HCG Diet vs. Carbohydrate Restriction for Weight Loss
In a recent small study that hasn’t yet been published, researchers from the Netherlands looked at body composition changes in people losing weight rapidly on a 500-calorie diet for 5 weeks vs. more gradually on a 1250-calorie diet for 12 weeks. Of the roughly 19 lbs lost on average between both groups, at the end of the study, the 500-calorie group had lost almost 3 times as much lean muscle mass as the 1250-calorie group (3.5 lbs vs. 1.3 lbs, respectively). This isn’t surprising, since when caloric needs aren’t being met, the body uses protein for energy, and muscle mass is broken down to provide amino acids that are essential for survival. After 4 weeks, the numbers looked a little better, which the study authors attribute to improved hydration and glycogen repletion (No mention of how much water weight was regained), but the 500-calorie group was still down about 2 lbs of muscle mass from where they started.
The results of this study made me think about the very-low-calorie HCG diet, which people follow for 3 to 6 weeks at a time, often in several rounds. First popularized in the 1950’s by British endocrinologist ATW Simeons, the diet protocol involves taking injections containing HCG, human chorionic gonadotropin — a hormone produced by pregnant women and approved for use as a fertility treatment — and restricting calories to 500 per day. (There are also HCG drops, but apparently they contain negligible quantities of the hormone). HCG purportedly has appetite-supressant properties that make subsisting on such low energy intake bearable, and although studies suggest otherwise, many proponents claim it also increases fat burning and weight loss. The HCG diet fell out of favor years ago when researchers reported that the dramatic weight loss of up to a pound a day was due to starvation-level caloric intake rather than the hormone injections. However, within the past few years, there has been a resurgence in its use (thanks in part to the diet being featured on the Dr. Oz show), particularly among anti-aging doctors.
HCG diet lunch, sans melba toast. Repeat for dinner.
In addition to containing very few calories, the HCG diet is extremely low in fat. The original HCG diet menu below specified the following menu every day, although some updated versions allow people to move some of the foods around to different meals:
Breakfast:
Tea or coffee in any quantity without sugar. Only one tablespoon of milk allowed in 24 hours. Saccharin or stevia may be used.
Lunch:
1. 100 grams of veal, beef, chicken breast, fresh white fish, lobster, crab, or shrimp. All visible fat must be carefully removed before cooking, and the meat must be weighed raw. It must be boiled or grilled without additional fat. Salmon, eel, tuna, herring, dried or pickled fish are not allowed. The chicken breast must be removed from the bird.
2. One type of vegetable only to be chosen from the following: spinach, chard, chicory, beet-greens, green salad, tomatoes, celery, fennel, onions, red radishes, cucumbers, asparagus, cabbage.
3. One breadstick (grissino) or one Melba toast.
4. An apple, orange, or a handful of strawberries or one-half grapefruit.
Dinner:
The same four choices as lunch (above).
This is what dieters are instructed to eat for 4 weeks straight while undergoing HCG injections. Not much to look forward to at mealtimes, which is probably by design in order to prevent overindulging. Characterizing the diet as unappetizing would be an understatement.
The plan provides roughly 55 grams protein, 50 grams carbohydrate, and 9 grams fat. So the macronutrient percentages are about 44% protein, 40% carbohydrate, and 16% fat. 44% of calories from protein sounds like a lot but isn’t in this case, and when calories restricted to 500, the protein will be used for energy rather than preservation of muscle mass anyway. After a 6-week break from the diet (I couldn’t find any specific dietary guidelines to follow during this period), those who want to lose additional weight often resume the HCG injections and 500-calorie diet for another 4 to 6 weeks.
A Sustainable Alternative to HCG
Doctors recognize that loss of lean mass results in a lower resting metabolic rate. So why are many anti-aging physicians promoting a diet that will, if anything, accelerate the aging process by causing significant muscle loss and other health problems? Some claim that HCG allows people to burn their own body fat for fuel and prevent muscle breakdown, but there is no evidence for this. Studies going as far back as the 1970s indicate that the weight loss achieved on this diet is due to its very low calorie content rather than the HCG injections. (As an aside, I had to laugh at some of the “benefits” claimed on the HCG Doctors Directory site, such as “Improves one’s singing voice.” Really? And I would like to see clinical evidence that thyroid and adrenal function improve in people consuming 500 calories a day for weeks at a time.)
On the other hand, we have research suggesting that a carbohydrate-restricted diet with adequate calories and protein preserves muscle mass during weight loss, including an analysis of 87 studies that found greater fat loss and better retention of lean mass at lower carbohydrate and higher protein intakes. In addition, carb restriction tends to increase satiety, and most people report enjoying the diet and the wide variety of foods they can eat every day. Many experience rapid weight loss at the beginning, which typically slows down to a more gradual pace after the first week or two. Another benefit of a well-balanced low-carbohydrate way of eating is its suitability for long-term use, both for weight loss and maintenance.
I understand how difficult it is to lose weight and how rewarding it can be to lose rapidly. But it concerns me that there are doctors prescribing a diet so low in calories and nutrients along with hormone injections that were discredited years ago. Rather than encouraging immediate gratification with claims like “Lose up to 30 pounds in a month,” why not recommend a sustainable way of eating that not only promotes safe weight loss but is highly pleasurable as well? Carbohydrate restriction has all of these things going for it, and more. In a nutshell, it doesn’t feel like being on a diet, and that’s one of the primary reasons it works well for so many people.
References:
1. Stein MR, et al. Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study. Am J Clin Nutr. 1976 Sep;29(9):940-8.
2. Rabe T, et al. Risk-benefit analysis of a HCG 500-kcal reducing diet (cura romana) in females.
Geburtshilfe Frauenheilkd. 1987 May;47(5):297-307.
