Weight loss.

Two little words that carry a lot of meaning this time of year.

Just ask the authority on all things, Google.

I popped the term ‘weight loss’ into Google Trends and whaddyaknow, there’s an uptick in searches every January. To a lesser extent, a similar trend can be seen for the other fear-inducing term on the tip of everyone’s tongues…err, fingertips… this time of year, ‘diet.’

January, after all, marks the shift from the ever-indulgent holiday season to a stricter, more temperate sort of living in which we endeavor to atone for the dietary revelry of the days, weeks, or sometimes months prior.

#YOLO, right?

Taking up this draconian cause has become a rite of passage, fueled by pervasive enticements from the fitness and weight loss industries to engage in various weight loss detoxes, fixes, recharges, resets, and my personal favorite – ‘jump starts.’

Jump starts? Really?

Not impressed.

I think this weight loss fervor draws its roots from our Puritan ancestors, who willingly undertook all sorts of self-flagellating behaviors to make up for transgressions large and small. Today, we reconcile going off the dietary rails by telling ourselves that it’s ok, as long as we buy our tickets for the weight loss pain train come January.

I get it. I’m not impervious to the siren songs of workout programs promising aesthetic impeccability in just 20 minutes a day or nutrition programs all but guaranteeing the attainment of ideal body weight in 14 days.

Even in writing these few short sentences, it strikes me how much morality is woven into the ways in which we approach weight loss, weight maintenance, fitness, and healthy living. These things are treated as efforts, endeavors, projects for which we must gird our loins and harden our hearts in preparation. Penances we must undertake to compensate for the sins of dietary indulgence and neglected gym regimens.

It’s all a bit much, this sort of transactional thinking.

And it makes me appreciate Chinese Medicine, which takes a much more reasonable stance on eating, moving, and living.

To that end, I thought I’d spill some ink on the ways in which Chinese Medicine can play a role in weight loss, weight maintenance and the regulation of hormonal function necessary for proper hunger and satiety signaling, starting with a look at the scientific research.

Spoiler alert: Chinese Medicine, encompassing acupuncture, nutrition, herbal medicine, and meditation, among other practices, is never going to deliver a fast and flashy 10 pound weight loss in 3 days. It’s just not. But it’s also not going to incur the hormonal, energy, and mood deficits that comprise the oft un-talked about side effects of these quick fixes. And, if utilized properly, it will set you up for long term, sustained success.

Sounds like a better proposition than the master cleanse if you ask me, tbh.

So, what does the research say? Does acupuncture and by extension, Chinese Medicine, promote weight loss?

WHY YES, YES IT DOES.

I reviewed a number of studies and the data does indeed point to a beneficial effect of acupuncture on excess weight. Excess being the key point here. Many of the studies I looked at evaluated populations of subjects who could be categorized as overweight (BMI 25 – 29.9) or obese (BMI >30). This is important because the more weight one has to lose, the more likely one is to have a significant response to weight loss interventions in the short term.

If, like Regina George, you are already at a healthy BMI but really want to lose three pounds, the impact of acupuncture will be slower to take hold, though with conscious nutrition and dialed-in lifestyle habits, acupuncture can certainly help motor you down the weight loss road.

Acupuncture has been shown to be effective at reducing body weight, body fat, waist circumference, and visceral adipose tissue (the most metabolically dangerous type of fat) in various randomized controlled trials. Some of these studies pitted acupuncture against reduced calorie (hypocaloric) diet, some compared acupuncture + diet with diet alone, some looked at acupuncture + diet + exercise vs nothing at all (control); ultimately, the research sliced and diced the examination of acupuncture’s effects on weight loss from multiple angles, and the response, though nuanced, clearly indicates that acupuncture’s got it goin’ on when it comes to promotion of healthy weight.

Lest you think this lends itself to a simple ‘needle x, y, and z to drop muchos lb’s’ equation, know that the mechanisms behind this are varied and complex, operating on multiple systems to achieve the desired effect.

Let’s take a look at how acupuncture can impact weight loss:

1.) Anti-Inflammatory Effects

Excess weight has been unequivocally associated with inflammation. The state of being overweight is inflammatory and occupying a body that is chronically inflamed perpetuates weight gain, as the inflammatory state over time creates a maladaptive response that makes weight loss and even weight maintenance increasingly difficult.

A vicious cycle, if you will.

And no one likes a vicious cycle.

