Neuro Acupuncture Weight Loss
As a well-trained and fairly conservative Chinese medicine practitioner,
I assumed that acupuncture for weight loss was a marketing fad
and complete fantasy. In fact, at least two of my professors during
my medical training said just that. Little did I know, that even
while I was at school, licensed acupuncturists and herbalists
were already helping people lose weight clinically. In fact, some
people lose weight under Chinese medical treatment as a result
of getting healthier while treating other problems.
But, back to my skepticism. While researching an upcoming book,
I found some positive research results that began to change my
mind. Here's the story of my journey from skeptic to detective:
One of the more difficult tasks of planning and writing a book,
especially on such a large and foreign subject as Chinese medicine,
is trying to figure out how to make it interesting to the average
reader. With some reluctance, I began to look for ways to make
this powerful and valuable medicine's wisdom more, shall we say,
The fact is, those "5 steps to get all the money, sex, and
love you want in just 5 minutes without lifting a finger!"
article titles really do grab people's attention - they sell magazines,
and they get authors on radio and TV. As I was considering what
people were really interested in, of course the topic of weight
loss came up, and, with it, my skepticism. But then I found the
research, and heard the experience of patients and practitioners.
Reviewing the Facts:
Scientific Evidence For and Against
Chinese Medicine Weight Loss
So, let me examine this issue with you in detail. How real is
this possibility that Chinese medicine can help you with weight
loss? To do that, we'll have to look at several therapies, including
acupuncture, diet modification, and exercise. And the first thing
we're going to do is look at the research. We'll talk about the
quality of the research, and the conclusions of each study. If
the results are bad, we'll try to figure out why. If they're good,
we'll make sure the study quality was good too.
It's likely that given the thousands of possible acupuncture
point selections, and herbal formulas, that there may not be any
research on certain parts of the Chinese medicine weight loss
plan. Remember that there are levels of evidence- the best is
certainly the level 1 double-blind placebo controlled study (considered
the "gold standard" or best kind), and the worst is
level 8, conjecture or common sense - but in between, when there
are no gold standard studies, a level 5 series of patient cases
(without a control group) does count for something. It may not
be rock solid evidence, but neither is it easily dismissed. They
demonstrate the need for more research.
Adrenal Function and Metabolic Rate
A 1993 study conducted at the Nanjing College of TCM (China)
and published in the Journal of Traditional Chinese Medicine looked
at the relationship between simple obesity, adrenal function,
and acupuncture. They also watched the patients' lipids, blood-glucose,
noradrenaline, dopamine, and cortisol levels.
Simple obesity means obesity that is not caused by some other
medical condition, like an endocrine disease (e.g., hypothyroidism).
They found that simple obesity patients had two under active bodily
- The sympathetic-adrenal (sympathetic nervous) system (SNS)
- The hypothalamus-pituitary-adrenal (HPA) system/axis
The first system, the sympathetic-adrenal, or SNS system [click
for a picture], is the normal "fight or flight"
response. The adrenal gland releases DHEA, among other hormones,
and DHEA had been shown to inhibit the development of obesity.
The opposite of the SNS is the parasympathetic nervous system,
which is involved in relaxation, sleep, and meditation. So, maybe
you're too relaxed! In any case, the SNS helps determine the way
energy is spent, and this means your metabolic rate and fat oxidation
Both systems are involved with the regulation of leptin, the
fat cell hormone that leads to weight loss. The sympathetic system
can decrease leptin secretion, but the HPA system [click
for a picture] can increase it. Low levels of leptin may contribute
to further obesity, and are associated with type 2 diabetes.
In the Nanjing study, acupuncture led to weight loss and enhanced
the function of both the SNS system and the HPA axis. They speculated
that there might have been a relationship between these systems
and weight loss.
More on Obesity and the Hypothalamus-Pituitary-Adrenal (HPA)
In 1990, the Department of Acupuncture & Moxibustion at the
Nanjing College of TCM studied acupuncture and moxibustion (heating
acupuncture points) for weight loss in 39 patients. They found
that acupuncture and moxibustion were markedly effective for 38.5%
of them, effective for 51.3%, and ineffective for 10.3%.
In this study, researchers monitored the body mass index (BMI),
lipid levels, plasma ACTH, and salivary cortisol. They saw that
obese patients had an under active HPA axis. Acupuncture and moxibustion
regulated lipid levels, reduced weight, and enhanced the function
of the HPA system. The scientists concluded that the "key
factor of anti-obesity by acupuncture and moxibustion was to increase
the function of hypothalamus-pituitary-adrenal system."
