Review: Effect of combined manual acupuncture and massage on body weight and body mass index reduction in obese and overweight women: A randomized, short-term clinical trial

Massage is commonly used as an adjuvant therapy with acupuncture. This research article was chosen as it attempts to test the synergistic benefits of adding massage therapy to acupuncture treatment in the reduction of body weight (BW) and body mass index (BMI). This paper will assess the research article with respect to research design, evidence information, and prospective recommendations for related research.

The evaluated article describes research using a randomized experimental design. Participants were divided into two groups based on their BMI determination as being overweight or obese. Each group was randomly divided into two groups to receive combined manual acupuncture and massage therapy (MAMT) or only manual acupuncture therapy (MAT).

The strength of this research was that anthropometric data was collected daily during the trial to evaluate the maximal time for reduction of BW and BMI as opposed to typical obesity study designs that only compare the difference of these measurements at the start and end times of the trial (Abdi et al, 2012).

Several factors limit the value of the observed outcomes in this research including not testing a control group that received sham acupuncture, sham massage, and/or no treatment. Long-term effects of the treatment groups were not evaluated for statistical differences. Follow-up to evaluate remission risk was also not conducted. The treatment groups were small and limited to only women.

Obesity is approached from a biomedical perspective with a preventive strategy including integration of multiple interventions including lifestyle modification such as diet and physical activity. Despite this approach, worldwide prevalence of obesity has nearly doubled from 1980 to 2008 (Seidell & Halberstadt, 2015). Additional medical therapies include pharmacological and surgical management of obesity.

A systematic review and meta-analysis favors acupuncture to lifestyle modification techniques like low-calorie diets, placebo treatment, and no treatment at all (Cho et al, 2009). Herbal supplementations are also used.

Obesity is becoming a growing global concern and has been closely linked to negative health impacts and a reduced quality of life (Bombak, 2014). Acupuncture can be used alone or with other interventions to provide beneficial outcomes when addressing obesity with few if any reported adverse effects. Further high-quality studies will be helpful to support acupuncture’s efficacy and determine its optimal use in the treatment of obesity.

 

References

Abdi H., Zhao B., Darbandi M., Ghayour-Mobarhan M., Tavallaie S., Rahsepar A.A., Parizadeh S.M., Safariyan M., Nemeti M., Mohammadi M., Abbasi, Parizad P., Darbandi S., Akhlaghi S., Ferns G.A. (2012). The effects of Acupuncture on Obesity: Anthropometric Parameters, Lipid Profile, and Inflammatory and Immunologic Markers. The Scientific World Journal, 2012, http://doi.org/10.1100/2012/603539

Bombak A. (2014). Obesity, health at every size, and public health policy. American Journal of Public Health, 104(2):e60-7. http://doi.org/10.2105/AJPH.2013.301486

Cho S.H., Lee J.S., Thabane L., Lee J. (2009). Acupuncture for obesity: a systematic review and meta-analysis. International Journal of Obesity, 33, 183-196. http://doi.org/10.1038/ijo.2008.269

He, J., Zhang, X., Qu, Y., Huang, H., Liu, X., Du, J., Guo, S. (2015). Effect of combined manual acupuncture and massage on body weight and body mass index reduction in obese and overweight women: A randomized, short-term clinical trial. Journal of Acupuncture and Meridian Studies, 8(2):61-65. http://doi.org/10.1016/j.jams.2014.08.001

Seidell J.C., Halberstadt J. (2015). The global burden of obesity and challenges of prevention. Annals of Nutrition & Metabolism, 66(suppl 2):7-12. http://doi.org/10.1159/000375143

Review: Acupuncture for obesity: A systematic review and meta-analysis

This review published in 2009 (Cho et al) reviewed 29 randomized controlled trials (RCTs) that compared acupuncture with a control group receiving no treatment, a placebo, pharmacological treatment, or non-pharmacological interventions. RCTs were only included if statistical heterogeneity was not observed. Acupuncture was analyzed to be favored to lifestyle modifications like dieting and exercising, as well as to placebo or sham treatment, and groups receiving no treatment. Improvement to the risk rates for a remission of obesity was also observed when acupuncture was used with diet than to when diet was used alone. Publication bias was identified. Minimal adverse effects were observed including redness, pain or discomfort, and bleeding in ears in an auricular acupuncture group. Bruising and abdominal discomfort after electroacupuncture was reported. This review concludes that acupuncture for obesity has some beneficial effect although there was insufficient data available with acceptable methodological quality and narrowed clinical heterogeneity. As a result, the study placed limited value on its findings and cannot conclusively answer if acupuncture should be widely recommended and which form of acupuncture is most effective.

 

Reference

Cho S.H., Lee J.S., Thabane L., Lee J. (2009). Acupuncture for obesity: A systematic review and meta-analysis. International Journal of Obesity, 33, 183-196. http://doi.org/10.1038/ijo.2008.269

Review: The effects of acupuncture on obesity: Anthropometric parameters, lipid profile, and inflammatory and immunologic markers

This study (Abdi et al, 2012) included 196 subjects from Quem Hospital in Mashhad, Iran with a body mass index (BMI) between 25 and 45 kg/m2. They were randomized into 2 groups of equal size. The case group received body acupuncture with manipulation and electroacupuncture while the control group received sham acupuncture with very superficial needling at inaccurate locations and disconnected electric lines. A standard point selection protocol was administered plus one of two sets of points chosen if patients had higher or lower energy. Each subject received two treatments per week for 6 weeks while on a low-calorie diet. After, a low-calorie diet with no treatment was continued for six weeks. Body weight (BW) and other anthropometric measurements, as well as blood samples were collected at the start of the trial, after six weeks, and after 12 weeks. 79 subjects in the case group and 82 subjects in the control group completed the 12 week trial. Analysis showed acupuncture was more effective in reduction of WC and HC than in the sham group and had lowered levels of immune-related inflammatory markers. Hs-CRP was not significantly changed in both the case and control groups. Acupuncture produces reduced levels of anti-heat shock protein antibodies while the control did not.

 

Reference

Abdi H., Zhao B., Darbandi M., Ghayour-Mobarhan M., Tavallaie S., Rahsepar A.A., Parizadeh S.M., Safariyan M., Nemeti M., Mohammadi M., Abbasi-Parizad P., Darbandi S., Akhlaghi S., Ferns G.A. (2012). The effects of acupuncture on obesity: anthropometric parameters, lipid profile, and inflammatory and immunologic markers. The Scientific World Journal, 2012, 603539. http://doi.org/10.1100/2012/603539