Acupuncture has profound anti-inflammatory effects. Some effects are local and some systemic. Some achieved through activation of the parasympathetic branch of the nervous system – the ‘rest and digest’ part of our physiology that is responsible for keeping us calm and primed to fire on all cylinders – digestively, hormonally, cognitively, etc. It’s not particularly fun or sexy but maintaining a measure of calm, even in the face of stress, can go a long way towards promoting healthy eating habits and healthy weight.

When the immune system gets all whacked out, whether from diet, lifestyle, stress, environmental toxins, or a combination thereof, it loses its capacity to self-regulate and maintain an appropriate balance of immune mediators involved in the inflammatory response. Acupuncture has been shown to restore balance to unhappy immune systems and in so doing, ensure that the helpful components of the immune system aren’t vastly outnumbered by the bad guys, the inflammatory viking destroyers that left unchecked, will plunder and pillage internally, leading to rampant inflammation and its resultant disease states, not the least of which is excess weight. Most notably, acupuncture has been shown to decrease excess levels of tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6), both strongly associated with chronic inflammation and excess weight.

2.) Anti-Oxidant Effects

As if inflammation isn’t bad enough, being overweight is also associated with oxidative stress, which disrupts normal cellular signaling. Cells within fat tissue called adipocytes can generate gnarly little purveyors of oxidative damage called reactive oxygen species (ROS) which contribute to the inflammatory burden and over time lead to insulin resistance, which – you guessed it – perpetuates a state of overweight. Furthermore, reactive oxygen species can decrease the amount of healthful anti-oxidants such as superoxide dismutase (SOD), glutathione (GSH), and glutathione peroxidase (GSH-Px), ultimately leaving the overweight individual with more of the bad and less of the good.

But there’s hope! Acupuncture pitches in on this front as well, reducing oxidative damage and upregulating the amount and function of anti-oxidants in the body. Win, win.

3.) Hormonal Regulation

This alone could be another blog post, if not an entire book, so I’ll slim it down (PUN INTENDED) to the most salient takeaways.

Acupuncture promotes proper signaling of hormones involved in the regulation of appetite and satiety, including:

Insulin, notorious for being the ‘fat storage’ hormone

Leptin, which is largely involved with satiety

Ghrelin, the hormone we can thank for the ever-squawky and unwelcome feelings of hunger

It’s also worth mentioning that acupuncture has profound effects on the stress response mediated by the hypothalamic pituitary adrenal (HPA) axis – a feedback loop between the brain and the adrenals that helps the body adapt to stressors. Though all the composite parts of the HPA axis are unduly critical to the stress response, the scene-stealer I want to highlight here is the hormone everyone loves to hate, cortisol.

Cortisol is supremely necessary and beneficial, particularly in instances of immediate stress and danger, however in the context of chronic stress, the cortisol response goes crazy, leading to an excess of cortisol and sluggishness on the part of the body to adequately respond to it (cortisol resistance), which sets one up for a host of issues, including impaired immunity, water retention, weight loss resistance, and dysregulated sleep, among others. Numerous studies demonstrate that acupuncture modulates the HPA axis to restore its proper connectivity and function, ultimately reversing cortisol resistance to re-establish cortisol sensitivity and with that, create a healthy stress response.

This of course, reinforces what I mentioned earlier about staying calm to stave off the weight gain. Stress is no bueno for the waist line.

4) Effects On Neurotransmitters

Acupuncture modulates the expression and function of neurotransmitters that impact mood, energy, cognition, and other factors that ultimately trickle down to appetite and food intake, whether directly or indirectly. Though there are many, the most prominent that springs to mind is serotonin (5-HT), which is the neurotransmitter responsible for those warm, cozy, happy feelings we get when we eat carbohydrates. Acupuncture’s effects on serotonin have been proposed as one of the mechanisms by which it affects weight regulation. Furthermore, acupuncture has been shown to upregulate activity of anorexigenic (appetite-squashing) neuropeptides and downregulate activity orexigenic (appetite stimulating) neuropeptides.

5) Promotion Healthy Gut Flora

The much-revered microbiome, the largest repository in our bodies of gut microbes, is so hot right now. In all seriousness, the minuscule microorganisms in our guts have profound effects on our health, as emerging research increasingly indicates. Acupuncture research in this realm has indicated an effect on both composition and function of the gut flora, resulting in dramatic improvements in inflammatory and digestive disorders and of course, weight regulation. One of my favorite studies to cite showed that acupuncture affected a significant reduction in BMI and shift in gut flora composition and function among obese women absent any dietary intervention. AKA acupuncture alone delivered the weight loss goods, no slimfast shakes required.

