HCG Diet: What You Need to Know

In 1927, researchers discovered that pregnant women's urine contained a substance not normally present outside of pregnancy: human chorionic gonadotropin, or hCG. This represented the first modern pregnancy test, and to this day, we still check urine for signs of hCG to determine pregnancy. Doctors also look at hCG levels (among other factors) in pregnant women to assess risk of birth defect.

HCG may play many roles, but one function it performs is guaranteeing that a developing fetus receives the calories and nutrients it needs to grow, nearly independent of the daily caloric intake of the pregnant woman in those early developmental months. How does it do this?

We aren't ravenous for fatty foods for no reason. Our bodies like to maximize caloric intake in case lean times are ahead. In the case of women, excess calories tend to wind up in "problem" areas such as the hips, buttocks, abdomen and thighs. However, once pregnant, fat from these areas is released in the presence of hCG, and this fat then makes its way to the fetus. This way, if a woman doesn't consume the nutrients needed for fetal growth, her fat reserves will suffice. (Structural fat, such as that found in the face or layered beneath the entire skin, isn't affected.)

HCG is produced by a woman early in her pregnancy, and levels of hCG in the bloodstream peak at around 14 weeks. After that, levels gradually decrease. HCG's presence in a pregnant woman seems to occur in the timeframe when a woman would be least likely to know she is pregnant, and therefore least likely (especially in ancient -- and leaner -- times in human history) to be consciously trying to secure nutrients to sustain a pregnancy.

Furthermore, hCG was soon found to be gonadotrophic, meaning that it prompts genital development, and was soon used as a treatment for boys experiencing a delay in adolescence or genital development due to disorders of the pituitary gland.

It was during research in the 1930s when one doctor, A.T.W. Simeons, noticed that boys being treated with hCG for underdeveloped gonads were also able to lose excess weight by eating much less without any accompanying hunger pangs. Simeons' interest in hCG soon shifted to its potential as a diet aid, and after two decades of research, he published a paper touting its effects, and developed a dietary regimen for using the drug as a weight-loss tool.

So, how few calories is one instructed to consume on the hCG diet? You'll find out in the next section, and you may be shocked.

Though subsequent hCG diets have tinkered with the elements, most programs hold pretty true to the original formed by Dr. Simeons.

Each round of treatment lasts a minimum of 26 days, and 23 of those days require a daily dose of hCG, either through injections or under-the-tongue drops. Treatment may last as long as 43 days (with 40 injections), unless a patient loses 34 to 40 pounds (15 to 18 kilograms) before the allotted time has passed. Patients don't receive hCG injections for the last three days of any treatment period so the hormone can cycle completely out of their bodies before they resume a normal diet. (It also takes about three days for hCG's effects to "kick in.")

Why stop after 40 days? Simeons noted that subjects seemed to develop immunity to hCG after 40 days and required a six-week break from the diet to fully resensitize to it. Simeons recommended no more than four total treatments, separated by breaks.

In addition to receiving the hormone, dieters are instructed to cut their daily intake of calories to just 500 a day, but not until after the third dose. Once the hCG is active in a dieter's body, its release of long-stored fat provides the body with the calories it needs to burn to get through a day (a day, it should be noted, without much exercise). As long as fat deposits are being released for use, the 500 daily calories being ingested is supposed to be enough to sustain the dieter without the crazy hunger pangs one would normally experience on a 500-calorie diet. Once a dieter drops the excess weight, the treatment must stop, because hCG only affects stored fat. Once that's used up, the body will quickly reject a self-imposed limit of 500 total daily calories.

Of the little food you can eat on the hCG diet, it's supposed to be high in protein and low in starches, carbohydrates and high-fat foods. Dairy, sugar and alcohol are forbidden, and if you goof up, you should spend the next 24 hours drinking water and eating six apples [source: Haupt].

Can this diet possibly be a healthy way to lose weight? Read on to find out some of the dangers of the hCG diet.

Losing weight at the rate of a pound a day may sound tempting, but the hCG diet may pose some very serious health risks.

Taking the hCG hormone itself can cause a variety of complications that can read like the fine print in a prescription disclaimer: Users may report incidences of headaches, blood clots, restlessness, leg cramps, constipation, temporary hair thinning, depression and male breast enlargement. Also, you may feel, well, like you're pregnant -- swelling, breast tenderness and water retention, anyone? HCG can also cause a potentially life-threatening condition called ovarian hyperstimulation syndrome (OHSS), in which ovaries over-stimulated by hormones can swell and leak fluid into the abdomen. This can cause abdominal pain and weight gain but can lead to blood clots, kidney failure, fluid build-up in the abdomen or chest, and electrolyte imbalances.

