Auricular acupuncture (placement of press needles) was applied at the stomach point (according to Nogier) and sometimes at the point of psychological balance (Shenmen) for the control of anxiety and for help in weight loss in 800 patients over a two year period. Press needles were inserted and left in for 10 to 15 days at the auricular acupuncture point and resited again after 4 to 5 days. At the same time, instructions were given for the standard treatment of obesity (information leaflet, low calorie diet, aerobic exercise, behaviour modification, psychological support, etc.). The patients were followed up for a period of one year. The participants were 683 women and 117 men aged between 15 and 76 years. The Body Mass Index (weight/height) was used to determine the degree of obesity, and cases were divided into three groups according to the number of acupuncture sessions as follows: 468 patients (Group A) had one acupuncture session, 278 (Group B) 2 to 4 sessions, and 54 (Group C) had over 4 sessions, all conducted at 15 to 20 day intervals. A reduction in overeating was reported by 81.1% of patients, and 46.7% of the 697 patients who had noted anxiety symptoms claimed that treatment had helped in the reduction of anxiety. Regular exercise was encouraged, and started by 43.4% of the 703 who had no such habit. There was no significant weight loss in 35.2% of patients. During the first 3 months there was an overall significant weight loss in 64.8% and 35.5% at 6–12 months. The percentage weight loss was higher in Groups B and C and remained higher at six months and one year after the start of acupuncture treatment. Group B presented a good six month result in 61.2% of patients and a good annual result in 39.1%. In Group C results were 88.9% and 77.8% respectively. The control of overeating and anxiety using auricular acupuncture al the stomach and Shenmen points in this audit has been beneficial. Its correct use in an integrated obesity control programme may prove of significant long tem help.

Obesity disproportionately affects rural populations; however, there is limited research examining disparities in bariatric surgery outcomes between patients from rural versus urban areas. This study aimed to compare the demographic characteristics of patients undergoing bariatric surgery from rural versus urban bariatric areas and to explore differences in weight-loss outcomes between these groups. A retrospective chart review identified a sample of 170 patients (52 rural, 118 urban) who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy procedures over a 1-year period. Data collected included age, race, gender, insurance status, surgery type, height, and pre-and postoperative weights at 3 and 6 months.Significant differences in race, ethnicity, and surgery type were observed between rural/urban patients (ps < 0.05). Patients from rural areas demonstrated significantly greater percent total weight losses at 3 months (p = 0.018; however, there were no significant differences between groups at 6 months (p > 0.05). The results suggest that patients from rural counties experience postoperative weight-loss outcomes comparable to those of their urban counterparts. K E Y W O R D Sbariatric surgery, health disparities, obesity, rural/urban | INTRODUCTIONAdults living in rural areas in the United States are disproportionately affected by obesity; as of 2016, the estimates show obesity prevalence of 43.1% of adults in non-metropolitan statistical areas compared to 35.1% in large metropolitan statistical areas. 1 Higher obesity prevalence among adults from rural areas contributes to the higher rates of chronic disease and mortality and poorer overall health and quality of life observed in rural versus urban areas. 2 Given these significant disparities, there is an urgent need for increased access to, and dissemination of, evidence-based obesity treatments in rural communities. Bariatric surgery is recognized as one of the most effective interventions for substantial weight loss among patients with moderate to severe obesity 3 ; however, eligible residents of rural areas are 23% less likely to undergo bariatric surgery than urban counterparts. 4 Further, there is a paucity of research evaluating bariatric surgery outcomes among patients living in rural communities. One study conducted by Bergmann and colleagues 5 found that rural status significantly predicted bariatric surgery completion among adults evaluated in a large university hospital in West Virginia; however, the authors noted that this finding was confounded by insurance type, given that patients from rural areas were more likely to be denied access to surgery based on their insurance payer (specifically,