OBJECTIVE: To observe the clinical efficacy of acupoint thread-embedding for overweight and obese young adults with phlegm-dampness constitution. METHODS: A total of 66 young adults with overweight and obesity of phlegm-dampness constitution were randomly divided into an observation group (33 cases, 2 cases dropped out, 1 case was discontinued) and a control group (33 cases, 3 cases dropped out). Health education guidance was adopted in the control group. On the basis of the intervention in the control group, acupoint thread-embedding was applied in the observation group, two groups of acupoints were used alternately, i.e. bilateral Tianshu (ST25), Daheng (SP15), Daimai (GB26), Shuidao (ST28), Huaroumen (ST24), Fenglong (ST40) and bilateral Feishu (BL13), Geshu (BL17), Weiwanxiashu (EX-B3), Pishu (BL20), Shenshu (BL23), Dachangshu (BL25), once a week. Treatment of 8 weeks was required in the two groups. Before treatment, after 4 weeks and 8 weeks of treatment, the body weight, body fat rate, waist circumference and hip circumference were measured, and the body mass index (BMI) was calculated in the two groups; before and after treatment, the phlegm-dampness constitution score and the heart rate variability (HRV) related indexes (total power [TP], low frequency [LF], high frequency [HF], LF/HF, standard deviation of the normal to normal inter beat intervals [SDNN], root mean square of the successive differences [RMSSD], percentage of normal RR intervals with duration [PNN50]) were observed, and the clinical efficacy and constitution improvement rate were compared in the two groups. Six months after the treatment completion, the body weight of patients with effective clinical efficacy was observed, and the body weight rebound rate was compared in the two groups. RESULTS: After 4 weeks of treatment, the body weight, BMI, body fat rate, waist circumference and hip circumference were decreased compared with those before treatment in the two groups (P<0.05); after 8 weeks of treatment, the body weight, BMI, body fat rate, waist circumference and hip circumference were decreased compared with those before treatment and after 4 weeks of treatment in the observation group (P<0.05), and the body weight was decreased compared with that before treatment in the control group (P<0.05). After 8 weeks of treatment, the body weight, BMI, waist circumference, hip circumference and phlegm-dampness constitution score in the observation group were lower than those in the control group (P<0.05). The differences in the body weight, BMI, body fat rate, waist circumference and hip circumference between before treatment and after 4 weeks of treatment, as well as after 4 weeks of treatment and after 8 weeks of treatment in the observation group were higher than those in the control group (P<0.05). After treatment, the TP, LF, HF, SDNN and RMSSD in the observation group were higher than those in the control group (P<0.05). After treatment, the total effective rate was 90.0% (27/30) in the observation group, which was higher than 46.7% (14/30) in the control group (P<0.05); the improvement rate of phlegm-dampness constitution was 90.0% (27/30) in the observation group, which was higher than 50.0% (15/30) in the control group (P<0.05). Six months after treatment completion, the weight rebound rate was 37.0% (10/27) in the observation group, which was lower than 71.4% (10/14) in the control group (P<0.05). CONCLUSION Acupoint thread-embedding can effectively reduce the body weight, BMI, waist circumference, hip circumference and improve the phlegm-dampness constitution in overweight and obese young adults with phlegm-dampness constitution, regulate autonomic nerve disorders and improve vagus nerve activity, and has a certain long-term effect.
Humans ; Acupuncture Points ; Female ; Male ; Adult ; Obesity/physiopathology* ; Young Adult ; Acupuncture Therapy ; Overweight/physiopathology* ; Treatment Outcome ; Adolescent

