International Journal of Endocrinology and Metabolism

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Complementary and Alternative Medicine for the Treatment of Obesity: A Critical Review

Alireza Esteghamati 1 , * , Tina Mazaheri 1 , Mona Vahidi Rad 1 and Sina Noshad 1
Authors Information
1 Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
Article information
  • International Journal of Endocrinology and Metabolism: April 01, 2015, 13 (2); e19678
  • Published Online: April 20, 2015
  • Article Type: Review Article
  • Received: April 24, 2014
  • Revised: September 3, 2014
  • Accepted: December 2, 2014
  • DOI: 10.5812/ijem.19678

To Cite: Esteghamati A, Mazaheri T, Vahidi Rad M, Noshad S. Complementary and Alternative Medicine for the Treatment of Obesity: A Critical Review, Int J Endocrinol Metab. 2015 ; 13(2):e19678. doi: 10.5812/ijem.19678.

Copyright © 2015, Research Institute For Endocrine Sciences and Iran Endocrine Society. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Context
2. Evidence Acquisition
3. Results
4. Conclusions
  • 1. Alwan A. Global status report on noncommunicable diseases 2010. 2011;
  • 2. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. Jama. 2001; 286(10)
  • 3. Chandrasekaran C, Vijayalakshmi M, Prakash K, Bansal V, Meenakshi J, Amit A. Review Article: Herbal Approach for Obesity Management. Am J Plant Sci. 2013; 3
  • 4. Obesity: The Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. 2006; [PubMed]
  • 5. Hurt RT, Kulisek C, Buchanan LA, McClave SA. The obesity epidemic: challenges, health initiatives, and implications for gastroenterologists. Gastroenterol Hepatol (N Y). 2010; 6(12): 780-92[PubMed]
  • 6. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003; 348(17): 1625-38[DOI][PubMed]
  • 7. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med. 2001; 161(13): 1581-6[PubMed]
  • 8. Kannel WB, Adrienne Cupples L, Ramaswami R, Stokes III J, Kreger BE, Higgins M. Regional obesity and risk of cardiovascular disease; the Framingham Study. clinical epidemiology J. 1991; 44(2): 183-90
  • 9. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346(6): 393-403[DOI][PubMed]
  • 10. Marmot M, Atinmo T, Byers T, Chen J, Hirohata T, Jackson A, et al. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. UCL Discovery. 2007;
  • 11. Sui Y, Zhao HL, Wong VC, Brown N, Li XL, Kwan AK, et al. A systematic review on use of Chinese medicine and acupuncture for treatment of obesity. Obes Rev. 2012; 13(5): 409-30[DOI][PubMed]
  • 12. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006; 3(11)[DOI][PubMed]
  • 13. Organization WH . Global health risks: mortality and burden of disease attributable to selected major risks. 2009;
  • 14. Organization WH . Global recommendations on physical activity for health. 2010;
  • 15. Ezzati M, Organization WH. . Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. 1
  • 16. Mitchell NS, Catenacci VA, Wyatt HR, Hill JO. Obesity: overview of an epidemic. Psychiatr Clin North Am. 2011; 34(4): 717-32[DOI][PubMed]
  • 17. Health NIo . Complementary, Alternative, or Integrative Health: What's In a Name? 2014;
  • 18. Sharpe PA, Blanck HM, Williams JE, Ainsworth BE, Conway JM. Use of complementary and alternative medicine for weight control in the United States. J Altern Complement Med. 2007; 13(2): 217-22[DOI][PubMed]
  • 19. Astell KJ, Mathai ML, Su XQ. A Review on Botanical Species and Chemical Compounds with Appetite Suppressing Properties for Body Weight Control. Plant Foods for Human Nutrition. 2013; 68(3): 213-21[DOI]
