Many individuals seeking weight loss wonder whether combining different treatments might enhance results. Wegovy (semaglutide), a licensed GLP-1 receptor agonist approved by the MHRA for chronic weight management, has demonstrated significant efficacy in clinical trials. Human chorionic gonadotropin (HCG), conversely, is promoted by some private clinics for weight loss despite lacking robust scientific evidence and MHRA licensing for this purpose. This article examines whether taking Wegovy and HCG together is safe, explores potential risks and interactions, and provides guidance aligned with NHS and NICE recommendations for evidence-based weight management.

Understanding Wegovy and HCG: How Each Works for Weight Loss

Wegovy (semaglutide) is a prescription medication licensed by the MHRA for chronic weight management in adults with obesity or overweight with weight-related comorbidities. It belongs to a class of drugs called GLP-1 receptor agonists, which mimic the action of glucagon-like peptide-1, a naturally occurring hormone that regulates appetite and food intake. Wegovy works by:

• Slowing gastric emptying, which prolongs feelings of fullness

• Acting on appetite centres in the brain to reduce hunger

• Reducing food intake and caloric consumption

Clinical trials have demonstrated that semaglutide, when combined with lifestyle interventions, can lead to significant weight loss—with mean reductions of approximately 15% in non-diabetic adults (STEP 1 trial) and around 10% in people with type 2 diabetes (STEP 2 trial) over 68 weeks. Wegovy is administered as a once-weekly subcutaneous injection and is available through NHS prescription in accordance with NICE guidance (TA875) for eligible patients.

Human chorionic gonadotropin (HCG), by contrast, is a hormone naturally produced during pregnancy. Some private clinics and practitioners promote HCG injections or drops as part of very low-calorie diet (VLCD) programmes for weight loss, typically involving severe caloric restriction (500–800 kcal/day). However, there is no robust scientific evidence supporting HCG's efficacy for weight loss beyond the effects of caloric restriction alone. Systematic reviews, including Cochrane reviews, have consistently found HCG to be no more effective than placebo. The MHRA does not license HCG for weight management, and its use for this purpose remains controversial. Weight loss observed in HCG programmes is primarily attributable to the extremely low calorie intake rather than any pharmacological action of the hormone itself. Understanding these fundamental differences in mechanism, evidence base, and regulatory status is essential when considering any combination therapy.

Can You Take Wegovy and HCG Together? Safety Considerations

Combining Wegovy and HCG is not recommended and lacks any clinical evidence base or regulatory approval. There are several important safety considerations that patients and healthcare professionals must understand:

Firstly, no clinical trials have evaluated the safety or efficacy of using semaglutide alongside HCG. The absence of research means potential interactions, adverse effects, or complications remain unknown. Wegovy's clinical development programme did not include combination with HCG, and the Summary of Product Characteristics (SmPC) provides no guidance on such use.

Secondly, HCG protocols typically involve severe caloric restriction (500–800 kcal/day), which poses significant health risks including:

• Nutritional deficiencies (vitamins, minerals, essential fatty acids)

• Muscle loss and reduced metabolic rate

• Fatigue, dizziness, and electrolyte imbalances

• Gallstone formation

• Cardiac arrhythmias in susceptible individuals

When combined with Wegovy—which already reduces appetite and food intake—the risk of inadequate nutrition becomes substantially greater. Patients may struggle to consume even minimal calories, potentially leading to dangerous nutritional deficits and metabolic complications.

Additionally, both interventions can cause gastrointestinal side effects. Wegovy commonly causes nausea, vomiting, diarrhoea, and constipation, particularly during dose escalation. Combining these effects with severe caloric restriction could exacerbate gastrointestinal distress and increase the risk of dehydration.

Importantly, Wegovy is contraindicated in pregnancy and should be discontinued at least 2 months before a planned pregnancy. Since HCG is a pregnancy hormone, this raises additional concerns about potential physiological interactions.

Regulatory perspective: The MHRA has not approved HCG for weight loss, and NICE does not recommend it. Using unlicensed treatments alongside licensed medications like Wegovy raises significant governance and safety concerns. Patients should only use medications as prescribed and licensed, under appropriate medical supervision.

If you experience side effects from any medication, report them to the MHRA through the Yellow Card Scheme (yellowcard.mhra.gov.uk).

Potential Risks and Drug Interactions Between Wegovy and HCG

Whilst there is no official documented interaction between semaglutide and HCG in pharmaceutical databases, the physiological and metabolic effects of combining these agents warrant serious consideration.

Metabolic and hormonal effects: HCG is a glycoprotein hormone that shares structural similarities with luteinising hormone (LH) and can affect reproductive and metabolic pathways. Semaglutide influences glucose metabolism, insulin secretion, and appetite regulation. The combined metabolic burden of both agents, particularly in the context of severe caloric restriction, could potentially affect:

• Reproductive hormone balance

• Glucose homeostasis

• Fluid and electrolyte balance

Hypoglycaemia risk: For people with diabetes taking Wegovy alongside diabetes medications, there is an increased risk of hypoglycaemia. The Wegovy SmPC advises that doses of insulin or sulfonylureas may need reduction when starting treatment. Adding severe caloric restriction through an HCG protocol could further increase this risk.

