OBJECTIVETo observe the efficacy of acupuncture and moxibustion on female obesity complicated with climacteric syndrome and its impact factors.

METHODSOne hundred and fifty-one cases of female obesity complicated with climacteric syndrome were treated according to the basic principle as "pattern/syndrome differentiation". Accordingly, the reinforcing or reducing technique was applied at Quchi (LI 11), Zhongwan (CV 12), Tianshu (ST 25), Daheng (SP 15), Zusanli (ST 36), Shangjuxu (ST 37), Sanyinjiao (SP 6), Neiting (ST 44), etc. The auricular point sticking was applied at Hunger Point, Ear-shenmen, Sympathetic Nerve, Endocrine and Stomach. The treatment was given once every two days. The duration of treatment was 3 months. The changes in the symptoms, physical signs, obesity index, Kupperman index, the vegetative equilibrium index (Value Y), estradiol (E2) and follicle stimulating hormone (FSH) were observed before and after treatment.

RESULTSThe obesity patients complicated with climacteric syndrome presented unusually high level of obesity index, Kupperman index and FSH levels and unusually low level of E2. After treatment, the obesity index, Kupperman index and FSH levels were all reduced significantly (all P < 0.01) while E2 level was increased significantly (P < 0.05).

CONCLUSIONAcupuncture and moxibustion achieve the significant efficacy on obesity complicated with climacteric syndrome, which is closely related with the pattern/syndrome of the disorder and obesity grade. For the effective and curative rate of obesity index, the efficacy of liver qi stagnation pattern/syndrome is better than that at liver stagnation and spleen deficiency pattern/syndrome than spleen and kidney yang deficiency pattern/syndrome than liver and kidney yin deficiency pattern/syndrome than yin and yang deficiency pattern/syndrome; the efficacy of mild obesity is better than that at moderate obesity than severe obesity.

Acupuncture Therapy ; Adult ; Female ; Humans ; Middle Aged ; Moxibustion ; Obesity ; metabolism ; therapy ; Postmenopause ; metabolism

Oesity is a major global health problem. However, current therapeutic strategies for obesity are limited. Obesity results from an imbalance between energy intake and energy expenditure, and the treatment of obesity is based on the correction of this metabolic imbalance. Anti-obesity drugs can shift this balance in a favorable way by reducing food intake, altering metabolism, and by increasing energy expenditure. There is a growing consensus that pharmacotherapy is appropriate for many individuals who are unable to lose weight through less intensive measures. However, side effects may ensue phamacotherapy for obesity. Only two drugs (sibutramine and orlistat) are currently approved for the long-term treatment of obesity. Sibutramine inhibits the reuptake of serotonin and norepinephrine. Orlistat works by blocking the pancreatic lipase. However, phamarcotherapy may not be the ultimate resolution for obesity management. Because the underlying pathophysiology in each individual varies in many aspects, it is recommended to provide individualized and tailored medication in addition to other antiobesity supportive treatments.
Anti-Obesity Agents ; Consensus ; Drug Therapy ; Eating ; Energy Intake ; Energy Metabolism ; Health Expenditures ; Lipase ; Metabolism ; Norepinephrine ; Obesity* ; Serotonin

Brown adipose tissue (BAT) is a specialized thermoregulatory organ that has a critical role in the regulation of energy metabolism. Specifically, energy expenditure can be enhanced by the activation of BAT function and the induction of a BAT-like catabolic phenotype in white adipose tissue (WAT). Since the recent recognition of metabolically active BAT in adult humans, BAT has been extensively studied as one of the most promising targets identified for treating obesity and its related disorders. In this review, we summarize information on the developmental origin of BAT and the progenitors of brown adipocytes in WAT. We explore the transcriptional control of brown adipocyte differentiation during classical BAT development and in WAT browning. We also discuss the neuronal control of BAT activity and summarize the recently identified non-canonical stimulators of BAT that can act independently of beta-adrenergic stimulation. Finally, we review new findings on the beneficial effects of BAT activation and development with respect to improving metabolic profiles. We highlight the therapeutic potential of BAT and its future prospects, including pharmacological intervention and cell-based therapies designed to enhance BAT activity and development.
Adipocytes/cytology/metabolism ; Adipogenesis ; Adipose Tissue, Brown/cytology/metabolism/*physiology ; Animals ; Humans ; Obesity/therapy

