Obesity and overweight

Trials of acupuncture for obesity weigh people before and after a course of treatment and report the change in body weight in kilograms, in body mass index (BMI, weight in kilograms divided by the square of height in metres) and in waist circumference. Trials from China describe their participants as having simple obesity: obesity that no other disease or medicine explains. Cochrane registered a review, Acupuncture for overweight or obese people, and in July 2018 the Cochrane Metabolic and Endocrine Disorders Group withdrew it because the project could not be finished within adequate deadlines, recording it as low priority and closed to new authors. The evidence on this page therefore comes from reviews in other journals, which differ in the technique they pool and in what the control group received: sham acupuncture, a procedure made to look like acupuncture without being it, or lifestyle advice or usual care alone. Sham acupuncture describes the kinds in use.

Reviews of body acupuncture and electroacupuncture

The 2009 review by Cho and colleagues at Kyung Hee University in Seoul, in the International Journal of Obesity, searched 19 databases in English, Korean, Japanese and Chinese and covered every type of acupuncture. Twenty of its 31 trials had the lowest possible score on the Jadad scale, a five-point rating of how a trial was randomised and blinded, and only four reported adverse events, which were mostly minimal. The authors wrote that the amount of evidence was not fully convincing because of the poor quality of the trials, and called for well-planned, long-term studies.

A 2020 review by Zhong and colleagues at Chengdu University of Traditional Chinese Medicine kept to trials against sham. Waist circumference was 0.97 cm lower and body fat 1.01 percentage points lower; waist-to-hip ratio did not differ. Every one of the 8 trials came from an Asian country, and treatment lasted 2 to 8 weeks. A 2024 network meta-analysis by Youngjin Kim and colleagues at Wonkwang University in Korea, which compares several techniques in one model, included 14 trials with 868 people whose BMI was 25 or more. It ranked electroacupuncture, in which a current runs between the needles, first for weight and BMI, and laser acupuncture first for waist circumference. The authors noted that most trials lasted 6 to 12 weeks and that publication bias may have occurred. Electroacupuncture describes the method.

Ear acupuncture and ear acupressure

Ear acupressure tapes small seeds, usually of Vaccaria, over points on the ear, and the person presses them, often before meals; ear acupuncture leaves small needles in place for days. A 2017 review by Tzu-Lin Yeh and colleagues at Hsinchu MacKay Memorial Hospital in Taiwan searched to April 2017 and included 18 randomised trials with 1,775 adults published between 1995 and 2016, mostly against sham procedures, two against no intervention. It pooled 13 of them: body weight was 1.21 kg lower, BMI 0.57 lower and waist circumference 1.75 cm lower, with high inconsistency between trials for weight (I² 88%, where higher values mean the trials disagree more). The most common points were Shenmen and Stomach. Most participants were middle-aged Asian women, and a test for publication bias was positive for weight and BMI.

A 2024 review by Kevin Hua and colleagues at the Charité in Berlin searched to November 2021, adding electrical stimulation of the ear’s vagus nerve branch to needles and acupressure, and pooled 15 trials with 1,333 people, 91% of them women, against any control. BMI was 0.38 lower, weight 0.66 kg lower in 12 trials with 655 people, and waist circumference 1.44 cm lower. The authors judged that the size of the effect did not appear clinically relevant, and that it might be underestimated because several trials used active sham procedures. Ear acupuncture explains how the ear points are mapped.

A 2014 trial at Kyung Hee University in Seoul randomised 91 Korean adults with a BMI of 23 or more to indwelling needles at five ear points (Shenmen, Spleen, Stomach, Hunger and Endocrine), at the Hunger point alone, or at the same five points with the needles withdrawn immediately, renewed weekly for 8 weeks. Among the 58 who gave data at 8 weeks, BMI fell by 6.1% with five points and 5.7% with one, with no significant difference between the two treated groups, and both differed from sham.

Catgut embedding

Acupoint catgut embedding pushes a short length of absorbable suture under the skin at a point through a hollow needle and leaves it to dissolve, so that sessions come every one or two weeks rather than several times a week. Thread embedding describes the materials and the procedure. A 2024 review by Yue and colleagues in Shenzhen searched to April 2022 for trials of embedding against sham embedding and found 6, with 679 adults. Weight was 1.68 kg lower, BMI 0.51 lower and waist circumference 2.42 cm lower, and adverse events did not differ significantly between the groups.

