A fad diet that
involves daily dosing of a pregnancy hormone is experiencing a
"rebirth" with a big push from one of America's most popular
television doctors, Mehmet Oz, MD.
Last month, Oz devoted
an entire show to claimed benefit of the human chorionic gonadotropin (hCG) diet. A highlight of the Oz
show — an audience packed with believers who offered testimonials about the
sure fire combination of a daily injection of the hormone and 500 calorie a day
diet.
His bottom line:
Though studies from the past have found that hCG is no better than a placebo,
he sees "a lot of reasons — intriguing reasons — to re-evaluate the diet.
"By researching
hCG — and this is something I'm excited about — I think we might find new ways
to help millions of people who do not have another solution, find an
option," he said. "And for that reason, I think it's worth
investigating."
Skeptics point out
that a 500 calorie diet would alone cause a drop in pounds, and Oz does not
recommend that severely restricted regimen. He advocates 1,200calories instead.
Moreover, Oz said the
diet should only be undertaken under the supervision of a doctor, who would
prescribe hCG for injection. He warned that over-the-counter oral supplements
do not work.
Yet a handful of
specialists contacted by MedPage Today and ABC News questioned
the ethics of colleagues who endorse — even market — the hCG diet, which costs
anywhere between $800 and $1,150 for a consultation that includes blood work,
assessment of body metrics, and an initial prescription.
"I think it is
sad that there are quality devices and pharmaceuticals that have data that
prove weight loss that cannot be sold, but that marketers who pose as doctors
can profit from selling something that has no proven benefit," said
Mitchell Roslin, MD, of Lenox Hill Hospital in Manhattan.
"It is not
surprising that Mehmet has taken this position," Roslin added.
"Mehmet is a wonderful cardiac surgeon, excellent athlete, and a
phenomenal self-promoter."
Carla Wolper, EdD, RD,
of the obesity research center at St. Luke's and Roosevelt Hospitals in
Manhattan, said Oz used bad judgement when he had as a guest a doctor who
promotes the treatment — Sheri Emma, MD, a New Jersey physician.
"Allowing her to
go unchallenged is more evidence that Oz is no longer legitimately interested
in the truth, but in notoriety, money, and keeping his program on the
air," Wolper said.
"This is nothing
but a new scam by greedy MDs," she added.
However, some
clinicians agreed with Oz that further study may be warranted, given that many
of the studies were done years ago and more modern injections may yield
different results.
"I would agree
that research needs to be updated," said Lona Sandon, MEd, RD, of the
University of Texas Southwestern Medical Center and spokesperson for the
American Dietetic Association, which does not endorse the hCG diet.
"Just because
something is allowed for off-label use does not mean it is safe or
effective," she said. "People are spending thousands of dollars on
this with little guarantee of safety and efficacy."
But David Katz, MD, of
Yale University, who wrote a Huffington Post article critical of the hCG diet
in January, said it would be "a waste of research funding to re-discredit
a scam every time it gets reintroduced."
"The treatment
doesn't make any sense," he said. "Who associates pregnancy with
either weight loss or fat loss, or appetite suppression? And the
studies have been negative. What is the basis to reintroduce it?"
British physician
Albert Simeons first championed the diet in the 1950s. Since then, more than a
dozen trials have refuted its efficacy, including several randomized,
placebo-controlled trials that found hCG no better than a saline injection.
As a guest on the
episode of the Dr. Oz Show devoted to the hCG diet, Pieter Cohen, MD, of
Harvard Medical School, said the heart of the debate lies in whether the shot
simply generates a placebo effect.
That's a possibility
given that no one is quite sure of the mechanism by which hCG may work since
pregnancy is not usually associated with a decrease in hunger.
Albert Levy, MD, of
Mount Sinai Medical School in New York City, said reducing caloric intake to
500 calories per day could induce a ketotic state, "which will induce a
lack of appetite and consequently more weight loss."
"Let's not forget
the bad consequences of a ketotic state, particularly in diabeticpatients," Levy added.
Although hCG
injections are FDA-approved for treating female infertility (as well as certain
male conditions including undescended testes and hypogonadism secondary to a
pituitary deficiency), the agency maintains the stand it took on the diet years
ago:
"Since the
mid-1970s, FDA has required labeling of hCG to state that [it] has not been
demonstrated to be effective adjunctive therapy in the treatment of obesity.
Numerous clinical trials have shown hCG to be ineffectual in producing weight
loss," the agency said in a statement.
FDA also warns of a
host of potential side effects, including an increased risk of blood clots, headaches,
irritability, fatigue, restlessness, depression, swelling, breast tenderness or
enlargement, and water retention.
The drug can also
cause potentially life-threatening ovarian hyperstimulation, a syndrome of
sudden ovarian enlargement.
Whether the hCG diet
will be re-evaluated remains to be seen, but many researchers are confident the
hype will eventually recede.
"The resurgence
of the hCG diet only goes to show that fads, much as their name states, come
and go on a regular basis," said Connie Diekman, RD, MEd, director of
university nutrition at Washington University in St. Louis. "It is more
important that people lose weight with an eating and activity plan that ensures
they can keep the weight off."