Being a great threaten for human health, obesity has become a pandemic chronic disease. There have been several therapeutic treatments for this social health issue, including diet and exercise therapy, medication and surgery, among which the diet is still the most common way. However, none of these therapeutic measures available is ideal, making it necessary to find an effective medical treatment. The endocannabinoid system, which is well known for its contributions in certain mental processes such as relaxation, amelioration of pain and anxiety, and sedation initiation, has been recently reported to play an essential role in regulating appetite and metabolism to maintain energy balance, leading to the belief that endocannabinoid system is closely related to obesity. This new discovery deepens our understanding of obesity, and provides us with a new direction for clinical obesity treatment. Rimonabant is an antagonist for CB1, and has entered the market in some countries. However, although effective as an anti-obesity drug, rimonabant also causes obviously adverse side-effects, thus is being doubted and denied for medical usage.
Animals ; Anti-Obesity Agents ; therapeutic use ; Cannabinoid Receptor Modulators ; antagonists & inhibitors ; metabolism ; Endocannabinoids ; Humans ; Obesity ; drug therapy ; metabolism ; Piperidines ; therapeutic use ; Pyrazoles ; therapeutic use ; Receptors, Cannabinoid ; metabolism

Women have an increased tendency to gain weight after menopause. The increase of body fat and central obesity may be due to hormonal changes occurring during or after the menopausal transition. The decline of endogenous estrogen and decreased physical activity are the major causes of these phenomena. The insufficiency of estrogen? leads to decreased basal metabolic rate and energy expenditure. Postmenopausal overweight and obesity increases the risk of hypertension, coronary artery disease, diabetes, and mortality. Weight control can reduce the obesity-related diseases. Lifestyle modification is essential in managing postmenopausal overweight and obesity. Diet, behavioral modifications, and physical activity are the major elements to reduce body fat and central fat distribution. Hormone replacement therapy helps to reduce the body fatness and to attenuate the accumulation of central fat in postmenopausal women. Antiobesity drugs are also selectively used in menopausal women. In conclusion, low-calorie diet, regular physical activity and estrogen replacement are likely to provide metabolic benefits for postmenopausal women's health.
Adipose Tissue ; Anti-Obesity Agents ; Basal Metabolism ; Caloric Restriction ; Coronary Artery Disease ; Diet ; Energy Metabolism ; Estrogen Replacement Therapy ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Hypertension ; Life Style ; Menopause ; Mortality ; Motor Activity ; Obesity* ; Obesity, Abdominal ; Overweight ; Women's Health

Obesity results from an imbalance between energy intake and energy expenditure. Drugs can shift this balance in a favorable way by reducing food intake, altering metabolism, and by increasing energy expenditure. All patients with obesity should make efforts to change their lifestyle behaviors to decrease energy intake and increase physical activity. Lifestyle modifications also should be a component of all other levels of therapy. Pharmacotherapy can be a useful adjunctive measure for well-selected patients. Anti-obesity pharmacological treatment is indicated when the patient's body mass index (BMI) is >25 kg/m2 or when the patient's BMI is >23 kg/m2 with co-morbidities such as diabetes, hypertension, hypercholesterolemia, and coronary artery disease. Obesity is a chronic disease that requires long-term therapy for successful long-term weight management. Often, the patients regain their lost weight after therapy is discontinued, so it should be stressed that obesity is not a curable disease, and thus the maintenance of the reduced weight is very important. Obese patients must be examined in detail regarding mood, obesityrelated complications or conditions, current medications, eating habits, and history of drug side-effects. The physicians' choice for anti-obesity medications is based on both the patient's medical conditions and long-term safety and efficacy of antiobesity drugs.
Anti-Obesity Agents ; Body Mass Index ; Chronic Disease ; Coronary Artery Disease ; Drug Therapy ; Eating ; Energy Intake ; Energy Metabolism ; Humans ; Hypercholesterolemia ; Hypertension ; Life Style ; Metabolism ; Motor Activity ; Obesity

INTRODUCTIONDeveloping effective exercise programmes for the paediatric population is a strategy for decreasing obesity and is expected to help in eventually limiting obesity-associated long-term health and societal impact. In this study, the effects of a 12-week twice weekly additional exercise training, which comprised a combination of circuit-based resistance training and aerobic exercises, in additional to typical physical education sessions, on aerobic fitness, body composition and serum C-reactive protein (CRP) and lipids were analysed in 13- to 14-year-old obese boys contrasted with a control group.