An Outcome Study Using Traditional Criteria
In a 2003 Chinese study, 40 men and women (7 male) fit a specific
set of symptoms , which in Chinese medicine define a pattern called
Yang Ming Replete Heat. The patients also all had greater than
20 BMI's, and more than 30% body fat. A specific acupuncture protocol
, which often included electroacupuncture, was followed.
After 1 to 4 courses of treatment (which usually means 10-40
treatments, and in China they often treat every day or every other
day), the results were as follows:
- Two cases (5%) were clinically controlled, and had fat reduction
of up to 30%.
- Thirteen cases (32.5%) seeing a 9-10% reduction in percentage
- Twelve cases (30%) got a 5-8% reduction in percentage of fat.
- Ten cases (25%) experienced a 2-5% reduction in percentage
- Three cases (7.5%) got no result. Therefore, the total effectiveness
rate was calculated as 92.5%.
The important characteristics of this study, which may be essential
to acupuncture weight loss success, were:
- Pattern differentiation: Usage of points based on the Chinese
medical pattern (Yang Ming replete heat), rather than just one
point prescription for all weight loss situations
- Strong needle technique: Typically, Chinese acupuncturists
use strong needle technique, which produces strong sensations
for the patient. Not all acupuncturists practice this way. In
fact, Japanese acupuncturists barely puncture the skin. Plus,
some patients are quite needle sensitive, and Americans are
pain phobic, so not all patients will allow this kind of treatment.
- Electro-acupuncture: This may be enough even if the previous
technique is not used. The electricity increases the stimulation
of the points.
As translator Bob Flaws goes on to discuss, most patients cannot
see an acupuncturist this often, but herbs can be added to the
treatment strategy to take up the slack. This is also where food
selection according to Chinese medical pattern diagnosis, and
the right exercise program come in.
Ear Acupuncture for Weight Loss
The previous study used what are called "body points,"
acupuncture points located everywhere but the scalp or ears. In
1998, two Australians, one a private practice acupuncturist, and
the other an MD, studied the use of only ear acupuncture points
for weight loss. There are hundreds of points on the ears, and
there are several charts that map these points to just about every
other part and function of the body [click
for a picture, another picture].
The study begins with the notion that, "acupuncture stimulates
the auricular branch of the vagal nerve and raises serotonin levels,
both of which have been shown to increase tone in the smooth muscle
of the stomach, thus suppressing appetite. "
This study tested two ear acupuncture points (Shenmen, which
has a calming effect, and Stomach, which is indicated for indigestion,
gastritis, peptic ulcer, stomach distention, belching, and insomnia.).
The points were not needled, but instead were stimulated electrically.
They conducted this study on 60 overweight people, randomly divided
between the therapy group, and the control group, who received
electrical stimulation on their thumb. The electrical stimulation
happened twice daily for 4 weeks. The results were:
- 95% of the therapy group had less appetite, while the control
group's appetite was unchanged.
- None in the control group lost more than 4.4 lbs, while 78.5%
of the active therapy group did.
- The average weight loss over those 4 weeks for the therapy
group was about 6.6 lbs.
- Those who continued for 3 months lost as much as 22 lbs.
I want to make a few comments on these results. First, if you
think that's not very much weight loss, you're right. I agree.
My overall sense of the research and reports is that acupuncture
patients lose more weight than this, and faster. So why would
the results be positive but diminished in this study?
First, we have to look at their point selection. They chose their
points backwards- they went from what was known at the time about
acupuncture mechanisms, and applied those to what they thought
were the weight loss mechanisms. They did not choose all the points
used traditionally and in modern China for weight and hunger.
They only chose points that raise serotonin levels, stimulate
the vagus nerve, and produce endorphins and dopamine. Other research
- even science released before this acupuncture study - makes
it clear these are not the only factors in weight loss.
Knowing what we know from other acupuncture weight loss studies,
to increase the effectiveness, we could also choose these ear
- Spleen, to improve digestion.
- Hormone, may affect the HPA axis.
- Subcortex, may regulate metabolism.
- Pituitary, should affect the HPA axis.
- Endocrine, the adrenals and pituitary are involved
in the endocrine system.
- Adrenal, to stimulate adrenalin and adrenocortical
hormones- might fix the under activity of the SNS in obesity.
- Hunger, relieves hunger, diabetes, and compulsive eating.
Because the study's point selection was based on a limited view
of how acupuncture works in the body, and because obvious points
like Hunger were not chosen, we can see that the study designers
did not include everything we would want for weight loss success.
