Ep. 15: Can acupuncture help you lose weight? Not really.

Speaker A [00:00:00]:

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Speaker B [00:00:43]:

Welcome to Notes From Your Acupuncturist, the podcast for anyone who's interested in acupuncture, complementary medicine, holistic, health, and self care. I'm your host, alexa Bradley Halsey. If you enjoy this show, you can help other people discover it by leaving a rating or a review, by following or subscribing on your favorite podcast listening app, or simply by telling someone about it. And if you'd like to support this show financially, you can become a paid subscriber on Substac for just a few dollars a month. Just head over to Substac.com and search notes from your acupuncturist, or click the link in the show notes. And one more thing before we get started, just a disclaimer that this podcast is for educational purposes only and is not a replacement for medical care from a qualified healthcare provider. Okay, on with the show.

Speaker C [00:01:34]:

Hello, everyone. Welcome to the show. I'm your host, Alexa, and today is a solo episode. I'm going to address a question that most acupuncturists get asked with some regularity, which is, can acupuncture help with weight loss? I'm just going to go ahead and give you the short answer, which is not really, but there's more in that answer that I want to unpack, and that's what today's episode is all about. So I was inspired to take on the question of acupuncture and weight loss, because recently, my daily Google News alert for acupuncture has been just brimming with stories about how Ericular acupressure using acupressure beads on the ears can help with weight loss. And this is all because of a recent research paper that was presented at the 2023 European Congress on Obesity.

So let's talk about this study that was presented. It was conducted in Japan at Clinic F by Dr. Takihiro Fujimoto and colleagues, and they wanted to look at whether acupressure beads on the ear would be as effective as intradermal needles on the ear for weight loss. So intradermal needles are tiny, tiny needles that are inserted into the skin and then left in place and secured onto the skin by tape. And you need a trained acupuncturist to place intradermal needles. Acupressure beads, however, don't pierce the skin, so they're less invasive and anyone can place them. You don't need an expert. You just need someone who is trained in where the points are. And there was a Japanese study published in 2020 that supported the use of intradermal needles for weight loss. And I'll talk a bit later about that 2020 study. So Dr. Fujimoto and his team wanted to see if they could replicate those results using a simpler tool, pressure beads instead of needles. So this recent study included 81 men in Japan between the ages of 21 to 78. They had an average BMI, which is body mass index of 28.4, which falls into the quote unquote overweight category, and BMI, we're going to talk more about that later. But the participants all had this quote overweight BMI level, and they all also had quote unhealthy levels of abdominal fat, unquote. So researchers placed acupressure beads at 6.6 points on each ear. So twelve beads total. And the points that they used in this study were Shenmen food pipe, which I guess is esophagus, maybe upper stomach, opening stomach, lungs, and endocrine. So they placed pressure beads at six points on each ear, same points for every participant and the same points on each ear. So I'm going to read a direct quote from this press release for this study and listen carefully. They said, quote, the beads were replaced twice a week during hospital visits. At the same time, participants were given guidance on diet and body weight was measured. Participants were asked to reduce their total food intake by half during the three months of their treatment and kept food diaries.