MATERIALS AND METHODSBoth the exercise group (EG, n = 12) and control group (CG, n = 12) participated in the typical 2 sessions of 40-minute physical education (PE) per week in schools, but only EG participated in additional 2 sessions per week of 45 to 60 minutes per session of exercise training, which comprised a combination of circuit-based resistance training and aerobic exercises maintained at 65% to 85% maximum heart rate (HRmax = 220 - age). Body composition was measured using dual energy X-ray absorptiometry (DEXA). Fasting serum CRP and blood lipids were analysed pre- and postexercise programme. Aerobic fitness was measured by an objective laboratory submaximal exercise test, PWC170 (Predicted Work Capacity at HR 170 bpm).

RESULTSExercise training significantly improved lean muscle mass, body mass index, fitness, resting HR, systolic blood pressure and triglycerides in EG. Serum CRP concentrations were elevated at baseline in both groups, but training did not result in a change in CRP levels. In the CG, body weight increased significantly at the end of the 12-week period.

CONCLUSIONThis study supports the value of an additional exercise training programme, beyond the typical twice weekly physical education classes, to produce physiological benefits in the management of obesity in adolescents, including prevention of weight gain.

Adolescent ; C-Reactive Protein ; analysis ; metabolism ; Exercise Therapy ; Humans ; Lipids ; analysis ; blood ; Male ; Obesity ; physiopathology ; therapy ; Physical Fitness ; physiology

OBJECTIVETo compare the differences of clinical effects in female patients with obesity and hyperlipidemia of yang deficiency of spleen and kidney syndrome between warm acupuncture combined with auricular acupuncture and simple warm acupuncture.

METHODSOne hundred and thirty patients were randomly divided into an observation group and a control group, 65 cases in each one. In the control group, acupuncture was used at Pishu (BL 20), Zhongwan(CV 12), Shenshu(BL 23), Zhongji(CV 3), Guanyuan(CV 4), Mingmen(GV 4), Taibai(SP 3), Fenglong(ST 40), etc.; warm acupuncture was applied at Pishu(BL 20), Zhongwan(CV 12), Shenshu(BL 23) and Zhongji(CV 3); the treatment was required once every two days and for 3 months continuously. In the observation group, based on the treatment in the control group, thumbtack intradermal needles were embedded at auricular points, including pi(CO13), shen(CO10), pangguang(CO9), sanjiao(CO17), neifenmi(CO18), neishengzhiqi(TF2), etc. Obesity indices [body mass(W), obesity degree(A), body mass index(BMI), body fat percentage(F%)] blood lipid indices [serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C)] and clinical efficacy were observed before and after treatment in the two groups. Results After treatment in the two groups, the obesity indices of W, A, BMI, F% and the blood lipid levels of TC, TG, LDL-C were obviously decreased compared with those before treatment (all P<0. 01) and the HDL-C levels were apparently increased than those before treatment (both P<0. 01). After treatment, the improvement of TC and HDL-C in the observation group was superior to that in the control group (both P<0. 01). The difference was not statistically significant in the aspect of improving every obesity index between two groups (all P>. 05). The comprehensive total effective rate of the observation group was 95.4% (62/65), which was better than 84. 6% (55/65) of the control group (P<0. 001).

