Obesity is a serious social problem and it is considered one of the plagues of the modern world. The World Health Organization estimates that in 2008 there were 1.4 billion overweight people in the world, including 500 million obese (source).1 In Poland, in 2003-2005 the problem of overweight occurred in 40.4% of men and 27.9% of women, and obesity related to 21.2% of men and 22.4% of women (source).2 Overweight and obesity are dangerous, as these problems are correlated with the occurrence of many serious diseases, such as:

  • insulin resistance,
  • type 2 diabetes,
  • arterial hypertension,
  • coronary heart disease,
  • fat metabolism disorders,
  • inflammatory diseases of the gallbladder.

Therapies offered by modern medicine may be troublesome for patients and do not always guarantee success in the form of permanent weight reduction. For this reason, patients often try complementary therapies, and their interest in Chinese Medicine and acupuncture has been growing rapidly (source).3

A meta-analysis published in 2007 included 29 clinical trials to examine the effectiveness of acupuncture in the treatment of obesity (source).4 Having analyzed the results, the authors concluded that acupuncture is more effective than placebo, false acupuncture and conventional therapies. Unfortunately, 2/3 of the data included in the meta-analysis came from China, were of low quality and received a low score on the Jadad quality scale. For this reason, it was not possible to draw any binding conclusions on that basis.

Another analysis was published in 2012 in “Obesity Reviews”, an official journal of the International Association for the Study of Obesity (source).5 The authors analyzed 2,545 potentially relevant articles and eventually considered 96 randomized controlled clinical trials describing the efficacy of various Chinese Medicine therapies in the treatment of obesity and overweight. Among these, 44 publications (2,421 patients in the study groups and 1,746 patients in control groups) related to acupuncture. 16 studies reported minor adverse effects of acupuncture, mostly in the form of skin redness, pain or bruising at the injection site. As in the case of the above-mentioned meta-analysis, the authors exhibited that acupuncture was more effective in reducing body weight than placebo, changes in the patient’s lifestyle or western medications. Unfortunately, that meta-analysis and the previous one share some reservations related to the quality of the included studies, as 75 out of the 77 Chinese studies were assigned fewer than 3 points on the Jadad scale; however, 16 out of the 19 English-language studies were assigned more than 3 points on that scale.

In view of these concerns, in order to obtain a clear picture of the impact of acupuncture on body weight, it was decided that a further review of the literature should be prepared, published in 2013 (source).6 The authors decided to describe the impact of different types of acupuncture on weight loss separately:

  1. In the studies, manual acupuncture results in a significantly greater weight loss than false acupuncture, dietary supplements, diet or exercise; when added to other recommendations (diet, or diet and exercise), it also significantly improves their efficiency. No significant differences were obtained in two of these studies; however, in both of them the groups were very small (40 and 27 people); additionally, in one of the studies 12 out of 20 people resigned, which may indicate an incorrect use of acupuncture.
  2. In the vast majority of studies, electro-acupuncture is significantly more effective than false electro-acupuncture, diet, physical exercise or stimulation of random skin areas. Only one study reports the efficacy of electro-acupuncture to be similar to that of physical exercise.
  3. Aural acupuncture – this specific technique is often used in patients willing to reduce their body weight. Two studies described state significant effects, while in one of them both acupuncture and false aural acupuncture rendered similar clinical effects; however, these reports differed in terms of positive effect on the balance between ghrelin and leptin secretion.

The present review of literature also features some interesting information about the biochemical basis for the effects of acupuncture on human metabolism and body weight.

  1. Effect on obesity-related proteins. Obesity is characterized by leptin resistance, and thus by the increased levels of leptin in the blood. Acupuncture (manual, aural or electro-acupuncture) reduces leptin resistance and leptin blood levels. In addition, manual and aural acupuncture increases plasma levels of ghrelin, while electro-acupuncture increases the secretion of β-endorphins and adiponectin.
  2. Effects on blood glucose and insulin resistance. Depending on the situation, acupuncture either affects insulin levels, increasing insulin secretion or normalizes its levels, reducing insulin resistance.
  3. Effects on fat metabolism. Manual acupuncture and electro-acupuncture has a beneficial effect on the body’s lipid management, which results in a significant decrease in the levels of total cholesterol, LDL cholesterol and triglycerides, while preserving the levels of HDL cholesterol. One of the studies described a significant reduction in lipoprotein(a) and apolipoprotein.

The above-mentioned effect of acupuncture on various aspects of lipid management and obesity in humans is also confirmed in animal models, which is also described in this literature review.

The results of further studies published after the above-mentioned review was published, also confirm the beneficial effects of acupuncture on weight reduction. In an experiment conducted by Korean researchers, stimulation of acupuncture points on the ear, or even a single point responsible for the sensation of hunger, resulted in a significant reduction in BMI (Body Mass Index) of 6.1% and 5.7%, respectively (source).7

A prospective randomized placebo-controlled trial related to the efficacy of electro-acupuncture at three points on the ear, which was carried out in Austria and covered 56 obese women, rendered similar results in the form of a significant reduction in body weight and BMI (source).8 The patients did not report any adverse effects during the trial.

STRENGTH OF EVIDENCE
Power of arguments
BIBLIOGRAPHY

1 http://www.who.int/mediacentre/factsheets/fs311/en/

2 Wieloośrodkowe Ogólnopolskie Badanie Stanu Zdrowia Ludności. Program WOBASZ. Wyd Instytut Kardiologii Warszawa, 2005, 90: 1-128.

3 Belivani M, Dimitroula C, Katsiki N, Apostolopoulou M, Cummings M, Hatzitolios AI. „Acupuncture in the treatment of obesity: a narrative review of the literature.” Acupunct Med. 2013 Mar;31(1):88-97. doi: 10.1136/acupmed-2012-010247. Epub 2012 Nov 15

4 Cho SH, Lee JS, Thabane L, et al. „Acupuncture for obesity: a systematic review and meta-analysis.” Int J Obes (Lond) 2009;33:183–96.

5 Sui Y1, Zhao HL, Wong VC, Brown N, Li XL, Kwan AK, Hui HL, Ziea ET, Chan JC. „A systematic review on use of Chinese medicine and acupuncture for treatment of obesity”  Obes Rev. 2012 May;13(5):409-30. doi: 10.1111/j.1467-789X.2011.00979.x. Epub 2012 Feb 1

6 Belivani M, Dimitroula C, Katsiki N, Apostolopoulou M, Cummings M, Hatzitolios AI. „Acupuncture in the treatment of obesity: a narrative review of the literature.” Acupunct Med. 2013 Mar;31(1):88-97. doi: 10.1136/acupmed-2012-010247. Epub 2012 Nov 15

7 Yeo S, Kim KS, Lim S. „Randomised clinical trial of five ear acupuncture points for the treatment of overweight people.” Acupunct Med. 2014 Apr;32(2):132-8. doi: 10.1136/acupmed-2013-010435. Epub 2013 Dec 16.

8 Schukro RP, Heiserer C, Michalek-Sauberer A, Gleiss A, Sator-Katzenschlager S „The effects of auricular electroacupuncture on obesity in female patients–a prospective randomized placebo-controlled pilot study.” Complement Ther Med. 2014 Feb;22(1):21-5. doi: 10.1016/j.ctim.2013.10.002. Epub 2013 Oct 31.

THE AUTHOR