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Acupuncture for obesity: a systematic review and meta-analysis

Abstract

Background and Objective:

Acupuncture is widely used in complementary and alternative medicine to reduce body weight. However, a systematic review and meta-analysis to assess an effect of acupuncture has not yet been performed. Aim of this study is to critically assess evidence for reduction of body weight and to evaluate adverse events of acupuncture therapy based on the results of randomized controlled trials (RCTs) that evaluate the effect of various types of acupuncture therapies.

Data sources:

A total of 19 electronic databases, including English, Korean, Japanese and Chinese databases, were systematically searched for RCTs of acupuncture for reduction of body weight or improvement in obesity up to March 2008 with no language restrictions.

Methods:

RCTs for acupuncture compared either with placebo controlled or with comparator intervention were considered. Studies’ methodological qualities were assessed using the Jadad scale. If no evidence of heterogeneity existed across study results, statistical pooling of data was performed using a fixed effects model; otherwise, a random effects model was used. Publication bias was assessed using funnel plots. Subgroup analyses were performed according to types of acupuncture.

Results:

A total of 31 studies, which comprised a total of 3013 individual cases, were systematically reviewed. Owing to insufficient data in 2 RCTs, 29 RCTs were used for meta-analysis. About two-thirds of the trials (20 out of 31) showed the lowest score of the Jadad. Compared to control of lifestyle, acupuncture was associated with a significant reduction of average body weight (95% confidence interval, CI) of 1.72 kg (0.50–2.93 kg) and associated with an improvement in obesity (relative risk=2.57; 95% CI, 1.98–3.34). Acupuncture significantly reduced a body weight of 1.56 kg (0.74–2.38 kg), on average, compared to placebo or sham treatments. Acupuncture also showed more improved outcomes for body weight (mean difference=1.90 kg; 1.66–2.13 kg), as well as for obesity (relative risk=1.13; 1.04–1.22), than conventional medication. Only four RCTs reported acupuncture-related adverse events, which were mostly minimal.

Conclusions:

Our review suggests that acupuncture is an effective treatment for obesity. However, the amount of evidence is not fully convincing because of the poor methodological quality of trials reviewed. In conclusion, there is an urgent need for well-planned, long-term studies to address the effectiveness of acupuncture for treating obesity.

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References

  1. Haslam DW, James W, Philip T . Obesity. Lancet 2005; 366: 1197–1209.

    Article  Google Scholar 

  2. Bray GA . Obesity: basic considerations and clinical approaches. Dis Mon 1989; 35: 449–537.

    CAS  Article  Google Scholar 

  3. World Health Organization Food, Agriculture Organization of the United Nations. (ed). Diet, Nutrition and the Prevention of Chronic Diseases. WHO: Geneva, 2002.

  4. Mulhisen L, Rogers JZ . Complementary and alternative modes of therapy for the treatment of the obese patient. J Am Osteopath Assoc 1999; 99: S8–12.

    CAS  PubMed  Google Scholar 

  5. Zollman C, Vickers A . ABC of complementary medicine. Users and practitioners of complementary medicine. BMJ 1999; 319: 836–838.

    CAS  Article  Google Scholar 

  6. Vickers A, Wilson P, Kleijnen J . Acupuncture. Qual Saf Health Care 2002; 11: 92–97.

    CAS  Article  Google Scholar 

  7. Birch S, Hesselink JK, Jonkman FAM, Hekker TAM, Bos A . Clinical research on acupuncture. Part 1. What have reviews of the efficacy and safety of acupuncture told us so far? J Altern Complement Med 2004; 10: 468–480.

    Article  Google Scholar 

  8. Shiraishi T, Onoe M, Kojima T, Sameshima Y, Kageyama T . Effects of auricular stimulation on feeding-related hypothalamic neuronal activity in normal and obese rats. Brain Res Bull 1995; 36: 141–148.

    CAS  Article  Google Scholar 

  9. Cabyoglu MT, Ergene N, Tan U . The treatment of obesity by acupuncture. Int J Neurosci 2006; 116: 165–175.

    Article  Google Scholar 

  10. Lacey JM, Tershakovec AM, Foster GD . Acupuncture for the treatment of obesity: a review of the evidence. Int J Obes 2003; 27: 419–427.