CONCLUSIONWarm acupuncture combined with auricular acupuncture and simple warm acupuncture can both benignly adjust abnormal lipid metabolism of obesity patients with hyperlipidemia, and warm acupuncture combined with auricular acupuncture are superior to simple warm acupuncture treatment on antiobesity action and improving the TC and HDL-C levels.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adult ; Blood Glucose ; metabolism ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Kidney ; physiopathology ; Middle Aged ; Obesity ; metabolism ; physiopathology ; therapy ; Spleen ; physiopathology ; Triglycerides ; metabolism ; Yang Deficiency ; metabolism ; physiopathology ; therapy ; Young Adult

OBJECTIVETo explore the efficacy and effect mechanism of the combined therapy of acupuncture and tapping method in the treatment of obesity and hyperlipidemia of liver qi stagnation and spleen deficiency pattern in the patients.

METHODSOne hundred and four female patients were randomized into a combined therapy of acupuncture and tapping (combined therapy group) group method and an acupuncture group, 52 cases in each group. In the acupuncture group, acupuncture was applied to Qimen (LR 14), Taichong (LR 3), Zhangmen (LR 13), Taibai (SP 3), Zusanli (ST 36), Geshu (BL 17), Ganshu (BL 18), Pishu (BL 20), etc. In the combined therapy group, on the basis of acupuncture treatment, the tapping method with plum blossom needle was used at each acupoint. The treatment was given once every two days, continuously for 3 months in the two groups. The indices were observed, including the obesity indices, such as body mass, body mass index (BMI), body fat percentage (F%) and obesity degree (A); the blood lipid levels such as total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL); the fat-islet axie relevant indices such as fasting plasma glucose (FBS), fasting leptin (FLP), fasting insulin (FINS), insulin sensitive index (ISI), insulin resistance in- dex (Homa IR), insulin secretion index (Homa-β) and autonomic nerve function index (Y value) before and after treatment in the patients of two groups. The efficacy was compared between the two groups.

RESULTSThe total effective rates were 96.2% (50/52) and 84.6% (44/52) in the combined therapy group and the acupuncture group respectively, without significant difference in comparison (P > 0.05). Obesity indices, blood lipid indices, fat-islet axie relevant indices and autonomic nerve function indices were all improved after treatment as compared with those before treatment in the two groups (P < 0.01, P < 0.05), and the improvements in the combined therapy group were much more significant (P < 0.01, P < 0.05).

CONCLUSIONThe combined therapy of acupuncture and tapping method achieves the double effects of weight loss and lipid loss in the treatment of obesity combined with hyperlipidemia. The effect mechanism is possibly related to the positive regulations of blood glucose, lipid metabolism and fat-islet axie in the patients.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Blood Glucose ; metabolism ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Insulin ; metabolism ; Leptin ; metabolism ; Liver ; physiopathology ; Middle Aged ; Obesity ; metabolism ; physiopathology ; therapy ; Qi ; Spleen ; physiopathology ; Treatment Outcome ; Triglycerides ; metabolism ; Young Adult

Obesity, which underlies various metabolic and cardiovascular diseases, is a growing public health challenge for which established therapies are inadequate. Given the current obesity epidemic, there is a pressing need for more novel therapeutic strategies that will help adult individuals to manage their weight. One promising therapeutic intervention for reducing obesity is to enhance energy expenditure. Investigations into human brown fat and the recently discovered beige/brite fat have galvanized intense research efforts during the past decade because of their pivotal roles in energy dissipation. In this review, we summarize the evolution of human brown adipose tissue (hBAT) research and discuss new in vivo methodologies for evaluating energy expenditure in patients. We highlight the differences between human and mouse BAT by integrating and comparing their cellular morphology, function, and gene expression profiles. Although great advances in hBAT biology have been achieved in the past decade, more cellular models are needed to acquire a better understanding of adipose-specific processes and molecular mechanisms. Thus, this review also describes the development of a human brown fat cell line, which could provide promising mechanistic insights into hBAT function, signal transduction, and development. Finally, we focus on the therapeutic potential and current limitations of hBAT as an anti-glycemic, anti-lipidemic, and weight loss-inducing 'metabolic panacea'.
Adipose Tissue, Beige ; metabolism ; pathology ; Adipose Tissue, Brown ; metabolism ; pathology ; Animals ; Cell Line ; Energy Metabolism ; Humans ; Mice ; Obesity ; metabolism ; pathology ; therapy