:
"Dr. Albrink's review of information available in 1969 did not allow her to determine a physiologic basis for the use of hCG or any proof of immediate or long term benefit. Subsequent discoveries and clinical studies only support her impressions. Despite these facts, this form of therapy has achieved a resurgence in popularity. The difference today is that patients no longer have to rely on health care providers to prescribe their medications since internet sites allow them to obtain medications "on line". This has potential adverse ramifications when we consider that the initial use of gonadotropins derived from the human pituitary was discontinued due to the iatrogenic transmission of Creutzfeld-Jakob disease...Systematic information has been obtained and has shown lack of evidence for the benefit of this therapy. "
The body of evidence on hCG for weight loss is summed up in a comment in The Medical Letter Online:
"Use of hCG as an adjunct to diet goes back to the 1950’s, when a British physician named Simeons recommended daily injections of the hormone combined with a 500 kcal diet, and such use came to be known as the Simeons method. One double-blind study after another throughout the second half of the 20th century found hCG to be worthless for weight loss or maintenance."
An interesting question remains. Human chorionic gonadotropin does have legitimate medical uses and is well known to increase testosterone levels. Since testosterone therapy given to hypogonadal men (men with low testosterone levels) has been shown to improve body composition, why not hCG? A fascinating study published in the journal Gynecological Endocrinology offers insight. The authors state:
"The aim of this study was to monitor serum leptin concentrations after altering the levels of testosterone, by intramuscular administration of human chorionic gonadotropin (hCG), in eugonadal men."
"Eugonadal" means their study subjects had normal testicular function. They monitored hCG, testosterone and leptin levels after intramuscular administration of a dose of 5000 IU hCG in thirty men. Blood samples were collectedafter an overnight fast for CG, testosterone and leptin levels, and a dose of 5000 IU hCG was administered intramuscularly immediately after. They kept testing the blood at 24-h intervals for a period of 7 days. What did their data show?
"Our results support the view that hCG administration in eugonadal men does not influence serum leptin levels. Moreover, a short-term increase of serum testosterone levels, after one dose of hCG, is not sufficient to affect and modify leptin secretion mechanisms in vivo."
Since a significant correlation between body mass index and serum leptin is well established, the failure to influence leptin may explain, at least in part, why hCG is not effective for weight loss.