Plus, we cannot know without further studies the difference in
effect only electrical stimulation and needling. For all we know,
there could be slightly different bodily effects from the same
point, depending on the mode of stimulation.
Acupuncture's Affect on the Satiety Center in the Hypothalamus
Next up, we have another Chinese study - this one was conducted
in 2000 at the Second Clinical College of Nanjing University of
Traditional Chinese Medicine and Pharmacy on rats with experimental
obesity. They monitored the effect of acupuncture on the part
of the brain that makes us feel satisfied with the amount of food
we've eaten (the VMH, or VentroMedial nucleus of the Hypothalamus
[click for picture]). They found more
activity in the VMH from acupuncture than in two other non-acupuncture
groups of rats. Their results also showed that acupuncture's effects
on the VMH lasted longer than the other non-control group.
Unfortunately, again we only have the abstract of this Chinese
study, and it leaves us with some serious questions: What was
the point selection? What was the other non-control group's therapy?
It has been observed by westerners that most Chinese writers and
researchers do not adhere to the same standards that we do in
the west. This would be a prime example.
Regardless, we can take their observations and conclusions, and
look into how important the effect of acupuncture on the VMH might
be. A good year 2000 review of the hypothalamus, eating, and energy
explains that though there may be anatomical areas that regulate
feeding and satiety, researchers are instead emphasizing the neurotransmitters
that affect these behaviors.
- Neuropeptide Y (NPY) stimulates appetite in the paraventricular
nucleus (PVN), and repeated administration causes obesity.
- Leptin and insulin inhibit the neurones that express NPY.
- Antagonists of the Y5 receptor are anti-obesity.
- Activation of Melanocortin-4 receptors (MC4-R) by agonists
such as alpha-melanocyte-stimulating hormone inhibits feeding
and causes weight loss.
- Conversely, MC4-R antagonists such as 'agouti' protein and
agouti gene-related peptide (AGRP) stimulate feeding and cause
Great information, but do we have any research about the effects
of acupuncture on these agents?
Neuropeptide Y: Neuropeptide Y (NPY) is the most abundant neuropeptide
in the brain. It is a member of a family of proteins that include
pancreatic polypeptide, peptide YY and seminalplasmin. In addition
to its function in feeding behavior, several other physiologic
roles have been assigned to NPY, including involvement in circadian
rhythms, sexual function, anxiety responses and vascular resistance.
NPY is known to be an extremely potent stimulator of feeding
behavior. Feeding behavior in rodents is blocked by injection
of antibodies or antisense RNAs against NPY. More importantly,
leptin appears to act, at least in part, by inhibiting NPY synthesis
and release in the hypothalamus. Additionally, mutations that
interfere with signaling via the hypothalamic melanocortin-4 receptor
lead to obesity that is at least partially explained by perturbations
of NPY expression.
Although NPY is clearly involved in control of food intake, the
complexity and apparent redundancy of that system is illustrated
by recent experiments in which the NPY gene was disrupted in mice.
Leptin's effect on body weight is mediated in part by its effect
on NYP expression, but that other systems have overlapping control
over food intake and energy expenditure.
Acupuncture's Effects on Neuropeptide Y:
(More NPY in hypothalamus = More hunger = More Obesity)
- Acupuncture treatment at acupoint Shenmen (HT7) resulted
in a significant increase in both body weight and locomotion.
These findings suggest that acupuncture has an effect on the
depression-like disorder caused by MS, possibly by modulating
NPY expression in the hippocampus. Relevant? This is NPY in
the hippocampus, not the hypothalamus, and the weight gain might
have been in rats underweight due to depression. May not bear
- Stimulation of the acupuncture point, ST36, resulted
in increased cell proliferation in the dentate gyrus (DG) and
neuropeptide Y levels in the diabetic group. The dentate gyrus
can reduce in size due to stress, and is involved in the forming
of new memories. Relevant? Probably not.
- A 2001 Korean study at Semyung University studied the effect
of acupuncture on food-deprived rats. As might be expected,
the starving rats had increased production of NPY (to stimulate
feeding) [In this bullet, NPY levels are always in reference
to both the arcuate nucleus (ARN) and the paraventricular nucleus
(PVN) of the hypothalamus.]. So, it is even more important that
the auricular acupuncture they did decreased the NPY levels.
Even when they were starving, acupuncture could reduce the impulse
to eat by lowering NPY levels in the hypothalamus. Interestingly,
they also needled the same points on fed rats, and found that
it increased NPY levels. Unfortunately, this also is only an
abstract, and did not specify which ear points were used. Relevant?
