Acupuncture-induced fat thickness reduction in different body regions: A case report and review of literature

Table 1 Characteristics of weight-reduction effects and potential mechanisms of acupuncture points at different anatomical sites

Anatomical region	Acupoint	Observed effect	Proposed mechanism	Ref.
Head and neck	Baihui (GV20) Yintang (EX-HN3)	The integrated acupuncture plan for Baihui, Yintang and other acupoints has a positive impact on reducing depression and anxiety scores. Positive improvements have also been observed in obesity indicators such as weight, BMI and waist circumference, and the therapeutic effect is sustainable[32]	Acupuncture at Baihui and Yintang may improve mood and promote weight loss by regulating the function of the HPA axis[33], reducing related pro-inflammatory cytokines to improve neuroinflammation[34], and regulating leptin/insulin imbalance[35]	[32-35]
	Shenting (GV24)	In combination with Baihui and Yintang for acupuncture, there were significant improvements in weight, BMI, waist circumference, anxiety, depression and TCM symptoms, and the marked efficiency was higher than that of acupuncture at Tianshu and Zhongwan points alone[36]		[36]
Chest and abdomen	Shuifen (CV9); Shuidao (ST28)	Shuifen (CV9) and Shuidao (ST28) serve as key components of a compound acupoint prescription. They can synergize with other acupoints to exert effects such as promoting diuresis, reducing edema, and regulating body fluid metabolism, thereby contributing to weight loss[37]	Acupuncture at Shuifen (CV9) and Shuidao (ST28) has been shown to significantly reduce abnormally elevated serum immunoglobulin (IgM, IgG) levels and upregulate the expression of aquaporins AQP2 and AQP3 in renal tissue in model rats, providing mechanistic support for its diuretic and weight-loss effects[37]	[37]
	Tianshu (ST25)	Tianshu (ST25) comprehensively improves the intestinal microenvironment by modulating enteric glial cell autophagy, restoring intestinal barrier integrity, and suppressing local inflammation. This directly optimizes intestinal motility and mucosal barrier function, indirectly supporting the weight-loss process[38-40]	The mechanism of Tianshu (ST25) involves multi-target synergy. Network pharmacology analysis suggests that interventions focusing on this acupoint may regulate key molecules such as NFKB1, IL6, MyD88, TLR4, and TNF, thereby modulating systemic inflammatory responses and immune function balance[38]	[38-40]
	Zhongwan (CV12)	Stimulation of Zhongwan (CV12) effectively ameliorates gastrointestinal motility disorders and regulates gastrointestinal secretion, establishing a functional gastrointestinal foundation for weight loss	Electroacupuncture stimulation at acupoints including Zhongwan (CV12) and Tianshu (ST25) may reduce food intake and ultimately lead to weight loss by inhibiting hypothalamic inflammation and restoring the normal function of POMC neurons[41]	[41,42]
	Guanyuan (CV4)	Electroacupuncture stimulation at Guanyuan (CV4) effectively promotes gastrointestinal motility and alleviates systemic and local inflammatory responses, creating a favorable anti-inflammatory microenvironment for weight loss[43]		[41,43]
Back	Pishu (BL20)	It has the functions of regulating sugar and lipid metabolism, improving insulin resistance and enhancing insulin sensitivity. Lower blood sugar, alleviate chronic inflammatory responses in the islets, and improve the dedifferentiation of pancreatic β cells; Improve insulin resistance in the liver	Inhibit the expression and activation of MST1, reduce β-cell apoptosis and enhance insulin synthesis, regulate the expression of ZAG and GLUT4 in peripheral tissues, inhibit the pancreatic NF-κB pathway, and activate the Akt/FoxO1 signaling pathway to improve metabolism and inflammation	[44]
	Yishu (BL20)	Acupuncture at the Yishu point has the effect of reducing FBG. It can significantly increase the ISI and significantly reduce the levels of serum TG and LDL-C	Selectively reduce CORT, inhibit gluconeogenesis, and improve insulin resistance; Moreover, acupuncture at the Pancreatic Shu point can down-regulate the secretion levels of CRH and CORT in the HPA axis through subcortical centers such as the hypothalamus
Upper limb	Quchi (LI11)	Acupuncture at LI11 can enhance glucose sensing and promote energy expenditure, thereby reducing body weight by increasing caloric consumption	Acupuncture at LI11 can upregulate the expression of pAMPKα in the pancreas, thereby increasing energy expenditure and achieving the goal of treating obesity	[24]
Lower limb	Sanyinjiao (SP6)	Acupuncture at SP6 can restore the physiological function of energy expenditure in mice, while also suppressing appetite, regulating glucose homeostasis, and modulating immune responses, thereby achieving the goal of weight loss	SP6 exerts its effects by restoring microbial balance, enhancing SCFA production, activating vagal afferents, and influencing neuroendocrine feedback loops, positions it as a promising candidate for integrative obesity management. Electroacupuncture at ST36 can also modulate the gut microbiota, increase the expression of c-Fos in the central nervous system and hypothalamic regions, regulate the activation of neural circuits, suppress appetite, and ameliorate metabolic disorders induced by a high-fat diet[45]. Electroacupuncture at ST36 can also modulate gastric motility by vagal and sympathetic reflexes	[45]
	Zusanli (ST36)	Acupuncture at ST36 suppresses appetite and reduces nutrient intake. It also alleviates metabolic disorders associated with obesity, thereby increasing energy expenditure and achieving multi-faceted weight loss effects		[45-47]
	Yinlingquan (SP9)	Acupuncture at SP9 regulates fluid metabolism, alleviates edema associated with obesity, and thereby assists in the treatment of obesity	This effect may be achieved by regulating renal blood flow or related hormones (such as ADH) to promote water excretion
	Fenglong (ST40)	Acupuncture at the ST40 acupoint can suppress appetite, regulate metabolism, and consequently achieve weight loss	It improves insulin resistance, promotes processes like glucose oxidation and conversion, and finally boosts energy use