  • 20. Haller CA, Duan M, Benowitz NL, Jacob P3. Concentrations of ephedra alkaloids and caffeine in commercial dietary supplements. J Anal Toxicol. 2004; 28(3): 145-51[PubMed]
  • 21. Triscari J, Sullivan AC. Anti-obesity activity of a novel lipid synthesis inhibitor. Int J Obes. 1984; 8 Suppl 1: 227-39[PubMed]
  • 22. Marquez F, Babio N, Bullo M, Salas-Salvado J. Evaluation of the safety and efficacy of hydroxycitric acid or Garcinia cambogia extracts in humans. Crit Rev Food Sci Nutr. 2012; 52(7): 585-94[DOI][PubMed]
  • 23. Preuss HG, Rao CV, Garis R, Bramble JD, Ohia SE, Bagchi M, et al. An overview of the safety and efficacy of a novel, natural(-)-hydroxycitric acid extract (HCA-SX) for weight management. J Med. 2004; 35(1-6): 33-48[PubMed]
  • 24. Heymsfield SB, Allison DB, Vasselli JR, Pietrobelli A, Greenfield D, Nunez C. Garcinia cambogia (hydroxycitric acid) as a potential antiobesity agent: a randomized controlled trial. JAMA. 1998; 280(18): 1596-600[PubMed]
  • 25. Kovacs EM, Westerterp-Plantenga MS, de Vries M, Brouns F, Saris WH. Effects of 2-week ingestion of (-)-hydroxycitrate and (-)-hydroxycitrate combined with medium-chain triglycerides on satiety and food intake. Physiol Behav. 2001; 74(4-5): 543-9[PubMed]
  • 26. Mattes RD, Bormann L. Effects of (-)-hydroxycitric acid on appetitive variables. Physiol Behav. 2000; 71(1-2): 87-94[PubMed]
  • 27. Vasques CA, Rossetto S, Halmenschlager G, Linden R, Heckler E, Fernandez MS, et al. Evaluation of the pharmacotherapeutic efficacy of Garcinia cambogia plus Amorphophallus konjac for the treatment of obesity. Phytother Res. 2008; 22(9): 1135-40[DOI][PubMed]
  • 28. Onakpoya I, Hung SK, Perry R, Wider B, Ernst E. The Use of Garcinia Extract (Hydroxycitric Acid) as a Weight loss Supplement: A Systematic Review and Meta-Analysis of Randomised Clinical Trials. J Obes. 2011; 2011: 509038[DOI][PubMed]
  • 29. Wolfram S, Wang Y, Thielecke F. Anti-obesity effects of green tea: from bedside to bench. Mol Nutr Food Res. 2006; 50(2): 176-87[DOI][PubMed]
  • 30. Rains TM, Agarwal S, Maki KC. Antiobesity effects of green tea catechins: a mechanistic review. J Nutr Biochem. 2011; 22(1): 1-7[DOI][PubMed]
  • 31. Jurgens TM, Whelan AM, Killian L, Doucette S, Kirk S, Foy E. Green tea for weight loss and weight maintenance in overweight or obese adults. Cochrane Database Syst Rev. 2012; 12[DOI][PubMed]
  • 32. Gregersen NT, Bitz C, Krog-Mikkelsen I, Hels O, Kovacs EM, Rycroft JA, et al. Effect of moderate intakes of different tea catechins and caffeine on acute measures of energy metabolism under sedentary conditions. Br J Nutr. 2009; 102(8): 1187-94[DOI][PubMed]
  • 33. Kovacs EM, Lejeune MP, Nijs I, Westerterp-Plantenga MS. Effects of green tea on weight maintenance after body-weight loss. Br J Nutr. 2004; 91(3): 431-7[DOI][PubMed]
  • 34. Nagao T, Hase T, Tokimitsu I. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity (Silver Spring). 2007; 15(6): 1473-83[DOI][PubMed]
  • 35. Wang H, Wen Y, Du Y, Yan X, Guo H, Rycroft JA, et al. Effects of catechin enriched green tea on body composition. Obesity (Silver Spring). 2010; 18(4): 773-9[DOI][PubMed]
  • 36. Maki KC, Reeves MS, Farmer M, Yasunaga K, Matsuo N, Katsuragi Y, et al. Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults. J Nutr. 2009; 139(2): 264-70[DOI][PubMed]
  • 37. Auvichayapat P, Prapochanung M, Tunkamnerdthai O, Sripanidkulchai B, Auvichayapat N, Thinkhamrop B, et al. Effectiveness of green tea on weight reduction in obese Thais: A randomized, controlled trial. Physiology & Behavior. 2008; 93(3): 486-91[DOI]
