DR MANSOORI MD PHYSICAL MEDICICE & REHABILITATION WARD IUMS

MANAGEMENT OF OBESITY  REDUCED-CALORIC DIET  INCREASED ACTIVITY  BEHAVIOR MODIFICATION  PHARMACOTHERAPY  SURGERY  ACUPUNCTURE AS AN ADJUNCT THERAPY

BEST ADJUNCTION  ACUPUNCTURE + DECREASE CALORY  ACUPUNCTUTRE + EXERCISE

EFFECT OF ACUPUNCTURE  FEELING OF WELL BEING WHICH CAN SUPRESS THE DESIRE FOR EXCESS FOOD  STIMULATE METABOLISM & ENABLE THE BODY TO UTILIZE FOOD EFFICIENTLY INSTEAD OF STORING IT AS FAT

ACCORDING TO CHINISE MEDICINE  AGE  SEX  DIET REGIMEN  EMOTION  LIFE STYLE

SIMPLE OBESITY  SPLEEN-STOMACH EXCESS  STARTS IN CHILDHOOD  STRONG BODY  EXCESS DESIRE TO FOOD  EXCESS SWEATING  INTOLERANCE TO HEAT  ABDOMINAL FULLNESS AFTER DEFICATION  CONSTIPATION

TREATMENT  STOMACH 36  BLADDER  REN 4-6  SPLEEN 6-9  KIDNEY 3  EAR POINTS ( SPLEEN-STOMACH-ORAL & APETITE POINTS)

TYPE 2 OR SPLEEN DEFICIENCY  ACCUMOLATION OF PHLEGMON & DAMP  PALLOR  TIREDNESS  WEAKNESS IN EXTRIMITIES  COLD INTOLERANCE  SLEEPY  FULLNESS & CONSTIPATION  UNDERLYING DISEASE

TREATMENT  LA 4-11  Stomach  Spleen 9  Bladder  Ren 12

 Accumulation of Phlegm and Damp (Excess condition)  Clinical manifestations:  Obesity, excess appetite  Likes sweet and fatty, greasy food  Heavy sensations in body, foggy thinking  Aversion to heat  T: Flabby; thick, greasy coat  P: Wiry/slippery.  Wiry can suggest phlegm, heat, or food stagnation.  Left untreated, the Phlegm can lead to heat, leading to Yin deficiency, leading to Wind, leading to stroke.  Treatment principle  Remove damp and phlegm  Formula  Wen Dan Tang + Ping Wei San  These formulas are combined to lose weight, more gentle and safe than Ma Huang based formulas.

 Qi deficiency (Deficiency condition)  Clinical manifestations:  Fatigue, weak voice, shortness of breath  Phlegm damp accumulation  Aversion to cold, edema, puffy face, poor digestion, sleepy, hypofunctions.  Not necessarily an over eating problem.  T: Pale with white coating  P: Thready and weak.  Treatment principle  Tonify Yang, raise metabolism

a systematic review and meta- analysis. Int J Obes (Lond) Feb;33(2): Epub 2009 Jan 13.  Hospital of Korean Medicine, Kyung Hee University Medical Center, Seoul, Korea.

 DATA SOURCES: A total of 19 electronic databases, including English, Korean, Japanese and Chinese databases, were systematically searched for RCTs of acupuncture for reduction of body weight or improvement in obesity up to March 2008 with no language restrictions.

 A total of 31 studies, which comprised a total of 3013 individual cases, were systematically reviewed. Owing to insufficient data in 2 RCTs, 29 RCTs were used for meta-analysis.

 Compared to control of lifestyle, acupuncture was associated with a significant reduction of average body weight (95% confidence interval, CI) of 1.72 kg ( kg) and associated with an improvement in obesity (relative risk=2.57; 95% CI, ).

 Acupuncture significantly reduced a body weight of 1.56 kg ( kg), on average, compared to placebo or sham treatments

 Acupuncture also showed more improved outcomes for body weight (mean difference=1.90 kg; kg), as well as for obesity (relative risk=1.13; ), than conventional medication

 Only four RCTs reported acupuncture- related adverse events, which were mostly minimal.

CONCLUSION  Our review suggests that acupuncture is an effective treatment for obesity.  there is an urgent need for well- planned, long-term studies to address the effectiveness of acupuncture for treating obesity