Cardiovascular considerations: Severe caloric restriction can have adverse cardiac effects, including arrhythmias related to electrolyte disturbances. The combination with Wegovy may increase cardiovascular risks, particularly in patients with pre-existing heart conditions.

Gastrointestinal complications: Both Wegovy and extreme caloric restriction increase the risk of gallstone formation. Rapid weight loss (>1.5 kg per week) is a known risk factor for cholelithiasis. Combining two interventions that promote rapid weight loss could substantially elevate this risk, potentially necessitating surgical intervention.

Medication absorption: According to the Wegovy SmPC, the delayed gastric emptying effect of semaglutide does not have clinically relevant effects on the absorption of most oral medications. However, patients should be aware that timing of medications may need adjustment in some cases.

Psychological and behavioural risks: Combining multiple weight loss interventions may foster unhealthy relationships with food, promote disordered eating patterns, and create unrealistic expectations about sustainable weight management. This approach contradicts evidence-based principles of gradual, lifestyle-focused weight loss.

NHS and NICE Guidance on Combining Weight Loss Treatments

NICE guidance (CG189) on obesity management provides clear recommendations for pharmacological interventions, but does not endorse HCG for weight loss. NICE recommends that:

• Pharmacological treatment should only be used as part of a comprehensive weight management programme

• Medications should be prescribed only when licensed and evidence-based

• Very low-calorie diets (VLCDs, ≤800 kcal/day) may be considered for specific patients under specialist supervision, but should be time-limited and nutritionally complete

Wegovy is recommended by NICE (TA875) for specific patient groups: adults with a BMI of at least 35 kg/m² (or ≥30 kg/m² with weight-related comorbidities), who have at least one weight-related comorbidity and have completed a tier 3 service. Treatment should be provided within specialist weight management services and is recommended for a maximum of 2 years. The NICE guidance does not include a 5% weight loss stopping rule at 6 months.

Importantly, NICE does not provide any recommendation for HCG for weight management. The guidance emphasises that weight loss interventions should be evidence-based, safe, and sustainable. Combining licensed medications with unlicensed or unproven treatments contradicts these principles.

NHS position: The NHS does not fund or endorse HCG for weight loss. Patients seeking HCG typically access it through private clinics operating outside NHS governance frameworks. Healthcare professionals should:

• Advise patients about the lack of evidence supporting HCG

• Explain the risks of severe caloric restriction

• Discourage combining unlicensed treatments with prescribed medications

• Offer evidence-based alternatives within NHS weight management services

Professional responsibility: Prescribers have a duty to follow GMC guidance on prescribing unlicensed medicines, which requires clear justification and informed consent. The GMC states that prescribers should usually only prescribe licensed medicines for their licensed uses. There is no justifiable clinical rationale for combining Wegovy with HCG, and doing so could constitute inappropriate prescribing practice.

Safe Alternatives: Evidence-Based Weight Management Options

Rather than combining Wegovy with unproven interventions like HCG, patients should focus on evidence-based, sustainable approaches to weight management:

Optimising Wegovy treatment: When prescribed appropriately, Wegovy is highly effective as monotherapy. Patients should:

• Follow the dose escalation schedule to minimise side effects

• Attend regular follow-up appointments to monitor progress and safety

• Engage with dietetic support to ensure adequate nutrition whilst reducing calorie intake

• Combine medication with increased physical activity (aim for 150 minutes moderate-intensity exercise weekly, plus muscle-strengthening activities on at least 2 days per week, as per UK Chief Medical Officers' guidelines)

Structured lifestyle programmes: NICE recommends multicomponent interventions including dietary modification, physical activity, and behavioural strategies. NHS-funded programmes such as the NHS Digital Weight Management Programme provide evidence-based support without the risks associated with extreme diets or unproven treatments.

Other licensed pharmacological options: For patients unsuitable for or unable to tolerate Wegovy, alternatives include:

• Orlistat (lipase inhibitor that reduces fat absorption)

• Liraglutide 3mg (another GLP-1 receptor agonist, recommended by NICE TA664 for specific patient groups, though local NHS availability may vary)

• Consideration of bariatric surgery referral for eligible patients with severe obesity

Medically supervised diets: If rapid weight loss is clinically indicated (e.g., pre-bariatric surgery), options include:

• Very low-calorie diets (≤800 kcal/day) under specialist supervision for up to 12 weeks

• Low-calorie diets (800–1200 kcal/day) with appropriate nutritional support

These differ fundamentally from HCG protocols as they provide adequate protein, vitamins, and minerals and are used within NHS-approved frameworks.

When to seek medical advice: Patients should contact their GP or prescriber if they experience:

• Severe or persistent nausea, vomiting, or abdominal pain (particularly if severe and radiating to the back, which could indicate pancreatitis)

• Signs of dehydration (dark urine, dizziness, reduced urination)

• Symptoms of gallstones (right upper quadrant pain, jaundice)

• Any concerning symptoms while taking weight loss medications

If you experience side effects from Wegovy, report them through the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).

Sustainable weight management requires patience, professional support, and evidence-based interventions—not unproven combinations that may compromise safety and long-term success.

Frequently Asked Questions