Auricular Acupressure for Obesity? No, I don’t think so!

Obesity is, as we all know, a huge public health issue. We therefore must no be amazed that the ‘SCAM brigade’ has collectively jumped on this bandwaggon – even auricualar acupressure is being promoted as a solution!

This study aimed to evaluate the impact of auricular acupressure on obesity and sleep quality in middle-aged Korean women. The single-blind, randomized, sham-controlled trial included participants aged 40-65 years with a Body Mass Index (BMI) of 25-34 kg/m 2 , divided into an experimental group (n = 30) and a control group (n = 29).

The intervention involved 8 weeks of auricular acupressure using ear seeds on five acupoints associated with obesity and sleep. Obesity outcomes were assessed using anthropometric indices (body weight, BMI, waist circumference, body fat mass, body fat percentage), while sleep outcomes were evaluated using the Pittsburgh Sleep Quality Index and actigraphy. Measurements were taken thrice: before the intervention, and at 4 and 8 weeks post-intervention start.

The experimental group demonstrated a significant reduction in obesity measures and improvement in sleep quality over time compared to the control group.

The authors suggest that their findings suggest that auricular acupressure may serve as an alternative nursing intervention for managing obesity and improving sleep quality in middle-aged women.

I have to admit that firstly I do not subscribe to ‘HOLIST. NURSE. PRACT.’ and secondly I am not willing to spend my money on buying this article. This means that I only can read the abstract of this paper. Thus my following explanations are speculative [but, as always, I am happy to change my tune once someone shows me that I was wrong].

So, how can a single- [presumably patient-] blind, sham controlled RCT of auricular acupuncture produce a positive result?

Fraud?

Not necessarily!

More likely, I think, is a phenomenon called ‘de-blinding’. For the above trial, this would mean that the control patients were treated with a sham procedure that was deemed to be indistinguishable from the verum by the trialists. But, in fact, patients managed to tell the difference between verum an sham. As the investigators did not check the success of their blinding procedure, they were able to call their study a ‘single-blind trial’, while in reality it was at least partly deblinded. If I am correct, the patients who were treated with the sham intervention fellt cheesed off for not receiving a real therapy and thus kept on eating, while the verum group did as told and controlled their diet a bit better.

In addition, ‘single-blind’, as applied to the patients, means that the therapists were not blinded. As they had a strong interest to generate a positive result, they would have used their verbal and non-verbal communication skills to influence their verum patients to reduce their obesity measures, e.g. by persualding them to excercise more and eat less.

In turn, these mechanisms together had the effect that “the experimental group demonstrated a significant reduction in obesity measures and improvement in sleep quality over time compared to the control group”.

QED

Alternatively, ‘single-blind’ might mean that the therapists were blinded. But, in this particular case, I don’t quite see how this would be possible.

Yes, there is yet another alternative: auricular acupressure might be effective in reducing obesity. If that is so, the current trial does not prove it!