3. Lijesen GK, et al. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. Br J Clin Pharmacol Sep 1995; 40(3):237-243
4. Volek JS, et al. Comparison of energy-restricted very-low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutr Metab (Lond). 2004 Nov 8;1(1):13
5. Krieger JW, et al. Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression. Am J Clin Nutr 83: 260–274, 2006.
Thank you for exposing another unhealthy trend. I didn’t know HCG was developed in the 50’s & mistakenly thought it was recent. What restrictive, boring, nutrient deficient diet. I wouldn’t last a week.
There will never be a lack of doctors looking to make big bucks on quick results diet plans. HCG injections are expensive. Of course, doctors receive little nutritional education.
Thanks so much for your comments, Gerri! I wouldn’t last more than a day on the HCG diet. Just the thought of it makes me hungry and irritable.
Wow Franziska. What a great post. I just don’t get why when people want to lose weight and become healthy, they just don’t follow LCHF. There are so many food options and eating healthy fats keep you full. It is so easy. It boggles my mind why someone would want to subject themselves to an HCG diet; it sounds awful. I’ll just keep doing what I am doing by following the concept of JERF (just eat real food). And thank you, but I’ll keep the real heavy whipping cream for my morning coffee.
Hi Sharon! Thanks very much for commenting. Yes, I completely agree. Starvation diets are so unappealing and unhealthy. JERF is the way to go!
Although I’ve done very little research when it comes to the HCG diet, the though of injecting hormones into one’s body doesn’t seem so appealing to me-especially when, after the diet, people frequently go back to making poor food choices once again. I’ve seen several people I know try HCG, and have very poor results.
Someohow, I think eating whole, low-carb food makes so much more sense-of course, I know that I’m preaching to the choir here.
Thanks for the great article, Franziska 🙂
Thanks so much for your insight and nice feedback, Mike! I think the promise of quick weight loss is the major reason people subject themselves to extreme dietary measures like this. It’s much like Optifast, which became an instant success in the late ’80s after Oprah lost a lot of weight within a couple of months. As you said, generally people end up gaining back the weight because they haven’t made healthy, sustainable changes.
I have been on low carb since I was diagnosed with T2 diabetes 7 years ago. I started gaining weight, even though I scarcely ever consumed more than 1200 calories a day. I was advised to eat more fat. I did that, still on 1200 calories, and gained 30 more pounds. My blood sugar went up. Out of desperation, I put myself on a 500 calorie a day diet for 2 weeks, then raised it to 750 calories, which I have been on for 6 weeks. It’s incredibly hard to do high fat on very restricted calories, and too much protein raises my blood sugar. I have lost 25 pounds, my A1C went from 5.6 to 5.1, and I’ve had no bad effects that I can see. When another 5 lbs is gone, I’d like to figure out a sustainable diet, but having already tried 1200 calories a day for a long time, and failed, I’m just stumped. I am diligent about counting calories and measuring portions, by the way.
Thanks so much for sharing your story, Janice. I’m sorry you’ve had so much trouble losing weight, even on 1200 calories per day. I’m glad you’re no longer limiting calories to 500 daily, although 750 is still lower than I’d recommend. Congratulations on losing 25 lbs, but that is actually way too much to lose within a 6-week period of time, and at a least a portion is muscle.I don’t usually recommend increasing fat for people trying to lose weight, especially women, so I’m very sorry you got that advice. I would advise calorie cycling or intermittent fasting in order to preserve muscle mass and prevent thyroid issues, two of the most common side effects of very-low-calorie diets. I’d recommend working with a dietitian or nutritionist to develop a sustainable plan using one or both of these methods, but there is also a lot of information available in books and online. Again, I’m sorry you’ve been struggling so hard with weight, and I wish you the very best of luck.
Franziska
Hi Franziska, thanks so much for this article! I have to say it also made me laugh when I read what they are claiming on their website. Sadly, there will always be people trying to make money out of this. In fact, a calorie-restricted diet is the WORST you can do for your thyroid and I don’t think they will ever be able to provide any clinical evidence on their claims.
Thanks so much for your nice feedback, Martina! Your comments are spot on. I really hope this trend fizzles out again very soon.
I dropped 30kg on the hCG Protocol over 3 rounds (6, 5 & 4 weeks respectively) The version I used from changinghabits.com.au is slightly different than what’s commonly used in the US & homoeopathic drops are used rather than Rx injections. Yes, there was some loss of muscle tone, but there was also a massive loss of fat I hadn’t ever been able to shift. My adrenal fatigue symptoms went from severe to mild and I overcame years of secondary infertility (currently 36 wks pregnant).
One of the main things was the gradual re-introduction of foods to see which ones agreed with my body & which didn’t. That’s an important key to long-term success. I had done an elimination diet 20 years earlier under the watch of a dietician who diagnosed me with multiple food allergies. I felt weak, tired & malnourished all the time. However, this was never a problem when doing the protocol. If anything, I had more energy than ever.
So sure, this is anecdotal, not scientific, but it has worked for me & several people I know.
Thanks so much for sharing your story, Nyree. I’m glad to hear that HCG worked for you and that you had no long-term side effects. And congratulations on your pregnancy! That’s fantastic. Best of luck with everything 🙂
Hi , I tried HCG protocol and lost 20 lbs but have gained back about 15 lbs due to my high stress levels . I was thinking about doing it again but after reading your post I really would like to try another approach to weight management . Here’s the thing – I don’t know how to start that will motivate me to continue .
Hi Lisa,
I recommend Diet Doctor’s low-carb approach: https://www.dietdoctor.com/low-carb. The site has tons of great information, recipes, and inspirational stores from people who’ve made it work. Good luck!