The efficacy and safety of auriculotherapy for weight loss: A systematic review and meta-analysis

Obesity and overweight are common metabolic disorders, affecting people's physical and psychological health. Auriculotherapy is based on the understanding that the external ear represents all parts of the human body, including the internal organs, and provides acupuncture points corresponding to these parts. Previous randomized controlled trials (RCTs) have reported the preliminary results of auriculotherapy for weight loss, but the conclusions were controversial. Therefore, this review aimed to investigate the efficacy and safety of auricular therapy for obese and overweight patients. We searched 9 databases from their inception to August 1, 2020 for randomized controlled trials (RCTs) of auriculotherapy concerning obesity and overweight. All analyses were conducted by RevMan5.3. The Cochrane RoB tool and GRADE were used to assess the risk bias and quality of evidence, respectively. Eleven RCTs involving 892 patients were included. Auriculotherapy alone or combined with lifestyle modification showed more body mass index (BMI) reduction than no treatment (MD -1.08 kg/m2, 95%CI [-1.29 to -0.86], P < 0.001), sham auriculotherapy (MD -0.22 kg/m2, 95%CI [-0.44 to -0.01], P = 0.04), lifestyle modification alone (MD -0.87 kg/m2, 95%CI [-1.18 to -0.56], P < 0.001) or lifestyle modification plus sham auriculotherapy (MD -0.23 kg/m2, 95%CI [-0.44 to -0.02], P < 0.001). Both auricular acupuncture (MD -0.63 kg/m2, 95%CI [-0.99 to -0.28], P < 0.001) and acupressure(MD -0.65 kg/m2, 95%CI [-1.07 to -0.22], P = 0.003) favored BMI reduction. Finally, auriculotherapy was effective in the reduction of BMI and body weight (BW) for patients who were overweight (MD -0.76 kg/m2, 95%CI [-1.14 to -0.38], P < 0.001; MD -0.60 kg, 95%CI [-1.12 to -0.08], P = 0.001), not for patients with obesity. Three RCTs reported adverse events, which were mostly minimal. Both auricular acupuncture and acupressure seemed to be effective for weight loss, particularly for overweight patients. However, the results were inconclusive due to weak evidence, and robust methodological RCTs with appropriate placebo settings are still needed to reconfirm the findings of our review. (PROSPERO ID is CRD42020136827)