Is the hCG diet a safe, healthy and effective way to drop pounds? Or is it a gimmicky, unhealthy and even unsafe regimen that doesn’t help its followers achieve long-term weight loss?
Many experts think poorly of the hCG diet — which combines an extremely low daily calorie intake with the ingestion of the hormone hCG — as an effective way to lose weight.
“Two thumbs down,” says Lise Gloede, a registered dietitian based in Arlington, Virginia. “The hCG diet is considered very low calorie, and while you will likely lose weight, it will likely lower your metabolism and throw off the needed skill of listening to your hunger/satiety cues, which are very helpful in long-term weight management. “Making good food choices, attention to portions, and finding ways to stay physically active all year long will be far more health promoting and wiser for long-term weight loss.”
While a number of versions of the hCG diets are available online, science does not back up the claims of the eating regimen’s proponents that it’s a safe and efficient approach to weight loss, says Beth Czerwony, a registered dietitian with Cleveland Clinic’s Center for Human Nutrition.
“While the hCG diet provides quick weight loss, long term it’s too hard to maintain and can cause serious side effects including nutrient deficiencies,” she says.
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What Is hCG?
The acronym hCG stands for human chorionic gonadotropin. The hormone is made by cells formed in the placenta, which nourishes the egg after it’s been fertilized and becomes attached to the uterine wall, says David Friedman, a clinical nutritionist and board-certified alternative medical practitioner based in Wilmington, North Carolina. He’s the author of “Food Sanity: How to Eat in a World of Fads and Fiction.”
Cynthia Williams, an integrative nutrition practitioner in Louisville, Kentucky, says she’s worked with clients who have been on the hCG diet. Some received injections of the hormone, and some got synthetic versions. “Different clinics (that provide hCG for weight loss) have different approaches,” she says.
With its extreme calorie restrictions, the hCG diet isn’t sustainable, and many of her clients gain more weight than they initially lost when they aren’t able to maintain the regimen. Williams helps them attain a healthy, sustainable eating regimen.
What Is the hCG Diet?
The first iteration of the hCG diet was outlined in 1954 in the book “Pounds and Inches: A New Approach to Obesity,” by A.T.W. Simeons, who created the diet.
There are two key components of the hCG diet: One is that the hCG diet calls for adherents to take the hormone daily, either through an injection, typically into the thigh, or taking it orally, either as a pellet or tablet or from a spray.
The other key component of the hCG diet is limiting your intake to just 500 to 800 calories a day.
Many dietitians promote the importance of eating a healthy breakfast, but under the regimen that Simeons developed, there’s no solid food before lunch. If a dieter has breakfast, it typically consists of a cup of black coffee or tea of any size, with no sugar, though calorie-free sweeteners are allowed. If you drink milk, you can have one tablespoon every 24 hours.
Under the hCG diet, most of the day’s calories come from lunch and dinner, primarily from protein sources. Under the plan, you’d consume 3.5 ounces of lean, fat-free protein at each meal. The hCG eating plan also calls for consuming modest amounts of vegetables and fats.
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HCG Diet Foods: What Can I Eat?
The hCG eating regimen emphasizes getting protein from these broad food groups:
— Fish, such as scallops, crab or white fish.
— Lean meats, like buffalo or extra-lean beef.
Fattier seafood choices, such as salmon, tuna, herring and dried or pickled fish, are off-limits under the hCG diet eating plan. Dieters also need to remove the visible fat from protein sources before boiling or grilling them. It’s OK to substitute an egg or a serving of low-fat cottage cheese for meat on occasion.
One low-calorie vegetable is allowed as part of both lunch and dinner.
Recommended veggies include:
— Beet greens.
— Mixed greens.
— Red radishes.
You can have one fruit at lunch and at dinner.
HCG-approved fruit includes:
As for carbohydrates, people on the hCG diet can have one piece of Melba toast or one breadstick at dinner. Both are allowed because they don’t have fat, sodium or cholesterol and are low in calories.
The plan also doesn’t allow for carbohydrate-rich foods such as muffins, pasta and bagels, with or without cream cheese. Seasonings such as salt, pepper, sweet basil, parsley and mustard powder are acceptable. Oil (even healthy cooking oils), butter and any type of dressing are not allowed under the diet.
One thing that the hCG diet has in common with many other eating regimens is that it doesn’t recommend eating foods with added sugars. Among the food items not allowed under the hCG diet include cookies and chocolates.
What Does Science Say About the hCG Diet?
