Objective Acupuncture, as one of the complementary and alternative medicines, represents an efficient therapeutic option for obesity control. We conducted a meta-analysis to investigate the effectiveness of acupuncture in obesity and also summarized the available studies on exploring the mechanisms. Design We searched six databases from the inception to April 2017 without language restriction. Eligible studies consisted of acupuncture with comparative controls ((1) sham acupuncture, (2) no treatment, (3) diet and exercise, and (4) conventional medicine). The primary outcomes consisted of BMI, body weight reduction, and incidence of cardiovascular events (CVD). Secondary outcomes included waist circumference (WC), waist-to-hip ratio (WHR), body fat mass percent, body fat mass (kg), total cholesterol (TC), triglyceride (TG), glucose, low density lipoprotein cholesterol (LDL-c) reduction, high density lipoprotein cholesterol (HDL-c) increase, and adverse effects. The quality of RCTs was assessed by the Cochrane Risk of Bias Tool. Subgroup analyses were performed according to types of acupuncture. A random effects model was used to adjust for the heterogeneity of the included studies. Publication bias was assessed using funnel plots. Main Results We included 21 studies with 1389 participants. When compared with sham acupuncture, significant reductions in BMI (MD=-1.22, 95%CI=-1.87 to -0.56), weight (MD=-1.54, 95%CI=-2.98 to -0.11), body fat mass (kg) (MD=-1.31, 95%CI=-2.47 to -0.16), and TC (SMD=-0.63, 95%CI=-1.00 to -0.25) were found. When compared with no treatment group, significant reductions of BMI (MD=-1.92, 95%CI=-3.04 to -0.79), WHR (MD=-0.05, 95%CI=-0.09 to -0.02), TC (MD=-0.26, 95%CI=-0.48 to -0.03), and TG (MD=-0.29 95%CI=-0.39 to -0.18) were found. When compared with diet and exercise group, significant reduction in BMI (MD=-1.24, 95%CI=-1.87 to -0.62) and weight (MD=-3.27 95%CI=-5.07 to -1.47) was found. Adverse effects were reported in 5 studies. Conclusions We concluded that acupuncture is an effective treatment for obesity and inferred that neuroendocrine regulation might be involved.

Background Type 2 diabetes mellitus (T2DM) with obesity is a glycolipid metabolism disorder, which makes hypoglycaemic treatment more complex and increases the proportion of multidrug combinations. In addition, patients are more prone to adverse reactions and gradually lose compliance with treatment. Previous clinical trials have demonstrated that Daixie Decoction granules (DDG) can reduce body weight and blood lipids and improve the quality of life of T2DM with obesity. But there are a lack of further evaluations for the efficacy and safety of DDG combined with metformin. Methods/design The study is designed as a multicentre, randomized, double-blind, placebo-controlled clinical trial. Participants who meet the Nathrow criteria will be randomly assigned to the intervention group and control group (n1 = n2 = 133). Based on a unified diet control and exercise therapy, the intervention group will be treated with DDG and metformin, and the control group will be treated with DDG placebo and metformin. All subjects will receive a 6-month treatment followed by a 6-month follow-up. Effective rate of a 1% decrease in HbA1c and 3% decrease in body weight will serve as the primary outcome. The secondary outcome include fasting plasma glucose, blood lipids, C-peptides, insulin, inflammatory factors, insulin resistance index (HOMA-IR) and the subcutaneous and visceral fat content in the upper abdomen measured by MRI. Blood routine, urine routine, stool routine, liver and kidney function, EKG and other safety indicators and major adverse reactions were monitored during total treatment and follow-up time. Discussion We aimed to determine the efficacy and safety of DDG combined with metformin for the treatment of T2DM patients with obesity. Trial registration Trial registration: ChiCTR, ChiCTR2000036290. Registered 22 August 2014,  http://www.chictr.org.cn/showprojen.aspx? proj=59001