OBJECTIVES: To compare the effect of different frequency of acupoint thread-embedding on weight loss in subjects with overweight/obesity of spleen deficiency and dampness retention. METHODS: A total of 126 subjects with overweight/obesity of spleen deficiency and dampness retention were randomized into a 2-week group(63 cases, 13 cases dropped out)and a 3-week group(63 cases, 11 cases dropped out, 1 case was eliminated). The two groups were treated with acupoint thread-embedding once every 2 weeks and once every 3 weeks respectively, Zhongwan(CV 12), Shuifen(CV 9), Qihai(CV 6), Guanyuan(CV 4) and bilateral Zhangmen(LR 13), Tianshu(ST 25), Liangmen(ST 21), Daheng(SP 15), Fujie(SP 14), Pishu(BL 20), Yinlingquan(SP 9)were selected. Four times were required in the two groups. Before and after treatment, follow-up after 2 months of treatment completion, the body mass index(BMI), body weight, waist circumference, hip circumference, waist-to-hip ratio, obesity degree, fat percentage(F%), skin fold thickness were observed in the two groups. RESULTS: After treatment and in follow-up, the BMI, body weight, waist circumference, hip circumference, waist-to-hip ratio, obesity degree, F%, skin fold thickness in the two groups were decreased compared with those before treatment (P<0.001, P<0.01), the changes of BMI, body weight, obesity degree, F%, skin fold thickness in the 2-week group were larger than those in the 3-week group(P<0.05, P<0.01, P<0.001). CONCLUSIONS The effect of acupoint thread-embedding once every 2 weeks on weight loss in subjects with overweight/obesity of spleen deficiency and dampness retention is superior to that once every 3 weeks.
Humans ; Acupuncture Points ; Overweight/therapy* ; Spleen ; Obesity/therapy* ; Body Weight ; Acupuncture Therapy ; Weight Loss

Lingguizhugan Decoction (LGZG) has been investigated in basic studies, with satisfactory effects on insulin resistance in non-alcoholic fatty liver disease (NAFLD). This translational approach aimed to explore the effect and underlying mechanism of LGZG in clinical setting. A randomized, double-blinded, placebo-controlled trial was performed. A total of 243 eligible participants with NAFLD were equally allocated to receive LGZG (two groups: standard dose and low dose) or placebo for 12 weeks on the basis of lifestyle modifications. The primary efficacy variable was homeostasis model assessment of insulin resistance (HOMA-IR). Analyses were performed in two populations in accordance with body mass index (BMI; overweight/obese, BMI ⩾ 24 kg/m²; lean, BMI < 24 kg/m²). For overweight/obese participants, low-dose LGZG significantly decreased their HOMA-IR level compared with placebo (-0.19 (1.47) versus 0.08 (1.99), P = 0.038). For lean subjects, neither dose of LGZG showed a superior effect compared with placebo. Methylated DNA immunoprecipitation sequencing and real-time qPCR found that the DNA N6-methyladenine modification levels of protein phosphatase 1 regulatory subunit 3A (PPP1R3A) and autophagy related 3 (ATG3) significantly increased after LGZG intervention in overweight/obese population. Low-dose LGZG effectively improved insulin resistance in overweight/obese subjects with NAFLD. The underlying mechanism may be related to the regulation of DNA N6-methyladenine modification of PPP1R3A and ATG3. Lean subjects may not be a targeted population for LGZG.
Humans ; Non-alcoholic Fatty Liver Disease/drug therapy* ; Overweight/drug therapy* ; Insulin Resistance ; Obesity/drug therapy* ; China ; DNA/therapeutic use*

