Acupuncture for Treatment of Obesity: An Umbrella Review.

Background: Systematic reviews on acupuncture for obesity report conflicting findings, and the certainty of this evidence remains unclear. This umbrella review appraises the evidence to identify which effects on body mass index (BMI) and body weight (BW) are supported by high-quality findings.

Methods: We conducted an umbrella review by systematically searching PubMed, Embase, and the Cochrane Library through April 28, 2025 to obtain systematic reviews of randomized controlled trials evaluating acupuncture interventions for obesity. Two reviewers independently assessed methodological quality using a measurement tool to assess systematic reviews (AMSTAR) and evidence quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). We identified best evidence from high-quality systematic reviews with high or moderate GRADE ratings.

Results: Our analysis included 22 systematic reviews encompassing 60 meta-analyses. Seventeen reviews (77.3%) achieved high methodological quality ratings according to AMSTAR criteria. Five meta-analyses provided high-quality evidence consistently demonstrating significant benefits of acupuncture interventions. The strongest evidence supported acupuncture combined with lifestyle interventions compared to lifestyle interventions alone for both BMI and BW outcomes. Additional high-quality evidence demonstrated significant benefits for acupuncture versus no treatment and versus sham acupuncture. Fourteen meta-analyses provided moderate-quality evidence confirming acupuncture effectiveness, with no significant differences between acupuncture and pharmaceutical treatments.

Conclusions: Based on high-quality evidence, clinicians can recommend acupuncture to patients with obesity, particularly as adjunctive therapy to lifestyle interventions. For patients unable to tolerate pharmacological treatments, acupuncture represents a reasonable alternative. However, optimal benefits require integration with comprehensive lifestyle modifications rather than standalone use.