2/7/24, 8:38 AM Effects of auricular stimulation on obese women: A randomized, controlled clinical trial - ScienceDirect

European Journal of Integrative Medicine

Volume 4, Issue 1, March 2012, Pages e45-e53

Effects of auricular stimulation on obese women: A

randomized, controlled clinical trial
Chun-Ying Lien a b, Li-Lan Liao c, Pesus Chou d, Chung-Hua Hsu a c

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Abstract

Aim of the study

To investigate the therapeutic effect of different auricular acupoint stimulations on obese women.

Methodology
The subjects who met our inclusion criteria were randomly allocated to receive auricular stimulations by
needles or metal beads or sham auricular acupuncture on each ear alternatively at each treatment. The
inclusion criteria included body mass index (BMI) > 27 kg/m2 and taking no weight-control treatments in the
two months before and throughout the study. The outcomes evaluated included: physical parameters,
biochemical characteristics using blood samples, obesity-related hormone peptides and life quality scores at
both baseline and after 4-weeksof treatment for comparison.

Results
Though our results showed no significant differences in any of the outcome measures between the three
groups after treatment, but there were significant reductions in body weight, body mass index (BMI), and
waist circumferences within the groups receiving needles and metal beads auricular stimulations (p < 0.05
and p < 0.001, respectively. N = 30 in each group). Furthermore, there was a 1.9-unit reduction in insulin-
resistance level in the auricular acupuncture group, and a 41.3 pg/ml decrease in ghrelin level in the metal
beads auricular stimulation group.

Conclusions
The group receiving metal beads auricular stimulation showed a decreasing trend similar to that of the
auricular acupuncture group, indicating that metal beads could replace needles when using auricular

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2/7/24, 8:38 AM Effects of auricular stimulation on obese women: A randomized, controlled clinical trial - ScienceDirect

acupoint stimulation as obesity adjuvant treatment with less adverse effects. Our pilot study obtained
findings worthy of further and more in-depth research.

Introduction

Obesity has attracted much attention around the world due to its rapidly increasing prevalence and
numerous health-threatening co-morbidities [1], [2]. Obesity is defined according to the body mass index
(BMI), which is calculated by dividing body weight (kg) by height squared (m2). BMI ≥ 30 kg/m2 indicates
obesity [1]. According to epidemiological research, obese people are at greater risk of developing
undesirable or even fatal complications [3]. The complications of obesity include physical stress on the
body, hormone-related diseases, psychological problems and metabolic syndrome, all of which contribute
to cardiovascular diseases (CVDs) [4], [5]. Furthermore, obesity also changes physical self-images that could
affect quality of life and lead to depression or anxiety [6].

Conventional treatments of obesity which focus mainly on diet control and exercise cannot satisfy the
current needs for weight control. Advanced treatments like surgery or pharmaceuticals are used with strict
criteria and are applicable to only a restricted few [7], [8], [9]. Moreover, sibutramine, a widely used obesity
drug, had recently been withdrawal from the market and its use was banned in many countries due to its
high risk of causing CVDs [3]. Together, all these problems make weight control and reduction a difficult, if
not impossible, mission. As a result, many obese patients seek help from complementary and alternative
medicine (CAM).

Usually, CAM is defined as a treatment approaches aside from conventional therapeutic approaches. CAM
includes Traditional Chinese Medicine (TCM), Ayurvedic medicine, homeopathy and other interventions
[10]. In Taiwan, TCM is referred to CAM but as another conventional medicine on par with modern
medicine, and most people troubled with obesity would turn to TCM for help. Among TCM treatments,
herbal drugs and acupuncture are two most widely used interventions for obesity [11]. The therapeutic
effects of acupuncture have been extensively discussed and reported in previous studies [11], [12], [13].

Among all clinical applications of acupuncture, auricular acupuncture has been employed to treat obesity
since the 1970s and has become the most commonly used method for treating obesity [7]. However, adverse
effects such as auricular chondritis have also been reported [14], [15], [16], [17]. In addition, there is still a
lack of well-designed, randomized, controlled studies on the therapeutic effects of auricular acupoint
stimulation on obesity. This research aimed to investigate whether auricular stimulation contributes to
weight loss and whether auricular stimulation by metal beads achieve the same effects as auricular
acupuncture.

In this study, different types of auricular acupoint stimulation were performed in obese women. The
therapeutic effects of auricular stimulation on physical parameters, biochemical characteristics, obesity-
related hormone peptides and quality of life were examined.

Section snippets

Study design and participants

This study was a randomized, controlled trial conducted from August 2009 to March 2010 in Taipei City
Hospital, Taiwan. Two weeks before the study, 134 obese female patients at our clinic were prescreened. The

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2/7/24, 8:38 AM Effects of auricular stimulation on obese women: A randomized, controlled clinical trial - ScienceDirect

inclusion and exclusion criteria are shown in Table 1. The 90 patients who agreed to take part were enrolled
in the study and randomly divided into three groups. Group A received auricular acupuncture, Group B
received auricular stimulation by metal beads, and Group C was the control…

Quality of life measurement

To measure the quality of life among our subjects, we used the self-administered questionnaire of
WHOQoL-BREF, Taiwan version, which was well validated with consistency coefficients ranging from 0.70 to
0.77 [21]. The WHOQoL-BREF questionnaire evaluated quality of life in physical, psychological, social and
environmental domains, with scores ranging from 0 to 100. Subjects were asked to complete the
questionnaire before the start and at the end of the study.…

Statistical analysis

The data were analyzed using SPSS software (version11.5, Chicago, IL). One-way ANOVA tests were
employed to examine the means between groups. Differences within group at 0–4 weeks were analyzed by
paired t tests. All p values were two-tailed and considered statistically significant at α level of 0.05.…

Participants at baseline

Among the 90 participants, six in Group A, six in Group B and seven in Group C discontinued due to
personal reasons, except for one subject in Group A who withdrew due to dizziness experienced (Fig. 3). A
total of 71 subjects completed the study. Table 2 shows the detailed demographic data and measurement
outcomes at baseline. As can be seen, there was no significant difference among the three groups of
participants, except for the WHOQoL-BREF scores of the psychological domain.…

Comparisons among groups after four weeks

Table 3 shows…

Discussion

Though our findings showed no significant differences between the three groups at the end of the study, we
found significant reductions in physical parameters and obesity-related hormone peptides within the
groups receiving auricular acupuncture and auricular stimulation by metal beads.

Obesity has become as an important issue in recent years because of its high risks of developing several
health-threatening complications like diabetes mellitus, hypertension and hormone-related cancer [11].…

Conclusions

Despite the lack of significant differences between three groups after the 4-week treatment, significant
reductions in body weight, body mass index (BMI), and waist circumferences in the metal beads auricular
stimulations with similar decreasing trend to that of the auricular acupuncture group were observed.
Similar findings between these two groups indicate the possibility of replacing needles with metal beads as
the stimulation device for auricular acupuncture as adjuvant obesity treatment…

Financial support
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2/7/24, 8:38 AM Effects of auricular stimulation on obese women: A randomized, controlled clinical trial - ScienceDirect

This study was financially supported by the Department of Health, Taipei City Government, Taiwan, under
grant 98001-62-020.…

Conflict of interest

There is no conflict of interest of this study.…

Acknowledgements
We sincerely thank our colleagues, especially Dr. Pei-Ling Lo, Dr. Wan-Ching Chan and Ms. Yu-Chuang
Huang, at Lin-Sen (TCM) branch, Taipei City Hospital, Taiwan, for their assistance in this study.

ClinicalTrials.gov Identifier: NCT 00969267 …

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