A 2025 double-blind trial at the Fifth Affiliated Hospital of Southern Medical University in Guangzhou randomised 120 adults with simple obesity to six embedding sessions, one every 2 weeks, or to the same procedure with no catgut inside the needle. Its authors drew the points from a 2015 Chinese evidence-based acupuncture guideline for simple obesity: ST36 (Zusanli), ST40 (Fenglong), CV12 (Zhongwan), ST25 (Tianshu) and CV04 (Guanyuan) for everyone, with SP15 (Daheng) and GB26 (Daimai) added for central obesity. After 12 weeks the median weight loss was 2.8 kg with embedding and 1.95 kg with sham; over the 12 weeks of follow-up the change did not differ between the groups. Bruising or redness and swelling followed 2.8% of embedding sessions and 3.6% of sham sessions. The authors listed a single centre, follow-up limited to 12 weeks, and no set rules for diet and exercise among the trial’s limitations.

Abdominal obesity

A 2025 trial at Hubei Provincial Hospital of Traditional Chinese Medicine in Wuhan randomised 68 adults with abdominal obesity, defined as a waist of 85 cm or more in men or 80 cm or more in women, to electroacupuncture or sham electroacupuncture, 24 sessions over 8 weeks, with the same diet and exercise advice for both groups. The points included ST36, SP06 (Sanyinjiao), CV12, ST25, SP15 and GB26. Waist circumference fell by 7.38 cm more with electroacupuncture at week 8 and by 8.99 cm more at week 32, 24 weeks after treatment stopped. The authors noted that waist and weight at the start leaned towards an imbalance between the groups, which they adjusted for.

Reviews of the reviews

A 2022 overview by Jiaxin Chen and colleagues in Guangzhou and at RMIT University in Melbourne found 38 systematic reviews of acupuncture for overweight or obesity, published from 2009 to 2020, 33 of them from China. On AMSTAR-2, a checklist for how a review was conducted, it rated confidence in all of them critically low but one, which was low; the most common faults were no protocol registered in advance and no reasons given for excluding trials. It judged the evidence on catgut embedding and abdominal acupuncture insufficient. A 2025 umbrella review by Min Chen and colleagues in Chengdu, searching to April 2025, assessed 22 systematic reviews holding 60 meta-analyses and rated 17 of the reviews high in quality on the original AMSTAR tool. Five meta-analyses reached high certainty on GRADE, the scale reviews use to say how far a result can be trusted, the strongest for acupuncture added to lifestyle intervention against lifestyle intervention alone; 14 reached moderate certainty, including those finding no significant difference from drugs. The authors concluded that clinicians can recommend acupuncture, as an addition to lifestyle change rather than on its own.

What guidelines say

NICE’s guideline Overweight and obesity management (NG246), published in January 2025 and last updated in January 2026, replaced its earlier obesity guidance, including CG189. It covers behavioural programmes, diet, physical activity, medicines and surgery, and does not mention acupuncture. The Singapore Health Promotion Board and Ministry of Health clinical practice guidelines on obesity, published in 2016, state that acupuncture by trained professionals may be considered as a short-term addition to other obesity treatment, case by case, at grade B on their scale. PubMed listed no later Singapore edition by October 2026. Clinical guidelines compares other bodies’ positions.

What the reviews could not settle

Most trials in these reviews lasted 12 weeks or less, and the longest follow-up among the trials on this page ended 32 weeks after the start, so none says whether the weight stays off over years. Sham groups lose weight too: a 2025 review of 15 sham-controlled trials with 1,250 people found BMI fell from baseline in the sham groups, with high inconsistency between trials, and treatment length and added interventions changed how much. Hua and colleagues pointed out that a sham which is itself active narrows the gap a trial can show, and none of the reviews could say how much of the weight lost in either group came from the needling and how much from taking part in a trial. The two reviews of reviews rated the field with different checklists, one finding confidence in almost every review critically low and the other finding most reviews high in quality. The trials enrolled mostly women, mostly in East Asia, and no completed Cochrane review has weighed them.

AcuiQ’s obesity, overweight and abdominal obesity pages list the protocols individual studies prescribed, each with its citation.