6) Metabolic Effects

Derangements in glucose metabolism (dysglycemia and hyperglycemia) and lipid metabolism are hallmarks of obesity. Acupuncture has demonstrated a capacity to improve glucose tolerance by lowering glucose levels and improving insulin sensitivity and has indicated beneficial effects on lipid metabolism in the form of reductions in total cholesterol, LDL cholesterol, and triglycerides.

In summary, acupuncture can help one attain and maintain a healthy weight through reduction of inflammation and oxidative damage, regulation of neuroendocrine responses (hormones and neurotransmitters), modulation of the gut flora, and promotion of healthy metabolic markers.

No big deal.

So now that I’ve bored you to tears with my research ramblings, I feel compelled to let you marinate/recover for a hot minute. I’ll be back for a second installment on this topic that looks at how acupuncture and Chinese Medicine can be applied to weight loss efforts IRL, since none of us live in research laboratories. And I’ll introduce you to some accessible and tangible practices you can draw from Chinese Medicine to enhance your weight loss endeavors.

References:

1. Abdi, Hamid, et al. “The Effects of Body Acupuncture on Obesity: Anthropometric Parameters, Lipid Profile, and Inflammatory and Immunologic Markers.” The Scientific World Journal, vol. 2012, 2012, pp. 1–11., doi:10.1100/2012/603539.
2. Bao, Chun-Hui. “Randomized Controlled Trial: Moxibustion and Acupuncture for the Treatment of Crohn’s Disease.” World Journal of Gastroenterology 20.31 (2014): 11000. Web.
3. Belivani, Maria, et al. “Acupuncture in the Treatment of Obesity: A Narrative Review of the Literature.” Acupuncture in Medicine, vol. 31, no. 1, 2012, pp. 88–97., doi:10.1136/acupmed-2012-010247.
4. Güçel,Funda, et al. “Influence of Acupuncture on Leptin, Ghrelin, Insulin and Cholecystokinin in Obese Women: a Randomised, Sham-Controlled Preliminary Trial.”Acupuncture in Medicine, vol. 30, no. 3, 2012, pp. 203–207., doi:10.1136/acupmed-2012-010127.
5. Hu, Sen, Ming-Hua Du, Hong-Min Luo, Huan Wang, Yi Lv, Li Ma, Zhi-Long Lin, Xian Shi, Ingrid Gaischek, Lu Wang, and Gerhard Litscher. “Electroacupuncture at Zusanli (ST36) Prevents Intestinal Barrier and Remote Organ Dysfunction following Gut Ischemia through Activating the Cholinergic Anti-Inflammatory-Dependent Mechanism.” Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1-10. Web.
6. Nam, Min-Ho, et al. “Herbal Acupuncture for the Treatment Of Obesity.” Journal of Acupuncture and Meridian Studies, vol. 9, no. 2, 2016, pp. 49–57., doi:10.1016/j.jams.2015.09.002.
7. Xu, Zhuting, et al. “Effect of Acupuncture Treatment for Weight Loss on Gut Flora in Patients with Simple Obesity: Table 1.” Acupuncture in Medicine, vol. 31, no. 1, Aug. 2012, pp. 116–117., doi:10.1136/acupmed-2012-010209.
8. Xu, Zhuting, Ruifen Li, Cailian Zhu, and Mingyu Li. “Effect of Acupuncture Treatment for Weight Loss on Gut Flora in Patients with Simple Obesity: Table 1.” Acupuncture in Medicine 31.1 (2012): 116-17. Web.
9. Yin, Jieyun, et al. “Hypoglycemic Effects and Mechanisms of Electroacupuncture on Insulin Resistance.” American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, vol. 307, no. 3, 2014, doi:10.1152/ajpregu.00465.2013.
10. Yu, Jung-Sheng, Bai-Yun Zeng, and Ching-Liang Hsieh. “Acupuncture Stimulation and Neuroendocrine Regulation.” International Review of Neurobiology Neurobiology of Acupuncture (2013): 125-40. Web.
11. Zijlstra, Freek J., Ineke Van Den Berg-De Lange, Frank J. P. M. Huygen, and Jan Klein. “Anti-inflammatory Actions of Acupuncture.” Mediators of Inflammation 12.2 (2003): 59-69. Web.