    CAS  Article  Google Scholar 

  11. Ernst E . Acupuncture/acupressure for weight reduction? A systematic review. Wien Klin Wochenschr 1997; 109: 60–62.

    CAS  PubMed  Google Scholar 

  12. Ernst E, White A . Clinical effectiveness of acupuncture: an overview of systematic reviews. In: Ernst E, White A (eds). Acupuncture: A Scientific Appraisal. Butterworth-Heinemann: Oxford, 1999; 107–127.

    Google Scholar 

  13. British Medical Association Board of Science and Education. (ed). Acupuncture: Efficacy, Safety and Practice. Harwood: London, 2000.

  14. Tait PL, Brooks L, Harstall C (eds). Acupuncture: Evidence From Systematic Reviews and Meta-analyses. Alberta: Alberta, Canada, 2002.

    Google Scholar 

  15. Vickers A, Wilson P, Kleijnen J . Effectiveness bulletin: acupuncture. Qual Saf Health Care 2002; 11: 92–97.

    CAS  Article  Google Scholar 

  16. Pittler MH, Ernst E . Complementary therapies for reducing body weight: a systematic review. Int J Obes (Lond) 2005; 29: 1030–1038.

    CAS  Article  Google Scholar 

  17. The National Assembly Library, Korea. (Available at URL:http://www.nanet.go.kr) 2008.

  18. Korean Association of Medical Journal Editors. KoreanMed. (Available at:http://www.koreamed.org ) 2008.

  19. Korean Studies Information Corp. Korean studies Information Service System (KISS). (Available at:http://search.koreanstudies.net/) 2008.

  20. Nurimedia. DBpia. (Available at http://www.dbpia.co.kr ) 2008.

  21. Korea Education & Research Information Service (KERIS). RISS4U. (Available at:http://www.riss4u.net) 2008.

  22. Japan Science and Technology Agency. Japan Science and Technology Information Aggregator, Electronic. J-STAGE (Available athttp://www.jstage.jst.go.jp) 2008.

  23. Tsinghua Tongfang Knowledge Network Technology Group. China National Knowledge Infrastructure. CNKI (Available at: http://www.global.cnki.net) 2008.

  24. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17: 1–12.

    CAS  Article  Google Scholar 

  25. Follmann D, Elliott P, Suh I, Cutler J . Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol 1992; 45: 769–773.

    CAS  Article  Google Scholar 

  26. Abrams KR, Gillies CL, Lambert PC . Meta-analysis of heterogeneously reported trials assessing change from baseline. Stat Med 2005; 24: 3823–3844.

    Article  Google Scholar 

  27. Higgins JP, Thompson SG . Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539–1558.

    Article  Google Scholar 

  28. Higgins JP, Thompson SG, Deeks JJ, Altman DG . Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557–560.

    Article  Google Scholar 

  29. Egger M, Smith GD, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629–634.

    CAS  Article  Google Scholar 

  30. Mazzoni R, Mannucci E, Rizzello SM, Ricca V, Rotella CM . Failure of acupuncture in the treatment of obesity: a pilot study. Eat Weight Disord 1999; 4: 198–202.

    CAS  Article  Google Scholar 

  31. Hsieh CH . Auricular acupressure for weight reduction in obese Asian young adults: a randomized controlled trial. Med Acupunct 2007; 19: 181–184.

    Article  Google Scholar 

  32. Steiner RP, Kupper N, Davis AW . Obesity and appetite control: comparison of acupuncture therapies and behavior modification. Proceedings of the International Forum on Family Medicine Education. Society of Teachers of Family Medicine: Kansas City, MO, USA, 1983; 313–326.

    Google Scholar 

  33. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF . Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Lancet 1999; 354: 1896–1900.

    CAS  Article  Google Scholar 

  34. Richards D, Marley J . Stimulation of auricular acupuncture points in weight loss. Aust Fam Physician 1998; 27: S73–S77.

    PubMed  Google Scholar 

  35. Kim SC, Jang EH, Na WM, Lee SY, Lee JD, Moon HC . et al. A pilot study of Sa-am acupuncture treatment used by sham acupuncture for the simple obesity. J Kor Acupunct Moxibustion Soc 2007; 24: 67–88.