  • 38. Docherty JP, Sack DA, Roffman M, Finch M, Komorowski JR. A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving. J Psychiatr Pract. 2005; 11(5): 302-14[PubMed]
  • 39. Drake TC, Rudser KD, Seaquist ER, Saeed A. Chromium infusion in hospitalized patients with severe insulin resistance: a retrospective analysis. Endocr Pract. 2012; 18(3): 394-8[DOI][PubMed]
  • 40. Tian H, Guo X, Wang X, He Z, Sun R, Ge S, et al. Chromium picolinate supplementation for overweight or obese adults. Cochrane Database Syst Rev. 2013; 11[DOI][PubMed]
  • 41. Rainer L, Heiss CJ. Conjugated linoleic acid: health implications and effects on body composition. J Am Diet Assoc. 2004; 104(6): 963-8[DOI][PubMed]
  • 42. Pariza MW, Park Y, Cook ME. The biologically active isomers of conjugated linoleic acid. Prog Lipid Res. 2001; 40(4): 283-98[PubMed]
  • 43. Gaullier JM, Halse J, Hoye K, Kristiansen K, Fagertun H, Vik H, et al. Conjugated linoleic acid supplementation for 1 y reduces body fat mass in healthy overweight humans. Am J Clin Nutr. 2004; 79(6): 1118-25[PubMed]
  • 44. Kamphuis MM, Lejeune MP, Saris WH, Westerterp-Plantenga MS. The effect of conjugated linoleic acid supplementation after weight loss on body weight regain, body composition, and resting metabolic rate in overweight subjects. Int J Obes Relat Metab Disord. 2003; 27(7): 840-7[DOI][PubMed]
  • 45. Zambell KL, Keim NL, Van Loan MD, Gale B, Benito P, Kelley DS, et al. Conjugated linoleic acid supplementation in humans: effects on body composition and energy expenditure. Lipids. 2000; 35(7): 777-82[PubMed]
  • 46. Onakpoya IJ, Posadzki PP, Watson LK, Davies LA, Ernst E. The efficacy of long-term conjugated linoleic acid (CLA) supplementation on body composition in overweight and obese individuals: a systematic review and meta-analysis of randomized clinical trials. Eur J Nutr. 2012; 51(2): 127-34[DOI][PubMed]
  • 47. Lee RA, Balick MJ. Indigenous use of Hoodia gordonii and appetite suppression. Explore (NY). 2007; 3(4): 404-6[DOI][PubMed]
  • 48. Vermaak I, Hamman JH, Viljoen AM. Hoodia gordonii: an up-to-date review of a commercially important anti-obesity plant. Planta Med. 2011; 77(11): 1149-60[DOI][PubMed]
  • 49. MacLean DB, Luo LG. Increased ATP content/production in the hypothalamus may be a signal for energy-sensing of satiety: studies of the anorectic mechanism of a plant steroidal glycoside. Brain Res. 2004; 1020(1-2): 1-11[DOI][PubMed]
  • 50. Lu Y, Teng HL, Yang GZ, Mei ZN. Three New Steroidal Glycosides from the Roots of Cynanchum auriculatum. Molecules. 2011; 16(12): 1901-9[DOI]
  • 51. Gu XJ, Yao N, Qian SH, Li YB, Li P. Four New C21Steroidal Glycosides from the Roots ofCynanchum auriculatum. Helvetica Chimica Acta. 2009; 92(1): 88-97[DOI]
  • 52. Liu S, Chen Z, Wu J, Wang L, Wang H, Zhao W. Appetite suppressing pregnane glycosides from the roots of Cynanchum auriculatum. Phytochemistry. 2013; 93: 144-53[DOI][PubMed]
  • 53. Baldrick P. The safety of chitosan as a pharmaceutical excipient. Regul Toxicol Pharmacol. 2010; 56(3): 290-9[DOI][PubMed]
  • 54. Han LK, Kimura Y, Okuda H. Reduction in fat storage during chitin-chitosan treatment in mice fed a high-fat diet. Int J Obes Relat Metab Disord. 1999; 23(2): 174-9[PubMed]
  • 55. Sumiyoshi M, Kimura Y. Low molecular weight chitosan inhibits obesity induced by feeding a high-fat diet long-term in mice. J Pharm Pharmacol. 2006; 58(2): 201-7[DOI][PubMed]
  • 56. Thanou M, Verhoef JC, Junginger HE. Oral drug absorption enhancement by chitosan and its derivatives. Adv Drug Deliv Rev. 2001; 52(2): 117-26[PubMed]