OBJECTIVE: To measure the dangerous depth and the effective safe depth of needling at acupoints of kidney regions based on MRI imaging, and to provide the imaging support for clinical practice. METHODS: The abdominal enhanced T1 MRI imaging of horizontal plane of 61 healthy subjects was included, the anatomical structure of bilateral Weishu (BL 21), Sanjiaoshu (BL 22), Shenshu (BL 23), Weicang (BL 50), Huangmen (BL 51) and Zhishi (BL 52) was analyzed, and the dangerous depth and effective safe depth of perpendicular and oblique needling were measured between the left and right sides and subjects with different body sizes. RESULTS: There were no significant differences between dangerous depth and effective safe depth of perpendicular and oblique needling at bilateral acupoints of kidney region (P>0.05). The dangerous depth and effective safe depth of perpendicular and oblique needling at bilateral acupoints of kidney region in the moderate group were larger than the underweight group (P<0.05), while those in the overweight group were larger than the moderate group and the underweight group (P<0.05). CONCLUSION The safe depth of needling at acupoints of kidney region is related to body size, for moderate weight and overweight patients, the needling depth could be increased for better efficacy, while for underweight patients, the recommend direction and depth of needling should be restricted to avoid acupuncture accident.
Acupuncture Points ; Acupuncture Therapy/methods* ; Humans ; Kidney/diagnostic imaging* ; Magnetic Resonance Imaging ; Overweight ; Thinness

BACKGROUND: Obesity and insulin resistance (IR) are common features of polycystic ovary syndrome (PCOS). Metformin (MET) increases insulin sensitivity, but it is associated with unsatisfactory weight loss. The glucagon-like peptide-1 receptor agonist exenatide has been shown to reduce weight and IR in patients with diabetes. This study aimed to explore the therapeutic effects of exenatide once-weekly (QW) combined with MET on body weight, as well as metabolic and endocrinological parameters in overweight/obese women with PCOS. METHODS: Fifty overweight/obese women with PCOS diagnosed via the Rotterdam criteria were randomized to one of two treatment groups: MET (500 mg three times a day [TID]) or combination treatment (COM) (MET 500 mg TID, exenatide 2 mg QW) for 12 weeks. The primary outcomes were anthropometric changes associated with obesity, and the secondary outcomes included changes in reproductive hormone levels, glucose and lipid metabolism, and C-reactive protein. RESULTS: Forty (80%) patients completed the study. COM therapy was superior to MET monotherapy in reducing weight (P = 0.045), body mass index (BMI) (P = 0.041), and waist circumference (P = 0.023). Patients in the COM group on an average lost 3.8 ± 2.4 kg compared with 2.1 ± 3.0 kg in the MET group. In the COM group, BMI and waist circumference decreased by 1.4 ± 0.87 kg/m2 and 4.63 ± 4.42 cm compared with 0.77 ± 1.17 kg/m2 and 1.72 ± 3.07 cm in the MET group, respectively. Moreover, levels of fasting glucose, oral glucose tolerance test (OGTT) 2-h glucose, and OGTT 2-h insulin were significantly lower with COM therapy than with MET (P < 0.050). Mild and moderate gastrointestinal reactions were the most common adverse events in both groups. CONCLUSIONS: COM therapy was more effective than MET alone in reducing body weight, BMI, and waist circumference, and improving insulin sensitivity in overweight/obese women with PCOS, with acceptable short-term side effects. TRIAL REGISTRATION ClinicalTrials.gov, NCT04029272. https://clinicaltrials.gov/ct2/show/NCT04029272.
Exenatide/therapeutic use* ; Female ; Humans ; Metformin/therapeutic use* ; Obesity/drug therapy* ; Overweight ; Polycystic Ovary Syndrome/drug therapy*

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.
Adolescent ; Bariatric Surgery ; Child ; Diagnosis* ; Diet ; Drug Therapy ; Gastroenterology* ; Humans ; Korea ; Life Style ; Mental Health ; Obesity ; Overweight ; Pediatric Obesity*

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.
Adolescent ; Bariatric Surgery ; Child ; Diagnosis* ; Diet ; Drug Therapy ; Gastroenterology* ; Humans ; Korea ; Life Style ; Mental Health ; Obesity ; Overweight ; Pediatric Obesity*

