A publication of the Journal of the American Medical Association in 2013 indicated that based on a systematic review and meta-analysis through 2012, more than 270,000 deaths were associated with overweight and obesity.1 There has been studies showing the effectiveness of lifestyle counseling by chiropractors in reducing weight in obese patients. In 2008, Powell, et al, conducted a retrospective study of 28 patients who underwent a 21 day nutritional intervention program and obtained a significant reduction in weight and lipid profile.2 In 2013, Callahan conducted a prospective study of 7 patients who underwent the same 21 day nutritional intervention program and obtained a significant reduction in weight and lipid profile.3 In 2014, Demaria, et al, conducted a retrospective analysis of 16 patients who underwent a 13-week weight loss program and obtained a significant reduction in weight.4
Studies have reported a lack of counseling to patients who were obese for both adults and children. In 1999, Galuska, et al, conducted a survey of 12,835 adults who were obese and found that only forty-two percent of participants reported that their health care professional advised them to lose weight.5 In 2008, Branner, et al, conducted a study between 2001 and 2004 and found that in 55,695,554 visits from obese children, only in 42.1% of visits nutritional counseling was performed.6 In 2011, Smith, et al, conducted a nationally representative survey of 1211 primary care physicians sampled from the American Medical Association’s master file. Results indicated that fewer than 50% reported always providing specific guidance on diet, exercise, or weight control for obese and overweight patients.7
In 2014, Wilkinson, et al, conducted a study of 1,002 firefighters and found that 69% of them reported receiving no weight advice.8 A few studies have compared counseling effectiveness and health promotion efforts between chiropractic and allopathic physicians. In 2009. Ndetan, et al, conducted an analysis of the National Health Interview Survey of 2005 involving 31,248 patients and found that chiropractor-only patients were more likely to be physically active and less likely to be obese compared to medical doctor-only patients.9 In 2010, Ndetan, et al, conducted an analysis of the 2006 National Health Interview Survey data involving 24,275 patients (34.9% were overweight and 26.0% were obese) and found that the levels of compliance were similar when allopathic or chiropractic physicians advised (88.2% vs 88.7, respectively).
There was a decreased odd that patients having seen only a chiropractor within the last 12 months would report they were advised when compared to those reporting seeing only an allopathic doctor (38.9% / 21%).10 Also in 2010, Ndetan, et al, conducted an analysis of the 2006 National Health Interview Survey
data involving 6,374 patients diagnosed with arthritis for recommendations for known risk factors of arthritis. This study found no significant differences in weight loss and increased exercise health promotion efforts between chiropractors and allopathic physicians.11
Acupuncture has shown great results with weight loss. In 2009, Cho et al, carried out a systematic review and meta-analysis of 31 studies, which comprised a total of over 3000 individual cases. This study suggests that acupuncture is an effective treatment for obesity.12 In 2018, Kim, et al, published a systematic review and meta-analysis of 27 randomized controlled trials involving over 2000 patients. This study found that the effect of acupuncture on weight loss may be maximized when auricular and manual acupuncture or pharmacopuncture treatment is combined with lifestyle modification in patients with overweight.13
Finally, in 2018, Zhang, et al, performed a network meta-analysis of 34 randomized controlled trials involving over 2000 participants. This study showed that the combination of acupuncture and related therapies was ranked the optimal method for both reducing weight and body mass index.14
In conclusion, the combination of lifestyle modification and acupuncture can help promote weight loss in children and adults. The role of chiropractors in the treatment of obesity consists of nutritional and exercise counseling while potentially using acupuncture as adjunct therapy.
Dr. Adrian A. Isaza, DC, CCAP, PhD is a Chiropractic and a Certified Acupuncturist. He is practicing at Pharmedico and taking appointment for Saturdays. He is currently accepting new patients at Pharmedico location. You’re welcome to contact Dr. Isaza to discuss with him about your childhood obesity problems or any other illness you may have. He can be reached at Pharmedico (941) 952-3959.
Pharmedico Pharmacy
941-952-3959
www.PharmedicoRx.com
References:
1. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-
cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309(1):71-82.
2. Powell JP, Leonard JS. A nutritional program improved lipid profiles and weight in 28 chiropractic patients: a retrospective case series. J Chiropr Med. 2008;7(3):94-100.
3. Callahan E. Changes in weight loss and lipid profiles after a dietary purification program: a prospective case series. J Chiropr Med. 2013;12(1):30-8.
4. Demaria A, Demaria C, Demaria R, Alcantara J. A weight loss program in a chiropractic practice: a retrospective analysis. Complement Ther Clin Pract. 2014;20(2):125-9.
5. Galuska DA, Will JC, Serdula MK, Ford ES. Are health care professionals advising obese patients to lose weight?. JAMA. 1999;282(16):1576-8.
6. Branner CM, Koyama T, Jensen GL. Racial and ethnic differences in pediatric obesity-prevention counseling: national prevalence of clinician practices. Obesity (Silver Spring). 2008;16(3):690-4.
7. Smith AW, Borowski LA, Liu B, et al. U.S. primary care physicians’ diet, physical activity, and weight-related care of adult patients. Am J Prev Med. 2011;41(1):33-42
8. Wilkinson ML, Brown AL, Poston WS, Haddock CK, Jahnke SA, Day RS. Physician weight recommendations for overweight and obese firefighters, United States, 2011-2012. Prev Chronic Dis. 2014;11:E116.
9. Ndetan HT, Bae S, Evans MW, Rupert RL, Singh KP. Characterization of health status and modifiable risk behavior among United States adults using chiropractic care as compared with general medical care. J Manipulative Physiol Ther. 2009;32(6):414-22.
10. Ndetan H, Evans MW, Bae S, Felini M, Rupert R, Singh KP. The health care provider’s role and patient compliance to health promotion advice from the user’s perspective: analysis of the 2006 National Health Interview Survey data. J Manipulative Physiol Ther. 2010;33(6):413-8.
11. Ndetan H, Evans MW, Felini M, Bae S, Rupert R, Singh KP. Chiropractic and medical use of health promotion in the management of arthritis: analysis of the 2006 National Health Interview Survey. J Manipulative Physiol Ther. 2010;33(6):419-24
12. 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.
13. Kim SY, Shin IS, Park YJ. Effect of acupuncture and intervention types on weight loss: a systematic review and meta-analysis. Obes Rev. 2018;19(11):1585-1596.
14. Zhang Y, Li J, Mo G, et al. Acupuncture and Related Therapies for Obesity: A Network Meta-Analysis. Evid Based Complement Alternat Med. 2018;2018:9569685. Published 2018 Sep 30. doi:10.1155/2018/9569685