Traditional Chinese manual acupuncture for management of obesity: A systematic review

AIM: To evaluate the effectiveness and safety of acupuncture for the treatment of obesity by reviewing currently available randomised controlled trials. METHODS: This review followed the Cochrane Handbook for Systematic Reviews of Interventions. Fifteen English and three Chinese databases were searched from their respective inceptions until July 2014. Key words used in the search consisted of acupuncture, needles, obesity, overweight, randomised trial and their synonyms. The risk of bias of included studies was assessed. The differences in effect size between acupuncture and control (including sham, no treatment, western medicine and dietary therapy/exercise) groups were compared using Cochrane Collaboration's RevMan 5.3 software. RESULTS: Two thousand six hundred and twenty-one records were identified; after full-text articles assessed for eligibility, 9 of them met inclusion criteria. Majority of included studies had unclear or high risk of bias across all domains. All included studies had high or unclear risk of bias in randomisation, blinding and outcome data. Meta-analysis showed that acupuncture was more effective for reducing body weight and body mass index than no treatment group. Manual acupuncture was also superior to dietary therapy alone for decreasing body weight. With dietary therapy as co-intervention, combined acupuncture group achieved lower body mass index than combined sham acupuncture group or dietary therapy alone group at the end of treatment period. No severe adverse events from acupuncture group were reported from all included studies. CONCLUSION: Due to the poor quality of included studies the effectiveness of acupuncture cannot be concluded. Better-designed, large-scale, randomised, sham-controlled clinical trials with long-term follow-up are needed.