    Google Scholar 

  36. Elder C, Ritenbaugh C, Mist S, Aickin M, Schneider J, Zwickey H et al. Randomized trial of two mind-body interventions for weight-loss maintenance. J Altern Complement Med 2007; 13: 67–78.

    Article  Google Scholar 

  37. Li L, Wang Z . Clinical therapeutic effects of body acupuncture and ear acupuncture on juvenile simple obesity and effects on metabolism of blood lipids. Zhongguo Zhen Jiu (Chin Acupunct Moxibustion) 2006; 26: 173–176.

    Google Scholar 

  38. Hsu CH, Hwang KC, Chao CL, Lin JG, Kao ST, Chou P . Effects of electroacupuncture in reducing weight and waist circumference in obese women: a randomized crossover trial. Int J Obes (Lond) 2005; 29: 1379–1384.

    Article  Google Scholar 

  39. Kim K . The effect of auricular acupuncture in patients with obesity. Unpublished PhD dissertation, Kunghee University, Seoul, Korea, 2007, pp 1–57.

  40. Allison DB, Kreibich K, Heshka S, Heymsfield SB . A randomised placebo-controlled clinical trial of an acupressure device for weight loss. Int J Obes Relat Metab Disord 1995; 19: 653–658.

    CAS  PubMed  Google Scholar 

  41. Tong J, Yao H, Chen J, Zhang Z, Huang S . Clinical observation on the therapeutic effect of abdominal acupuncture therapy for simple obesity. Zhen Ci Yan Jiu (Acupunct Res) 2006; 31: 176–178.

    Google Scholar 

  42. Mok MS, Parker LN, Voina S, Bray GA . Treatment of obesity by acupuncture. Am J Clin Nutr 1976; 29: 832–835.

    CAS  Article  Google Scholar 

  43. Dong X . Clinical trial of acupuncture treatment of simple obesity. Liaoning J Tradit Chin Med 2005; 32: 1070–1071.

    Google Scholar 

  44. Mi Y . Clinical study on acupuncture for treatment of 80 cases of simple obesity. Zhongguo Zhen Jiu (Chin Acupunct Moxibustion) 2005; 25: 95–97.

    Google Scholar 

  45. Allison DB, Kreibich K, Heshka S, Heymsfield SB . A randomised placebo-controlled clinical trial of an acupressure device for weight loss. Int J Obes Relat Metab Disord 1995; 19: 653–658.

    CAS  PubMed  Google Scholar 

  46. Gao X, He L, Zhang X, Ding M . Effect of acupuncture on serum insulin level in the patient of simple obesity. Zhongguo Zhen Jiu (Chin Acupunct Moxibustion) 2007; 27: 738–740.

    CAS  Google Scholar 

  47. Luo SH . Clinical observation on acupuncture for treatment of 60 cases of simple obesity. J Clin Acupunct Moxibustion 2007; 23: 17–18.

    Google Scholar 

  48. Luo H, Li R . Effect of electroacupuncture on leptin and adiponectin in simple obesity patients. Zhen Ci Yan Jiu (Acupunct Res) 2007; 32: 264–267.

    Google Scholar 

  49. Nie L, Zhan Z, Yang L, Tan X . Clinical study on acupuncture of abdominal 8 points for simple obesity. Pract Clin J Integr Tradit Chin Western Med 2007; 7: 23–24.

    Google Scholar 

  50. Su X, Zhang R, Wu Y . Observation on therapeutic effect of acupuncture on obesity patients. China Trop Med 2007; 7: 769–770.

    Google Scholar 

  51. Zhang Y, Cui H . Clinical study on acupuncture for ′heart-spleen-deficiency′ type patients of simple obesity. J Sichun Tradit Chin Med 2007; 25: 112–113.

    Google Scholar 

  52. Li Y, Wu J . Clinical study on auricular acupressure for 80 cases of obesity. Guangming J Chin Med 2006; 21: 23–24.

    Google Scholar 

  53. Ma Q, Bi X, Ma J . Clinical study on acupuncture for 100 cases of simple obesity. Shandong J Tradit Chin Med 2006; 25: 464–465.

    Google Scholar 

  54. Wang C, Cheng Z . Clinical effective valuation and its mechanical analysis of acupuncture on obese hypertensive patients. Liaoning J Tradit Chin Med 2006; 33: 1327–1328.