Advocates of the hCG diet say the hormone boosts weight loss by “blasting” fat. But a meta-analysis published in 2020 in the Family Physicians Inquiries Network concluded that the hCG diet provides “no additional benefit” over a low-calorie diet alone when it comes to weight loss.
Additionally, a review of research that appeared in 2015 in the journal Blood, a peer-reviewed journal published by the American Society of Hematology, found that a dozen studies reported that weight loss associated with the use of hCG “was no greater than with the use of a placebo or with the use of diet only. It was concluded that there is no scientific evidence that hCG is effective in the treatment of obesity; it does not bring about weight loss or fat redistribution, nor does it reduce hunger or induce a feeling of well-being.”
FDA Warnings About hCG Diet Products
Friedman notes that the Food and Drug Administration warns consumers against using hCG for weight loss. The FDA advises people who are using “homeopathic” hCG for weight loss to stop using it and to discard the product.
In November 2011, the FDA and the Federal Trade Commission sent warning letters to seven hCG marketers, advising them that their products were mislabeled under the FDA Act. The letters warned the marketers that it’s unlawful under the FDA Act to make weight-loss claims that aren’t supported by reliable scientific evidence.
“These products are marketed with incredible claims, and people think that if they’re losing weight, hCG must be working,” Elizabeth Miller, who at the time was acting director of the FDA’s Division of Non-Prescription Drugs and Health Fraud, said in the statement. “But the data simply does not support this; any (weight) loss is from the severe calorie restriction. Not from the hCG.”
What’s more, in 2020 the FDA announced that hCG “is not approved without a prescription and is not approved for weight loss.” The statement noted that the FDA “has approved hCG as a prescription drug for the treatment of female infertility and for other medical conditions. HCG is not approved for use without a prescription for any purpose. It is not approved for weight loss.”
Despite the FDA warnings, Dr. Nancy Rahnama, a board-certified internist and bariatric physician in Beverly Hills, California, says she still sees patients who use hCG products. “We discuss the risks associated with the hormone and advise them to stop the medication,” she says. “Anyone who has considered or been prescribed hCG as a form of weight loss should discuss the risks with his or her primary care physician.”
Consumers can report harmful effects online to the FDA’s MedWatch program or by calling 1-800-332-1088. Dieters can also report ill effects from the regimen to their healthcare professionals.
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Health Risks of the hCG Diet
One of the main criticisms of the hCG diet is that its recommendation of consuming just 500 to 800 calories a day is extreme and could lead to nutritional deficits.
Depending on a person’s age, sex, height, weight and level of physical activity, the federal government recommends from 1,600 to 2,400 calories per day for adult women and 2,000 to 3,000 calories a day for adult men. If you’re trying to lose weight, the Academy of Nutrition and Dietetics recommends, in general, women shouldn’t dip below 1,200 to 1,500 calories per day and men should stick with 1,500 to 1,800 calories per day.
These low-calorie diets can also adversely affect your resting metabolic rate, or the number of calories your body normally burns when at rest. When the body tips into starvation mode, your metabolic rate drops.
Depending on how few calories you were eating — and how long you were following the diet — when you start consuming more calories, your metabolic rate may stay permanently sluggish. This means it’s easier to gain weight and even put on extra pounds than you had originally.
“In my opinion, eating just 500 (to 800) calories a day is dangerous. It deprives the body of vital vitamins, minerals and protein,” Friedman says.
Many registered dietitians, including Gloede, for example, share Friedman’s concerns that the number of calories the hCG diet calls for is too low to provide the nutrients the body needs.
Eating a restrictive diet can cause an array of health problems, Friedman says, including an imbalance of the electrolytes that keep the body’s muscles and hands functioning properly and an irregular heartbeat.
Side effects of hCG include:
— Blood clots.
— Enlarged breasts in men.
Can I Lose Weight on the hCG Diet?
While it may lead to quick weight loss for many people, the hCG diet’s strict calorie restriction isn’t sustainable or healthy in the long run, says Kaylee Jacks, a sports dietitian with Texas Health Sports Medicine in Dallas. “Nutrients from carbohydrates and healthy fats that are required for optimal health are avoided in this diet,” she says.
“The only ‘pro’ this diet has is weight loss,” Jacks says. “There are many cons, including the high risk of malnutrition from dietary restrictions. I can’t recommend this diet.”
Adhering to a low-calorie diet may produce short-term weight loss, Friedman adds. However, research suggests that such weight loss is no greater in people restricting their calories with hCG than in individuals who cut calories while taking a placebo, he notes.
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Update 01/30/23: This story was previously published at an earlier date and has been updated with new information.