Background   The prevalence of obesity is increasing in the United States. Treatment options for obesity include a reduced-calorie diet, increased activity, behavior modification, pharmacotherapy, and surgery. In addition to these treatment options, acupuncture may be an effective adjunct therapy.

Objective   To describe the efficacy of acupuncture in the management of obesity when administered in conjunction with a reduced-calorie diet and increased physical activity.

Design   Prospective, randomized controlled trial from February–April 2001.

Patients and Setting  Twenty obese female health care workers (22-42 years) were recruited in Phoenix, Arizona for the 8-week study; 10 of these women were randomized to receive ear acupuncture at the relevant points. All participants had a baseline body mass index higher than 27.

Intervention   Acupuncture treatment weekly for 8 weeks (15 minutes per session) with needling of the Shen Men, mouth, stomach, small intestine, and endocrine points. Patients also consumed a 2000-calorie/d diet and increased physical activity.

Main Outcome Measures  Change in weight from baseline to trial completion. In addition, change in appetite and compliance were documented.

Results   Mean weight loss for patients in the acupuncture group was 9 lbs, while controls demonstrated a mean weight loss of 4 lbs. Compliant acupuncture participants had a mean weight loss of 10.3 lbs; compliant controls had a mean weight loss of 3 lbs. ANOVA (analysis of variance) repeated measures yielded a significant change in weight loss from baseline to trial completion (P=.003). There was also a 2-way interaction between weight loss and group (P=.03).

Conclusion   These findings indicate that ear acupuncture at designated points, in conjunction with a reduced-calorie diet and increased physical activity, can be effective in treating obesity.

The human ear has been described as a microsystem of the body in an inverted fetal position.^7-9 The mouth, stomach, and small intestine are critical for eating, digestion, and absorption. The endocrine point assists in metabolic processes while the Shen Men helps ease anxiety related to dieting. The energy associated with needling these points helps the body to function well against obesity. The current study supports evidence from earlier trials of acupuncture for treating obesity.^5,6

Table 1. Patient Outcomes

Acupuncture Group Control   Group (n=10) Group (n=10) Patients experiencing weight loss 9 7 Compliant patients 6 4 Patients with decreased appetite 10 1

All 10 acupuncture participants (100%) reported a decrease in appetite, compared with only 1 in 10 controls (10%). Furthermore, total weight loss in the acupuncture group was nearly 3 times greater than in the control group. A mean weight loss of 10.3 lbs for compliant acupuncture participants supports the efficacy of the treatment design, particularly when compared with data for the compliant and noncompliant controls. Weekly ear acupuncture at the mouth, stomach, small intestine, endocrine, and Shen Men points, in conjunction with a 2000-calorie/d diet and 15 minutes of daily walking, led to weight loss for obese women.

Our findings indicate that ear acupuncture at designated points, in conjunction with a reduced-calorie diet and increased physical activity, is effective in treating obesity. The results of this study emphasize the need for continued research into the value of acupuncture as an adjunct treatment for obese people from a variety of populations. Future studies also need to follow up participants to evaluate the persistence of the acupuncture effect for longer periods.

Table 2. Weight Loss

Acupuncture Control   Group Group Net weight changes, lb        Loss 81 28    Gain 2 12    Loss in compliant patients 63 12    Loss in noncompliant patients 13 4 Net weight changes, lb        Loss per patient 9 4    Gain per patient 1 4    Loss in compliant patients 10.3 3    Loss in noncompliant patients 3.25 0.6