Holt on the HCG Diet Revolution Part 1

There is a major revival of interest in the short term use (3 or 6 weeks) of very low calorie diets (VLCD) for the induction of weight loss, especially in the obese individual ( BMI>30). This modern weight control revolution in Integrative Medicine involves a reactivation of the combined application of severe calorie restriction (very low calorie diet, VLCD, 500 Kcal day diet), combined with injections of modest amounts of the hormone, human chorionic gonadotrophin (HCG) or the oral use of homeopathic HCG preparations (modified Simeons Diet Protocols). The HCG diet is being enthusiastically applied by an increasing number of physicians who believe in its benefits and describe its successful outcomes. Some individuals continue to question the evidence-base for its use.

Weight management concepts, involving HCG injections, were first presented in 1954 by ATW Simeons, resulting in the use of the terms “Simeons protocol” or “Simeons diet”. The widespread use of the Simeons diet in the 1960’s and early 70’s bred “fat clinics” throughout Europe and to a lesser degree in the United States. The Simeons approach was corrupted and, in some cases, modified to advantage by many healthcare givers. However, the diet fell into disrepute because few advantages of HCG plus a VLCD were recorded or observed in comparison with the use of a VLCD alone; at least under the specific conditions of several studies under which the evaluations of the HCG
diet were made.

In recent times in the USA, many thousands of patients have received the Simeons protocol with apparent resounding claims of success. The modern, open-label experiences with the HCG diet imply that there are more desirable features to weight control as a consequence of the administration of HCG. Such observations include targeted removal of fat deposits, retention of muscle mass, a better body contour at the end of the HCG diet and postulations about a modification of the “set-point phenomenon” (resistance to weight loss during dieting). While Simeons used an HCG diet for some individuals with only modest weight gain, many proponents of the HCG diet believe that this approach is more ideal for individuals with significant degrees of overweight status or obesity.

In my book, I attempt to review the advantages, disadvantages, limitations and perceived benefit of the Simeons approach (HCG diet) to weight control. In common with several interventions that are used in Integrative Medicine, controversies exist and there is a need to seek a clear evidence-base for this weight loss approach. That said, it is difficult to ignore the growing consensus of opinion on the benefits of the Simeons diet in its expanding application in clinical practice. Regulatory authorities in the US have not embraced the efficacy of the “off label” use of the injected drug HCG in weight control. Even more criticism has been leveled at “homeopathic” HCD drops.
Before the “cannons of criticism” shoot down the HCG diet, a reappraisal of circumstances is required, together with more outcome research (www.worldhealth.net).

My book on HCG diets is an attempt to give details on HCG diets from a perspective of published evidence. One thing must be made very clear. The HCG diet involves the use of very low calorie intake which imposes a temporary phase of forced malnutrition. When very low calorie diets were introduced in the 1950’s with some degree of popularity, there were deaths reported with this type of diet. These deaths were often ascribed to mineral deficiencies or other micronutrient deficiencies or perhaps stress as a consequence of diminished calorie intake. This is why it is very important to supplement the HCG diet with minerals and vitamins. While Dr. Simeons did not recommend fat intake in his diet described in 1954, he was unaware of the benefits of essential fatty acids. Invariably individuals on a very low calorie diet will develop some degree of essential fatty acid deficiency and I recommend that at least one gram capsule of fish oil be taken on a daily basis to provide essential omega 3 fatty acids but opinions vary on this approach. It is my strong opinion that a very low calorie diet requires supervision and meticulous monitoring by a healthcare practitioner and I do not think it is wise for the average person to undertake a low calorie diet without some form of nutritional consultation. Above all, there must be no harm in weight loss tactics and this dictum of Hippocrates must be carefully followed with strict diets that are used in HCG protocol treatments. All readers must understand that there is a significant branch of medical opinion that does not see any benefit from the administration of a very low calorie diet with HCG addition. That said, very low calorie diets are described in medical literature as quite effective for short term weight loss but they have some safety concerns. It is necessary for me to reiterate this message and medical opinion remains divided on this subject regardless of some misleading information that is in existence on the internet (concerning HCG diets).

The global epidemic of obesity has bred its own subspecialty practice of medicine. I wish to coin the somewhat clumsy terms “ Obesitology” or “ Bariatology” that describe areas of comprehensive medical care that are required for the “overweight diathesis”. These terms are meant to incorporate a holistic approach to the battle against an overweight status. Obesity may now be the commonest cause of premature morbidity and mortality in many industrialized countries. Excessive body weight is one of the most recalcitrant disorders in modern medicine, for which there is no simple way out. That said, complacency prevails about expanded waistlines and mounting childhood obesity is bringing tears to the eyes of industrialized society. Our recognition of “fat societies” resonates with millions of people. The message about the benefits of controlling weight makes many people sickened, tired and desperate. The desperation of the obese individual is apparent in a common willingness of many people to respond to false promises of weight loss control. Is the HCG diet just another fad? Several physicians have published comments that the HCG diet has inherent false promises. I acknowledge that massive confusion has been created by fad diets and “gobbledygook” statements about weight loss control. It is time to tackle the horns of the “obesity bull”, with “head on” tactics.

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