  • 57. Zhang J, Liu J, Li L, Xia W. Dietary chitosan improves hypercholesterolemia in rats fed high-fat diets. Nutr Res. 2008; 28(6): 383-90[DOI][PubMed]
  • 58. Kumar SG, Rahman MA, Lee SH, Hwang HS, Kim HA, Yun JW. Plasma proteome analysis for anti-obesity and anti-diabetic potentials of chitosan oligosaccharides in ob/ob mice. Proteomics. 2009; 9(8): 2149-62[DOI][PubMed]
  • 59. Rahman M, Kumar SG, Yun JW. Proteome analysis in adipose tissue of ob/ob mice in response to chitosan oligosaccharides treatment. Biotechnology and Bioprocess Engineering. 2010; 15(4): 559-71[DOI]
  • 60. Ni Mhurchu C, Dunshea-Mooij CAE, Bennett D, Rodgers A, Ni Mhurchu C. Chitosan for overweight or obesity. 2005; [DOI]
  • 61. Hasani-Ranjbar S, Nayebi N, Larijani B, Abdollahi M. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. World J Gastroenterol. 2009; 15(25): 3073-85[PubMed]
  • 62. Joyal SV. A perspective on the current strategies for the treatment of obesity. Curr Drug Targets CNS Neurol Disord. 2004; 3(5): 341-56[PubMed]
  • 63. Kang JW, Nam D, Kim KH, Huh JE, Lee JD. Effect of Gambisan on the Inhibition of Adipogenesis in 3T3-L1 Adipocytes. Evid Based Complement Alternat Med. 2013; 2013: 789067[DOI][PubMed]
  • 64. NIH Consensus Conference. Acupuncture. JAMA. 1998; 280(17): 1518-24[PubMed]
  • 65. Belivani M, Dimitroula C, Katsiki N, Apostolopoulou M, Cummings M, Hatzitolios AI. Acupuncture in the treatment of obesity: a narrative review of the literature. Acupunct Med. 2013; 31(1): 88-97[DOI][PubMed]
  • 66. Cabioglu MT, Ergene N. Changes in serum leptin and beta endorphin levels with weight loss by electroacupuncture and diet restriction in obesity treatment. Am J Chin Med. 2006; 34(1): 1-11[DOI][PubMed]
  • 67. Gucel F, Bahar B, Demirtas C, Mit S, Cevik C. Influence of acupuncture on leptin, ghrelin, insulin and cholecystokinin in obese women: a randomised, sham-controlled preliminary trial. Acupunct Med. 2012; 30(3): 203-7[DOI][PubMed]
  • 68. Yin S, Lin-shan Z. Therapeutic idea and approaches to obesity with acupuncture. Journal of Acupuncture and Tuina Science. 2005; 3(4): 54-7[DOI]
  • 69. Sun Q, Xu Y. Simple obesity and obesity hyperlipemia treated with otoacupoint pellet pressure and body acupuncture. J Tradit Chin Med. 1993; 13(1): 22-6[PubMed]
  • 70. Tuǧrul Cabıoǧlu M, Ergene N. Electroacupuncture Therapy for Weight Loss Reduces Serum Total Cholesterol, Triglycerides, and LDL Cholesterol Levels in Obese Women. The American Journal of Chinese Medicine. 2005; 33(4): 525-33[DOI]
  • 71. Abdi H, Zhao B, Darbandi M, Ghayour-Mobarhan M, Tavallaie S, Rahsepar AA, et al. The effects of body acupuncture on obesity: anthropometric parameters, lipid profile, and inflammatory and immunologic markers. ScientificWorldJournal. 2012; 2012: 603539[DOI][PubMed]
  • 72. Abdallah Ismail N, Ragab SH, Abd Elbaky A, Shoeib AR, Alhosary Y, Fekry D. Frequency of Firmicutes and Bacteroidetes in gut microbiota in obese and normal weight Egyptian children and adults. Arch Med Sci. 2011; 7(3): 501-7[DOI][PubMed]
  • 73. Cho SH, Lee JS, Thabane L, Lee J. Acupuncture for obesity: a systematic review and meta-analysis. Int J Obes (Lond). 2009; 33(2): 183-96[DOI][PubMed]
  • 74. Lin XM, Li B, Du YH, Xiong J, Sun P. [Systematic evaluation of therapeutic effect of acupuncture for treatment of simple obesity]. Zhongguo Zhen Jiu. 2009; 29(10): 856-60[PubMed]
  • 75. Liang F, Koya D. Acupuncture: is it effective for treatment of insulin resistance? Diabetes Obes Metab. 2010; 12(7): 555-69[DOI][PubMed]