PURPOSE: This study was aimed at identifying the influence of initial weight and weight change during neoadjuvant chemotherapy (NAC) on pathologic complete response (pCR) and long-term survival in Chinese patients with operable breast cancer. METHODS: We conducted a retrospective study using data from 409 female patients who received NAC for stage II or III breast cancer and had complete record of body mass index (BMI) before and after NAC. BMI of < 25 kg/m² was categorized as normal weight/underweight (NW/UW); 25.0–29.9 kg/m² was categorized as overweight (OW); ≥30 kg/m² was categorized as obese (OB). BMI change was defined as the difference in BMI between day 1 of the first cycle of NAC and the day before surgery. A BMI gain or loss of > 2 kg/m² following NAC was considered to be significant, else was considered stable. The study end points included pCR rates, disease-free survival (DFS), and overall survival (OS). RESULTS: The median follow-up time was 43.2 (8.9–93.6) months. The average BMI was 23.40 ± 3.04 kg/m² before NAC and 23.66 ± 3.02 kg/m² after NAC (t = −3.604, p < 0.001). The pCR rate was 25.3% in the NW/UW group and 24.1% in the OW/OB group (p = 0.811), and was similar between the BMI-gain (23.3%) and the BMI-stable/loss (25.1%) groups (p = 0.787). Initial BMI was an independent prognostic factor for DFS (hazard ratio, 1.69; 95% confidence interval [CI], 1.13–2.53; p = 0.011) but not for OS, while BMI-gain was an independent prognostic factor for both DFS (hazard ratio, 2.09; 95% CI, 1.28–3.42; p = 0.003) and OS (hazard ratio, 1.97; 95% CI, 1.04–3.74; p = 0.039). CONCLUSION: BMI increased after NAC in Chinese breast cancer patients. Initial BMI and BMI change during NAC were not associated with pCR but were reversely associated with survival.
Asian Continental Ancestry Group ; Body Mass Index ; Breast Neoplasms ; Breast ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Neoadjuvant Therapy ; Overweight ; Polymerase Chain Reaction ; Retrospective Studies ; Weight Gain

Mindfulness training is growing in popularity as an adjunctive intervention in disordered eating and weight loss. Lifestyle modification, pharmacologic treatment, and surgical intervention have been widely used for weight reduction in obese persons, but these modifications are sometimes insufficient. In particular, stress-induced eating and binge-eating disorder have been frequently associated with increased risk of regaining weight. Initial research suggests that mindfulness training may be an effective intervention for binge eating. In this article, we reviewed 19 studies that investigated mindfulness training as an intervention for weight change and/or emotional eating. Results suggest that mindfulness training effectively decreases emotional eating in persons with good adherence to the training; evidence for its effect on weight reduction, however, is mixed. Further large-scale studies are warranted to explore the effectiveness of mindfulness training on long-term weight loss and emotional eating in persons with obesity.
Binge-Eating Disorder ; Bulimia ; Cognitive Therapy ; Eating ; Humans ; Life Style ; Mindfulness ; Obesity ; Overweight ; Weight Loss ; Weight Reduction Programs

There is not a set percentage of calories from carbohydrate, protein, and fat for all people with diabetes. It is recommended that diet be individualized according to each patient's eating patterns, preferences, and metabolic goals. Overweight or obese patients with diabetes could improve their insulin sensitivity, glycemia, blood pressure and dyslipidemia via weight loss. Therefore, various dietary patterns have been tried for weight and glucose control. The Ketogenic diet includes very low-carbohydrate and high fat and is known to be effective for weight loss in a short period of time. Short-term studies have demonstrated the effects of the Ketogenic diet on weight loss and glycemic control improvement, but long-term studies are not yet sufficient. In addition, various side effects such as hypoglycemia and nutritional imbalances are concerns, so there is a lack of evidence with respect to recommending this diet as nutrition therapy for diabetics.
Blood Pressure ; Diet ; Dyslipidemias ; Eating ; Glucose ; Humans ; Hypoglycemia ; Insulin Resistance ; Ketogenic Diet ; Nutrition Therapy ; Overweight ; Weight Loss