So after three months of this study, the participants wore these acupressure beads continuously on their ears. And there were a few key findings. On average, participants lost an average of 10.4 CM off their waist circumference. They lost, on average, 4% of total body fat. They also found that unhealthy abdominal fat was reduced and finally, BMI decreased by almost three points to 25.5, which is still considered in the quote over rate overweight range, but just barely. And again, we're going to talk a little more about BMI later. So here's a quote from Dr. Fujimoto about the results. He says, quote, our findings suggest that acupuncture on the ear may aid weight loss when paired with diet and exercise. It's likely that acupuncture has a positive effect by curbing cravings and appetite, improving digestion, and boosting metabolism. Unquote. Okay, but did you catch the part about participants being given guidance on diet, keeping food diaries, and most importantly, reducing their total food intake by half? So of course they lost weight. Anyone who reduces their food intake by half is going to lose weight and lose waste circumference. So there are a few other issues with this study. And just a quick note that I am not a researcher, so don't take my opinion on this study as gospel truth, but there are some pretty obvious design flaws here. One is that the study only included men. And this has long been a problem with scientific research on the whole because traditional research studies only included male subjects. This is changing, but it's still a problem if you're studying a health issue that affects all sexes, you should include people of all sexes as participants in your study. Another issue is that in this study, there's no control group. So a well designed study will include people who receive whatever treatment they're studying, and that's called the intervention group. And then there's just going to be a control group, and the people in the control group don't receive the intervention. You do this so that you have a way to compare your results. Now, this is a little tricky in an acupuncture research study, and sometimes researchers will do what they call sham acupuncture on the control group. But this study didn't even attempt a control group. And without a control group, there's no way to know if the acupressure had any effect on the results. It's really just speculation. And then finally, the study is of a relatively short duration, and there's no follow up. So what happens when participants stop wearing the ear acupressure beads all the time? Do they gain the weight back? Does the weight stay off? Do they continue with a reduced food intake? We really have no idea. So, in essence, there's absolutely no way to know if the results in this study were brought about by the use of acupressure beads. And authors even acknowledge this. And yet this paper was still presented at an international conference and is now being used as a basis for all sorts of misleading articles about how acupuncture can possibly help you lose weight. And I feel like this study really does not prove that.

Now, I mentioned a 2020 study that supported the use of intradermal needles for weight loss. So let's talk about that. The 2020 study was also led by Dr. Fujimoto at Clinic F in Tokyo. And this was a much larger study over a longer period of time. And this one only included women. And participants were divided into three groups. One received acupressure with metal beads, like in the 2023 study. Another received acupuncture with intradermal needles, which were taped to the skin and left in place. And the other group received no intervention. So that was the control group, and they did a six month follow up. So this was all around a more well designed study, and they evaluated weight loss and also asked participants to track their snacking habits and levels of satiety. And they also monitored blood glucose. So all participants in this 2020 study were asked to reduce their food intake. And all participants reported some amount of weight loss, which is not surprising because people reduced their food intake. Now, participants in the intervention groups so that's the acupressure and the endodermal groups did have higher rates of weight loss than those in the control group. Participants in the intervention groups also reported less snacking between meals and higher levels of satiety after eating, and also had decreased blood glucose levels. So the results from this 2020 study tell us that ear acupressure and acupuncture does do something. And this lines up with the fact that ear acupuncture has been used in the treatment of addiction for decades, starting in the 1970s, it was used in the treatment of heroin addiction, and it's still widely used in many alcohol and drug recovering settings today. Ear acupuncture does help curb cravings and reduce withdrawal symptoms and manage stress. And it's a cost effective and simple treatment to administer. And in fact, ear acupuncture has been widely researched for the treatment of many different health conditions, including pain, neurological issues, endocrine system disorders, and a lot more. And I'll put a link in the show notes to an article that summarizes some of the recent studies. So we know that ear acupuncture does, in fact, cause quantifiable changes in the body. But as to the question of whether ear acupuncture and acupressure promote weight loss, I don't see research that really strongly proves that connection.

Now, to be clear, I've certainly treated patients who have lost weight while undergoing a series of acupuncture treatments. But acupuncture wasn't the only thing they were doing to try to lose weight. For most people, diet and exercise are the things that lead to weight loss. Acupuncture can be a factor. But as my friend and colleague Jerusia DeGrote Stevens likes to say, it's a backup singer and not the lead vocalist. So here are a few ways in which I think acupuncture can play a role in weight loss. One is that acupuncture reduces pain. And when a person has pain, this will often have the effect of limiting their physical activity. And then when we reduce pain with acupuncture, they can move more easily, they can engage in more physical activity without it resulting in pain. And when you increase your level of exercise, you tend to lose weight. Acupuncture also improves sleep and reduces fatigue. And again, when you sleep better and you have more energy, you might then exercise more than you did when you were tired all the time and not sleeping well. So that could result in weight loss. Acupuncture also reduces stress, and we know that stress raises levels of the hormone cortisol. And elevated cortisol has been linked to increased appetite, a higher amount of belly fat, and weight gain. An acupuncture can also improve digestion, and this can help with abdominal bloating and fullness. So acupuncture can have an indirect effect on a person's weight. But I haven't seen evidence that acupuncture alone correlates to weight loss. The factors that most directly impact a person's weight are nutrition, physical activity, and, importantly, genetics.