On top of the possible complications from the hormone, severely reduced calorie diets have their own set of side effects. While the amount of calories your body needs depends on how much activity you do everyday, most adult women need between 1,800 and 2,400 calories per day, and adult men need 2,000 to 3,000 calories per day. Those trying to lose weight typically eat between 1,200 and 1,500 calories per day. At 500 calories, the hCG diet calls for only a fraction of those requirements.

When you're on an extremely reduced calorie diet such as the hCG plan, you're basically starving yourself. By allowing so few calories per day, it can be difficult to meet your daily nutritional needs. You may also experience some not-so-pleasant side effects such as fatigue, nausea, constipation and diarrhea. Your hair might start falling out. Even worse, you may develop gallstones, which could require surgery to correct.

Another problem with severely restricted calorie diets is that once you go off them and start eating a regular amount of calories, you're bound to regain some of the weight you lost.

The FDA has also received at least one report of an hCG dieter who developed a pulmonary embolism, a blood clot in the lung that can potentially be fatal [source: Haupt].

Proponents of the diet point out that the hormone hCG is natural and clearly safe for pregnant women and the fetuses they carry, and that dieters receive a much smaller dose of hCG than is found under normal conditions in pregnant women.

What does the FDA make of the hCG diet? Find out in the next section.

The FDA has provided its stamp of approval on the use of hCG -- as a fertility drug. In your attempts to lose weight by tricking your body with the presence of a pregnancy-related hormone, your body may turn the tables and help you get pregnant. Within five years of its discovery, hCG was already being packaged and marketed to the public as a fertility drug. (If you're a woman who doesn't want to get pregnant, you should be extra-careful if you're taking hCG.)

Aside from fertility, the FDA doesn't approve hCG use for any other reason, including weight loss. Moreover, the FDA has said that billing hCG drops, sprays and pills as homeopathic weight loss products is fraudulent and illegal [source: Hellmich]. However, lack of approval doesn't prevent hCG's use as a dietary aid. As long as you have a doctor willing to write a prescription, you can obtain hCG. With a surge in public interest in the hCG diet (owing almost entirely to a large marketing push of this dusted-off 60-year-old diet craze), there's no shortage of weight-loss clinics staffed by doctors who write such prescriptions all day long. There have been reports of people obtaining hCG (or something being passed off as hCG) on the Internet, despite the need for a prescription to obtain the drug. Such practice would bring up issues of safety and effectiveness of the doses being provided through the black market.

The hCG diet can be somewhat pricey: A consultation visit and 23- or 40-day supply of hormones and syringes could run you around $500 to more than $1,000 [sources: Hartocollis; Haupt]. Many people do a cycle of the hCG diet, eat normally for six weeks, and then follow up with one or more cycles of hCG. The hCG drops, pills and sprays range anywhere from $40 to $249 per bottle [sources: GNC MyHCGPlus].

Next, why did the hCG diet fall off the radar until recently?

While the initial study performed and published by Dr. Simeons backed his claims of the hCG diet's effectiveness, subsequent studies have produced the type of results that don't get mentioned on late-night diet-fad infomercials.

Most independent, peer-reviewed studies of the hCG diet have shown no difference in weight loss between subjects on a low-calorie diet who received hCG injections and subjects who received a placebo [source: Conis]. One study even showed that both the placebo group and the hCG group reported major hunger pangs throughout the treatment.

Regardless, once a person stops the hCG diet, he or she will have to adopt a normal and healthy lifestyle, or the weight's just coming back. Proponents of the hCG diet maintain that the purpose of the diet is to break food addictions and abnormal eating behaviors, and that the month or so of treatment allows a person to do so. In this sense, the diet hopes to achieve short-term weight loss with long-term behavioral modification.

Of course, eating well-proportioned meals is much easier when you're injecting stimulants and hunger-suppressing hormones. If you gain weight again, the doctor or clinic -- upon the follow-up visit -- may recommend you start the treatment over again. Therefore, you may just scrap real attempts to change eating habits and sign on to long-term use of chemicals without fixing the real problem: your diet and exercise habits.

A month-long course of hCG injections and crash dieting will likely help you lose weight, but perhaps what you should be asking yourself is whether or not this is the best way to permanently modify your poor eating habits.

In addition to the reliability of a new diet fad popping up to replace the one before it, there's another constant when it comes to dieting: No matter what you do, maintaining a healthy weight depends on eating right and exercising.

For more information on dieting and health through the years, see the next page.