Miracle Drug or Snake Oil?
Flipping through several women’s magazines and magazines that have specials for women, I have been amazed to see that most weight loss clinics are promoting hCG as a weight loss tool.
I don’t know if they really believe hCG is effective for weight loss, or if they are just responding to public demand for it.
Currently, I have not seen any randomized controlled trial which shows that hCG augments weight loss, except in a subset of patients…. men with low testosterone.
Proponents of hCG was a weight loss tool almost always say a variation of the same thing:
hCG is the hormone of pregnancy and diverts mom’s calories to the baby. Some also say it curbs appetite.
Let’s explore this for just a minute. Where is the data that supports these claims? If hCG is diverting calories to the baby, that would mean there needs to be a baby for hCG to work.
Think about it this way. Think of calories as dishes on the countertop of your kitchen. You clean up your kitchen by putting the dishes into the cabinets.
Now think of the dishes as calories and the cabinets as the baby and you as the hCG. How are you (hCG) going to put the dishes (calories) in the cabinet (baby) if you don’t have any cabinets (baby)?
In other words, without a baby, hCG does not have a place to divert those calories to. So the main mechanism touted makes no sense.
Now, I am not an expert in hCG, but I have spent years studying it, mainly as a hormone of pregnancy, as a fertility drug and as a way to boost testosterone. So let me tell you how hCG might work, if it works at all, as a weight loss enhancer.
Quiz
Before I go further, I must emphasize that hCG plus diet has not been shown to cause more weight loss than diet alone.
Physiology:
hCG is a hormone secreted by pregnancy
- In pregnant women hCG’s the only definitively known function is to increase the
amount of progesterone secreted by the ovary. - Ovarian progesterone is what keeps a woman pregnant for the first 7 weeks of pregnancy.
- After that, the placenta makes enough progesterone to maintain the pregnancy.
- Other affects of hCG is that it may enhance a baby boy’s testosterone production to help it develop normally.
- hCG is also thought to cause nausea.
How could these natural affects lead to weight loss? Well, if it induces low-grade nausea, some people might eat less. I have yet to hear a proponent of hCG say this is a feature of the treatment.
Pharmacology:
When used as a drug, hCG does have other purposes and this holds the key to how it is possible that hCG may one day be shown to be a weight loss enhancer. I emphasize might, because no one has shown that it’s effective.
- hCG is structurally similar to the hormone LH. In both men and women, LH increases testosterone production.
- Testosterone can have positive and negative effects. If it’s too high, women can get facial hair or balding. Men can accelerate balding.
- Testosterone is an anabolic steroid that promotes muscle mass.
- If muscle mass is created, a person would likely burn more calories due to a higher metabolism.
- hCG is commonly used in the fertility setting to promote ovulation. One potential side affect is cyst formation in women.
It is possible that hCG does augment diet. If it increases testosterone and therefore increases lean muscle, someone who loses 20 pounds may lose more fat but keep more muscle. Since muscle weighs more than fat, it is possible that that people who take hCG (while they weigh the same as those who don’t) are actually leaner.
It is essential to point out that this is just a theory! No one has yet to show this in a study. It is quite probable that even if this could be true that it might take a high dose of hCG to accomplish this. Higher doses would much more likely be associated with unintended side effects such as increased facial hair and hair loss.
With so many clinics now offering this therapy, I think it is time for one of them to actually do a well-designed double-blinded study (in which neither the doctor or the patient knows if the patient is getting hCG) and see if weight or body composition is different. Only if hCG leads to more fat loss and preserves muscle, could we endorse this treatment.
Until it’s proven to work…. we will not recommend it, as many other diet plans have been shown to be safe and effective.
One unintended consequence of the explosion of this diet’s popularity is that it has driven up the price for hCG for fertility patients. We don’t like that either, but if the diet ever is proven to work, we won’t begrudge it.