BMI: Body mass index; HPA: Hypothalamic-pituitary-adrenal axis; TCM: Traditional Chinese Medicine; IgM: Immunoglobulin M; IgG: Immunoglobulin G; AQP2: Aquaporin 2; AQP3: Aquaporin 3; NFKB1: Nuclear factor kappa B subunit 1; IL6: Interleukin 6; MyD88: Myeloid differentiation primary response 88; TLR4: Toll-like receptor 4; TNF: Tumor necrosis factor; POMC: Proopiomelanocortin; MST1: Mammalian Ste20-like kinase 1; ZAG: Zinc-alpha2-glycoprotein; GLUT4: Glucose transporter type 4; NF-κB: Nuclear factor kappa-light-chain-enhancer of activated B cells; Akt/FoxO1: Protein kinase B/forkhead box O1; FBG: Fasting blood glucose; ISI: Insulin sensitivity index; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol; CORT: Corticosterone; CRH: Corticotropin-releasing hormone; pAMPKα: Phosphorylated AMP-activated protein kinase alpha; SCFA: Short-chain fatty acids; c-Fos: Fos proto-oncogene; ADH: Antidiuretic hormone.

Table 2 Comparison of key patient metrics before and after treatment

Metric	Pre-treatment (March 15, 2025)	Post-treatment (May 10, 2025)
Body weight (kg)	122.5	116.5
Waist circumference (cm)	125.4	110.9
Body fat percentage (%)	41.5	39.3
Visceral fat thickness (VFT, mm)	118.29	100.09
Abdominal subcutaneous fat thickness (SCFT, mm)	44.33	32.01
Total cholesterol (mmol/L)	5.60	5.53
Low-density lipoprotein cholesterol (mmol/L)	3.84	3.53
High-density lipoprotein cholesterol (mmol/L)	1.16	1.31
Chinese visceral adiposity index	239.4	181.0
Visceral adipose tissue volume (cm³)	281.7	204.0

Chinese visceral adiposity index (CVAI) calculation formula: Male: CVAI = -267.93 + 0.68 × age + 0.03 × body mass index (BMI) + 4.00 × waist circumference + 22.00 × Log₁₀ (triglycerides) - 16.32 × HDL-C. Female: CVAI = -187.32 + 1.71 × age + 4.23 × BMI + 1.12 × waist circumference + 39.76 × Log₁₀ (triglycerides) - 11.66 × HDL-C. Visceral adipose tissue (VAT) calculation formula: VAT = -9.008 + 1.191 × [distance from inner abdominal muscle surface to splenic vein (mm)] + 0.987 × [distance from inner abdominal muscle surface to posterior wall of abdominal aorta at umbilicus (mm)] + 3.644 × [thickness of fat layer posterior to right kidney (mm)]. SCFT: Subcutaneous fat thickness.