Now, as promised, I want to zoom out a bit and talk about BMI or body mass index. The two studies I mentioned used BMI as one metric, as do many studies when they're assessing the effectiveness of weight loss interventions. So BMI is a measurement of a person's weight in proportion to their height. So to calculate BMI, you divide a person's weight by their height, and the resulting number is their body mass index, and their BMI will fall into one of four categories underweight healthy, overweight, or obese. Okay? Seems simple enough. But there are a lot of limitations to what the BMI can measure. It doesn't measure relative proportions of bone, muscle, and fat in the body. It doesn't measure where fat is distributed, and it doesn't actually measure any health markers such as blood pressure or blood sugar. It only measures a person's weight and proportion to their height, which is not, in fact, all that clinically useful. It doesn't really tell us anything about the state of a person's health. But BMI is still used in clinical and research settings as a marker of health, and this can create discrimination and barriers to health care for people who fall into the overweight or obese ranges of BMI. And so for those reasons, I really don't like to see BMI used as a health marker. It just doesn't tell us much. And the BMI is problematic for other reasons, too. If you look into the history of the BMI, you'll find ties to racism and eugenics, and it increases social stigma for fat people and reinforces false stereotypes. Critics of the BMI also argue that its continued use is promoted by the medical industrial complex to feed the profits of insurance companies and drugmakers. There's a whole fascinating history of the BMI which I'm not going to get into on this episode, but if you want to learn more, I highly recommend the podcast Maintenance phase and two episodes in particular. One titled The Body Mass Index and the other titled The Obesity Epidemic. Suffice to say, the BMI is not all that it's cracked up to be, and there are many healthcare providers and health advocates who make a compelling case for doing away with it. And while we're on the subject of weight, I think it's important to challenge some long held beliefs in our society about the connection between a person's weight and their health. For decades, the prevailing belief has been that people with lower body weight are healthier and live longer, and people whose body weight falls into the unhealthy or obese ranges of body mass index are sicker and die earlier. And a lot of the research actually just does not bear this out. And in fact, this ideology is often based on research that is full of statistical miscalculations, methodological errors, and even typographical errors. Research does show that most people who lose weight through dieting will eventually gain it back and sometimes gain back more weight than they lost. And the research also shows that a person's weight is not the only indicator, or even the most important indicator of their overall health picture. There are healthy people of all shapes and sizes, and conversely, there are sick people of all shapes and sizes, and weight can be a result of an underlying health condition and not necessarily the cause of it. And yet there's still a belief among the general public, and even among some healthcare providers, that when a person's weight falls into the overweight or obese ranges of BMI, that it's somehow a personal failing. And what's problematic about those beliefs is that they contribute to antifat bias and result in real harm being done to fat people. If you're curious to learn more and maybe challenge some of your own beliefs about weight and health, I again recommend the podcast Maintenance Phase, and in particular an episode called Is Being Fat Bad for you? One quote from that episode that really stuck with me is that obesity is not a behavior, it's a characteristic. And I will put links to all of those episodes in the show notes so that you can easily find them.

And one more thing that I think is important to remember is that there is an entire industry based on weight loss and dieting, and it is worth billions with a B. There are conflicting figures out there, but in the US. Alone, it was estimated to be worth $224,000,000,000 in 2021, and the weight loss industry is projected to be worth $405,000,000,000 by 2030. So there's an entire industry out there that is profiting from people trying to lose weight, and so, of course, it behooves them to keep sending messages equivocating thinness with health, whether or not those messages are based in actual science. So don't always believe everything you read and hear about weight and health. I don't think you need to lose weight. I think you're perfect just the way you are. Thanks for listening.