Electroacupuncture: A non-pharma Tx option for central obesity?

A Hong Kong study demonstrated the potential of electroacupuncture for the treatment of central or abdominal obesity.

“In this study, electroacupuncture was found to be effective in reducing waist circumference (WC), hip circumference (HC), body fat percentage, body weight, and BMI compared with sham acupuncture during the treatment period,” the researchers said.

During treatment (week 4)

With electroacupuncture, WC dropped significantly from baseline (mean change, –1.4 cm; p=0.002), whereas with sham, the corresponding reduction was minimal (mean change, –0.4 cm; p=0.406). Mean difference (MD) between groups was –1.0 cm (p=0.063). [BMC Complement Med Ther 2024;24:62]

Electroacupuncture consistently outdid sham in terms of body weight (MD, –0.9 kg; p<0.001), BMI (MD, –0.2 kg/m²; p=0.037), HC (MD, –1.5 cm; p=0.723), and waist-to-hip circumference ratio (WHR; MD, 0.03; p=0.032).

After treatment, during follow-up (weeks 8, 16)

Electroacupuncture still bested sham at week 8 in terms of reductions in WC (MD, –1.2 cm; p=0.003), weight (MD, –2.0 kg; p<0.001), BMI (MD, –0.2 kg/m²; p=0.021), HC (MD, –1.2 cm; p=0.041), WHR (MD, 1.2; p=0.001), and body fat percentage (MD, –0.1 percent; p=0.049).

Week 16 saw sustained effects with electroacupuncture in terms of WC (MD, –1.1 cm; p=0.029), weight (MD, –1.0 kg; p<0.001), BMI (MD, –0.5 kg/m²; p=0.005), HC (MD, –2.0 cm; p<0.001), and WHR (MD, 0.7; p=0.046).

“[The] significant improvements in body weight, BMI, and WHR [at week 16] might indicate the persistent effects of the therapy and its sustainable benefits on central obesity,” the researchers noted.

Safety

Adverse event (AE) rates were similar in both arms, with no serious AEs (eg, requiring hospital admission) reported. In the electroacupuncture group, AEs were headaches (n=4), dizziness (n=2), and insomnia (n=5). In the sham group, AEs were stomachache, headache, and worsening of depression (n=1, 2, and 3, respectively). All AEs were reported as mild.

Economic, medical burdens

As of 2020, nearly 3 billion individuals worldwide are considered overweight or obese (BMI ≥25 kg/m²). In Hong Kong, about a third of the adult population are overweight or obese. [https://www.chp.gov.hk/en/healthtopics/content/25/8802.html]

“As obesity is a chronic condition that can cause multiple metabolic diseases, the obesity problem will cause both economic and medical burdens in the long run,” said the researchers.

Despite the well-known efficacy of lifestyle changes (diet, exercise), adherence remains a problem due to the commitment required to sustain the desired effects. [JAMA 2020;324:879-887; Obes Rev 2012;13:409-430] For those who have considered slimming products, they have to deal with issues such as adverse and rebound effects. [Int J Obes Relat Metab Disord 2003;27:419-427]

The researchers evaluated 168 participants (mean age 47.5 years, 65 percent women) with central obesity (WC ≥90 cm [men]; ≥80 cm [women]) and BMI ≥25 kg/m². They were randomized 1:1 to receive electroacupuncture or sham acupuncture twice weekly for 8 weeks, with a follow-up session 8 weeks following treatment completion.

For the electroacupuncture group, disposable acupuncture needles were inserted into eight* body acupoints. For the sham group, Streitberger’s noninvasive acupuncture needles were used at the same acupoints with identical stimulation modalities.

Participants were advised to follow the Balanced Diet Food Pyramid guidelines designed by the Hong Kong Dietitian’s Association. Exercise was not a requirement, but they can continue with any exercise routine they have started prior to the study.

“Our study provided an option without pharmaceutical treatment and severe side effects for obese patients … It also provided reference to clinical practitioners in utilizing acupuncture for treating obesity,” the investigators concluded. They called for further studies to determine the mechanisms responsible for the favourable effects of electroacupuncture on obesity.