Efficacy and safety of anti-obesity herbal medicine focused on pattern identification: A systematic review and meta-analysis

Abstract

Background: Herbal medicine based on pattern identification (PI) is used widely in Traditional Chinese Medicine. Proper herbal medicine based on PI has been suggested for effective weight reduction and decreasing the adverse events. This systematic review examined the effectiveness and safety of herbal medicine, focusing on PI in treating obesity. Methods: Eight electric databases were used for searching randomized controlled trials (RCT) (to August 31, 2021). RCTs which prescribed herbal medicine to obese patients based on PI were included. Body weight (BW) and body mass index (BMI) were the primary outcomes. The risk of bias was assessed using Cochrane risk of bias tool, and the meta-analysis was conducted. Grading the evidence was conducted by using GRADEpro. Results: Sixteen RCTs (1052 patients) were included: 2 studies compared herbal medicine to placebo (128 patients); 2 studies compared them to western medication (161 patients); 12 studies compared them with usual care (763 patients). The meta-analysis showed that the herbal formulas reduced the BW and BMI without significant Adverse events compared to the control group (BW: mean difference = –4.10, 95% confidence interval: –5.14 to –3.06, I2 = 2% and BMI: mean difference = –1.53, 95% confidence interval: –1.88 to –1.19, I2 = 25%). Moderate-quality evidence on the primary outcomes was found. Conclusions: Herbal medicine – has good clinical efficacy and safety in treating obesity. This study has limitations that some literatures with high risk of bias in blinding or without using a standardized diagnosis of PI were included. However, the current evidence suggests the possibility of precision medicine using PI.

Effects of traditional Chinese medicines on weight management among adults with overweight or obesity: A systematic review and network meta‐analysis

“…This is consistent with several previous meta-analysis studies, which have reported that while TCMs like acupuncture and herbal medicines may be superior to lifestyle modifications or no intervention, they did not exceed the efficacy of Western medications in the management of overweight and obesity. 7,65,[68][69][70] Considering these insights, it is suggested that both…”

“…This is consistent with several previous meta‐analysis studies, which have reported that while TCMs like acupuncture and herbal medicines may be superior to lifestyle modifications or no intervention, they did not exceed the efficacy of Western medications in the management of overweight and obesity. 7 , 65 , 68 , 69 , 70 Considering these insights, it is suggested that both TCMs and WP could be considered preferential over non‐pharmacological interventions such as simple lifestyle modifications or placebo/no treatment in treating simple obesity.…”

Real-world evidence of characteristics and factors influencing herbal medicine use for weight loss in adults

“…In addition, healthcare providers can treat patients by considering these characteristics and needs, while researchers can use this information as a reference for designing future studies. For example, while the effectiveness and safety of HM for weight loss could not be directly compared with other treatment methods through KNHANES analysis, numerous studies have reported the effectiveness and safety of HM in this regard ( Maunder et al, 2020 ; Park et al, 2022 ). However, owing to low methodological quality and poor reporting of HM in previous studies ( Maunder et al, 2020 ; Park et al, 2022 ), further rigorously designed high-quality clinical trials are needed to evaluate its effectiveness and long-term safety.…”

“…For example, while the effectiveness and safety of HM for weight loss could not be directly compared with other treatment methods through KNHANES analysis, numerous studies have reported the effectiveness and safety of HM in this regard ( Maunder et al, 2020 ; Park et al, 2022 ). However, owing to low methodological quality and poor reporting of HM in previous studies ( Maunder et al, 2020 ; Park et al, 2022 ), further rigorously designed high-quality clinical trials are needed to evaluate its effectiveness and long-term safety. Furthermore, ongoing research on the HM registry for weight loss ( Ko et al, 2022 ) holds promise for confirming not only the long-term safety and effectiveness of HM but also elucidating the characteristics of HM users and factors influencing clinical outcomes through prospective longitudinal studies.…”

“…Moreover, a Korean medicine registry focusing on HM for weight loss has been established to investigate the clinical characteristics and safety profiles of various HM treatments ( Ko et al, 2022 ). In addition, several clinical studies have been conducted to evaluate the effectiveness and safety of HM in managing obesity ( Maunder et al, 2020 ; Park et al, 2022 ). According to the recent network meta-analysis, HM and HM plus acupuncture significantly reduced BMI compared with lifestyle management in children with simple obesity ( Lee and Kwon, 2022 ).…”