  • 76. Khan R, Ahmed A, Ismail FW, Abid S, Awan S, Shah H, et al. Perception and knowledge about dietary intake in patients with liver cirrhosis and its relationship with the level of education. J Coll Physicians Surg Pak. 2012; 22(7): 435-9
  • 77. Shaping B, Reduction C. Technology Proliferation Driven by Demand. 2009;
  • 78. Bernstein G, Hanke CW. Safety of liposuction: a review of 9478 cases performed by dermatologists. J Dermatol Surg Oncol. 1988; 14(10): 1112-4[PubMed]
  • 79. Mulholland RS, Paul MD, Chalfoun C. Noninvasive body contouring with radiofrequency, ultrasound, cryolipolysis, and low-level laser therapy. Clin Plast Surg. 2011; 38(3): 503-20[DOI][PubMed]
  • 80. Saedi N, Kaminer M. New waves for fat reduction: high-intensity focused ultrasound. Semin Cutan Med Surg. 2013; 32(1): 26-30[PubMed]
  • 81. Shalom A, Wiser I, Brawer S, Azhari H. Safety and Tolerability of a Focused Ultrasound Device for Treatment of Adipose Tissue in Subjects Undergoing Abdominoplasty: A Placebo-Control Pilot Study. Dermatologic Surgery. 2013; 39(5): 744-51[DOI]
  • 82. Zhou YF. High intensity focused ultrasound in clinical tumor ablation. World J Clin Oncol. 2011; 2(1): 8-27[DOI][PubMed]
  • 83. Stephan PJ, Kenkel JM. Updates and advances in liposuction. Aesthet Surg J. 2010; 30(1): 83-97[DOI][PubMed]
  • 84. Teitelbaum SA, Burns JL, Kubota J, Matsuda H, Otto MJ, Shirakabe Y, et al. Noninvasive body contouring by focused ultrasound: safety and efficacy of the Contour I device in a multicenter, controlled, clinical study. Plast Reconstr Surg. 2007; 120(3): 779-89[DOI][PubMed]
  • 85. Nestor MS, Newburger J, Zarraga MB. Body contouring using 635-nm low level laser therapy. Semin Cutan Med Surg. 2013; 32(1): 35-40[PubMed]
  • 86. Jackson RF, Stern FA, Neira R, Ortiz-Neira CL, Maloney J. Application of low-level laser therapy for noninvasive body contouring. Lasers Surg Med. 2012; 44(3): 211-7[DOI][PubMed]
  • 87. Avci P, Nyame TT, Gupta GK, Sadasivam M, Hamblin MR. Low-level laser therapy for fat layer reduction: a comprehensive review. Lasers Surg Med. 2013; 45(6): 349-57[DOI][PubMed]
  • 88. Jackson RF, Dedo DD, Roche GC, Turok DI, Maloney RJ. Low-level laser therapy as a non-invasive approach for body contouring: a randomized, controlled study. Lasers Surg Med. 2009; 41(10): 799-809[DOI][PubMed]
  • 89. Jalian HR, Avram MM. Cryolipolysis: a historical perspective and current clinical practice. Semin Cutan Med Surg. 2013; 32(1): 31-4[PubMed]
  • 90. Weiss RA. Noninvasive radio frequency for skin tightening and body contouring. Semin Cutan Med Surg. 2013; 32(1): 9-17[PubMed]
  • 91. Brightman L, Weiss E, Chapas AM, Karen J, Hale E, Bernstein L, et al. Improvement in arm and post-partum abdominal and flank subcutaneous fat deposits and skin laxity using a bipolar radiofrequency, infrared, vacuum and mechanical massage device. Lasers in Surgery and Medicine. 2009; 41(10): 791-8[DOI]
  • 92. Winter ML. Post-pregnancy body contouring using a combined radiofrequency, infrared light and tissue manipulation device. J Cosmet Laser Ther. 2009; 11(4): 229-35[DOI][PubMed]
  • 93. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004; 292(14): 1724-37[DOI][PubMed]
  • 94. Bray GA, Ryan DH. Drug treatment of the overweight patient. Gastroenterology. 2007; 132(6): 2239-52[DOI][PubMed]
  • 95. Cheung BM, Cheung TT, Samaranayake NR. Safety of antiobesity drugs. Ther Adv Drug Saf. 2013; 4(4): 171-81[DOI][PubMed]
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