Xinyu Zhao,1 Yang Wang,2,3 Xiaoyi Li,1 Peiqun Hu,2 Xiong-Fei Pan,4– 6 Benxiang He,7 Yunlu Liu,8 Yushi Hu,2 Tianmin Zhu9 

1School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 2School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China; 3Postdoctoral Workstation, Affiliated Sport Hospital of Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China; 4Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products in vitro and in vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 5West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 6Shuangliu Institute of Women’s and Children’s Health, Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan, People’s Republic of China; 7Sichuan Academy of Chinese Medicine Science, Chengdu, Sichuan, People’s Republic of China; 8Institute of Laboratory Animal Sciences, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China; 9School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China

Correspondence: Tianmin Zhu, School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China, Email tianminzhu@cdutcm.edu.cn Yushi Hu, School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China, Email huyushi@cdsu.edu.cn

Objective: This study aims to evaluate the efficacy of acupuncture as an adjunct to lifestyle interventions on weight loss in simple obesity.
Methods: Potentially eligible studies that assessed anthropometric outcomes as well as glucose and lipid metabolism following acupuncture combined with lifestyle interventions in simple obesity patients were searched from eight databases from inception to October 2023. All analyses were performed using the Review Manager software v5.4 and Stata software v17.0.
Results: Herein, 25 randomized controlled trials (RCTs) involving 2018 patients were included. Generally, acupuncture combined with lifestyle interventions outperformed lifestyle interventions alone in terms of body weight (MD = − 4.73, 95% CI [− 6.32, − 3.13], p < 0.00001), body mass index (BMI) (MD = − 2.11, 95% CI [− 2.75, − 1.48], p < 0.00001), waist circumference (WC) (MD = − 4.96, 95% CI [− 6.89, − 3.03], p < 0.00001), body fat percentage (BF %) (MD = − 2.61, 95% CI [− 4,51, − 0.71], p = 0.007), fasting plasma glucose (FPG) (SMD = − 0.66, 95% CI [− 1.02, − 0.31], p = 0.0002), fasting serum insulin (FINS) (SMD = − 1.12, 95% CI [− 1.44, − 0.81], p < 0.00001), homeostasis model assessment-insulin resistance (HOMA-IR) (MD = − 1.22, 95% CI [− 1.50, − 0.94], p < 0.00001), total cholesterol (TC) (SMD = − 1.14, 95% CI [− 1.83, − 0.45], p = 0.001), triglyceride (TG) (SMD = − 1.31, 95% CI [− 2.07, − 0.56], p = 0.0006), and low-density lipoprotein cholesterol (LDL-C) (SMD = − 1.81, 95% CI [− 3.11, − 0.51], p = 0.006). Subgroup analysis based on three subgroup variables (types of acupuncture and lifestyle interventions as well as treatment durations) could partially explain the heterogeneity of the results.
Conclusion: Acupuncture demonstrated an enhancing effect on the benefits of lifestyle interventions for weight loss in patients with simple obesity, including reducing body weight and improving glucose and lipid metabolism. This finding suggests its potential value as a complementary therapy alongside lifestyle interventions in a clinical setting. However, further validation with rigorously designed and high-quality RCTs is still needed in the future.

Keywords: obesity, acupuncture, acupuncture therapy, meta-analysis, systematic review