Acupuncture for weight loss and mental health

INTERVENTION: a single blinded randomised cross over design study was used The intervention phases was; a) Nutritional counselling plus Traditional Chinese Medicine(TCM) acupuncture The treatment phase was six weeks in duration with each participant receiving weekly nutritional counselling and twice weekly acupuncture (either sham or TCM acupuncture). There was a two week wash‐out period between the two treatment phases. Treatment Nutritional Counselling: Participants were provided with weekly lifestyle counselling during both phases of treatment. Nutritional counselling was provided by final year undergraduate nutrition students at the Victoria University nutrition teaching clinic in Melbourne, Australia. The nutrition teaching clinic was supervised by an experienced dietician and nutritionist. The treatment provided was structured in such a way that participants were encouraged to follow the Dietary guidelines for Australians. This entailed prescribing a moderate carbohydrate (approximately 55% total energy), low fat (approximately 25‐30%) and moderate protein (approximately 15‐20%) diet. All treatment providers for the nutritional counselling were blind to the type of acupuncture the participants were receiving. Acupuncture: TCM style manual acupuncture was used in the study. Point selection was based on a list of points previously reported as being effective in weight loss and mental health. Electro‐acupuncture has been shown to be effective in recent weight loss studies however its unknown effect on mental health and in particular, eating and weight concerns, excluded its use in this study. All participants received needling at the same prescribed acupoints at each acupuncture session; Bilateral Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36), Neiting (ST 44), Taichong (LR 3). All acupoints were located according to A Manual of Acupuncture (Deadman, et al., 1998). In addition three auricular acupoints were unilaterally needled on one ear; Unilateral Hungry, Stomach and Shen Men with the side being alternated every succeeding treatment. CONDITION: Overweight and Obesity PRIMARY OUTCOME: The primary outcome measure was body weight change (kg and percentage). SECONDARY OUTCOME: Secondary outcome measures were the validated Eating Disorder Inventory‐3 (EDI‐3, EDRC scale). the Becks Depression Inventory (BDI‐2). the SF‐36v2 Health Survey (physical and mental quality of life). the State‐Trait Anxiety Inventory (STAI). INCLUSION CRITERIA: Inclusion criteria included: a BMI of 25 to 40 at enrollment of the study (all participants’ commenced treatment within four weeks of enrolling); stable body weight three months prior to enrolling in the study and the ability to give written informed consent. The treatment was administered by one of the researchers (SF), an experienced acupuncture practitioner of eight years. Needling depth varied between 0.5 to 1.5 cm for sites across the body (both TCM acupuncture and sham) and was dependent on the thickness of the skin and subcutaneous fatty tissue. Single use sterilised needles (AcuGlide brand, 40 mm (0.20 or 0.25mm diameter) were used for the body acupuncture and 10 mm (0.16mm diameter) for the auricular acupuncture. Following insertion, halfway during the treatment and just prior to the needles being removed, the needles were manipulated using a gentle lift/thrust and rotation which has a homeostatic/supplementing effect. The needles were retained in situ for 30 minutes after which they were removed. To conceal the TCM acupuncture from the sham, vigorous needle manipulation was not employed. The sensation of de qi was not specifically elicited. No other interventions were co‐administered. A small number of participants (less than 10 percent) reported slight pain on needle insertion and mild bruising following acupuncture.