Acupuncture and Beta Endorphin
Beta endorphin stimulates feeding. Thus, acupuncture that affects
beta endorphin in these areas might affect feeding behavior -
acupuncture that decreases beta endorphin in these areas might
reduce feeding. However, I couldn't find an acupuncture study
that proved it could control beta endorphin.
Acupuncture and POMC
This is not what you'd call an immediately positive study - the
idea was that electroacupuncture (EA) of different frequencies
stimulates different opioids in the brain. The good news here
is that you can fine-tune which opioid you want released, depending
on the EA frequency.
EA can increase POMC.
Acupuncture's Effect on Leptin
Acupuncture's Effect on Insulin:
(Insulin Inhibits NPY -> Lower Appetite -> Weight Loss)
- In 2001, 21 cases of acute cerebral infarct due to non-insulin
dependent diabetes mellitus were treated with acupuncture vs.
a control group. The acupuncture group had lower levels
of insulin and glucagons, and improved hypercoagulability. No
more details provided.
- Animal experiments have shown that acupuncture can
activate glucose-6-phosphatase (an important enzyme in carbohydrate
metabolism) and affect the hypothalamus. Acupuncture can act
on the pancreas to enhance insulin synthesis, increase the number
of receptors on target cells, and accelerate the utilization
of glucose, resulting in lowering of blood sugar.
- A 1999 Taiwan study at China Medical College measured the
effects of electroacupuncture on the acupoint Ren-12 in
terms of blood glucose (sugar). They found that it lowered the
blood glucose level, and in looking for the agent of glucose
lowering, they found support for insulin, and eliminated glucagons.
Thus, their best guess was that Ren-12 had induced secretion
of beta-endorphins, and thus somehow led insulin to reduce the
blood glucose levels.
- A 1989 Chinese study look at the effects of moxibustion
of the acupoint St-36 (vs. a control group; 20 in each group)
in terms of blood levels of TSH, T3, T4, FSH, LH, testosterone
and insulin. The results were a significant increase in insulin,
and a prominent decrease in T4, but no marked difference was
found in FSH, LH, testosterone, TSH or T3.
- In 1990, 41 simple obesity patients with
hypertension received acupuncture and moxibustion at the
Nanjing college of TCM. 87.8% lost weight. Based on blood and
physical measurements, acupuncture and moxibustion regulated
overeating, blood pressure, lipid level and energy metabolism.
- In 1991, 46 cases of obesity were measured and given acupuncture.
Interestingly, they were sub-diagnosed in terms of an uncommon
Chinese medicine pattern; 39 were considered to have health
Liver yang (group 1) and 7 were considered Liver yang deficient
(group 2). The study found that SNS function was markedly higher
in the normal Liver yang group. Indeed, when Liver yang is hyperactive
and excess, symptoms like anger, red face, yelling, and hypertension
are rather SNS-like (fight or flight), arent
they? Fat metabolism was abnormal in both groups. The marked
effects were achieved on the cases which received one course
of treatment (1 month) by acupuncture, the total effective rate
being 84.8%. The effects were anti-obesity, and regulation of
fat metabolism. There was also an effect on blood pressure,
but not enough details were given to interpret. While generally
in standardized CM, Liver yang is usually only talked about
as being excess (not deficient, as it is here), there is some
diversity in Chinese medicine diagnosis. The famous physician
Qin Bowei discussed Liver yang deficiency. "Illnesses of
qi counterflow and hyperactivity of yang are generally referred
to as liver qi and liver yang patterns. When these are seen
with lassitude, anxiety, timidity, headache, numbness, and lack
of warmth in the extremities, they are called liver qi and liver
yang vacuity (deficient) patterns."
- In 1992, 102 cases of obesity were studied in terms of
reduction of heart disease risk. Acupuncture made positive
change in 88.24% of cases. The changes that reduced heart risk
were improvement of the hip-loin ratio, decrease
in arteriosclerosis, and improvement of the nerve functions
that regulate the heart and blood vessels. All this suggests
that acupuncture is a treatment of choice for obesity and an
important method of preventing and treating complicating cardiovascular
- In 1998, 202 case of childhood obesity were divided into
two groups. One used photo-acupuncture, and the other a
method of ear-pressing. Both resulted in significantly lowered
obesity indexes and marked improvement of the levels of blood
lipids, glucose, cortisol and triiodothyronine. Photo-acupuncture
is yet another method of stimulating acupuncture points, in
this case with a certain frequency of light. A typical device
is a light emitting diode of 15,000 millicandle callibrated
illumination, with a 660 Nanometer wavelength, and a pulse rate
of 266 cycles per second.
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