    Google Scholar 

  55. Yang B, Zhang C, Chen C . Observation and mechanism exploration of acupuncture on body weight reduction. J Tradit Chin Med 2006; 26: 250–253.

    Google Scholar 

  56. Zeng H, Nie B . The Clinical observation on electric acupuncture, catgut implantation at acupoints and auricular point sticking for treatment of simple obesity. J Clin Acupunct Moxibustion 2006; 22: 13–15.

    CAS  Google Scholar 

  57. Fan Y, Bai Y, Gui H . Clinical study on acupuncture for simple obesity with hyperlipidemia. J Ningxia Med Coll 2005; 27: 144–145.

    Google Scholar 

  58. Lee JH . The effect of combined treatment with ultrasound and electro-lopopysis acupuncture on the change of figure in obese women. Unpublished MS thesis. Yong-In University, Korea, 2005, pp 1–38.

  59. Wang S . Clinical study of auricular acupressure for simple obesity. J Chin Physician 2005; 7: 234–235.

    Google Scholar 

  60. Xy J . Clinical observation on 215 cases of obesity treated with acupuncture and auricular point sticking. J Clin Acupunct Moxibustion 2005; 21: 13–15.

    Google Scholar 

  61. Li J, Deng Y . Clinical study on electroacpuncture for 93 cases of simple obesity. Clin J Tradit Chin Med 2004; 16: 479.

    Google Scholar 

  62. Wang H . Observation on the therapeutic effects of acupuncture for 60 cases of simple obesity. J Tradit Chin Med 2002; 22: 187–189.

    PubMed  Google Scholar 

  63. Sun Q, Xu Y . Simple obesity and obesity hyperlipemia treated with otoacupoint pellet pressure and body acupuncture. J Tradit Chin Med 1993; 13: 22–26.

    PubMed  Google Scholar 

  64. Juni P, Witschi A, Bloch R, Egger M . The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 1999; 282: 1054–1060.

    CAS  Article  Google Scholar 

  65. Juni P, Altman DG, Egger M . Assessing the quality of randomized controlled trials. In: Egger M, Smith GD, Altman DG (eds). Systematic Reviews in Health Care: Meta-analysis in Context. BMJ Publishing Group: London, 2001; 87–108.

    Chapter  Google Scholar 

  66. Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet 1998; 352: 609–613.

    CAS  Article  Google Scholar 

  67. Moher D, Cook DJ, Jadad AR, Tugwell P, Moher M, Jones A et al. Assessing the quality of reports of randomised trials: implications for the conduct of meta-analyses. Health Technol Assess 1999; 3: 1–98.

    Article  Google Scholar 

  68. Moher D, Jadad AR, Nichol G, Penman M, Tugwell P, Walsh S . Assessing the quality of randomized controlled trials: an annotated bibliography of scales and checklists. Control Clin Trials 1995; 16: 62–73.

    CAS  Article  Google Scholar 

  69. Ernst E, White AR . Prospective studies of the safety of acupuncture: a systematic review. Am J Med 2001; 110: 481–485.

    CAS  Article  Google Scholar 

  70. MacPherson H, Thomas K, Walters S, Fitter M . The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists. BMJ 2001; 323: 486–487.

    CAS  Article  Google Scholar 

  71. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 1996; 276: 637–639.

    CAS  Article  Google Scholar 

  72. MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R . Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. Complement Ther Med 2001; 9: 246–249.

    CAS  Article  Google Scholar 

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Acknowledgements

We thank Tinna Kim LAc, NCC in New York, the Society of Teachers of Family Medicine, Leawood, Kansas and the Courtesy of the Center for the History of Family Medicine, Leawood, Kansas. We also thank two referees for their helpful comments that have contributed to the improvement of the paper. Dr Thabane is a clinical trials mentor for the Canadian Institutes of Health Research. This review was performed while Dr Lee was on sabbatical in the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.

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Cho, SH., Lee, JS., Thabane, L. et al. Acupuncture for obesity: a systematic review and meta-analysis. Int J Obes 33, 183–196 (2009). https://doi.org/10.1038/ijo.2008.269

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Keywords

  • acupuncture
  • weight management
  • systematic review
  • meta-analysis

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