Can acupoint catgut embedding help treat my abdominal obesity and insulin resistance?
Acupoint catgut embedding (ACE) is a technique where a small piece of surgical thread is placed under the skin at specific acupoints to provide continuous stimulation. For abdominal obesity and insulin resistance, ACE is being studied as a potential treatment. Current evidence is promising but limited: a randomized trial found that ACE reduced waist circumference and improved insulin resistance compared to a sham procedure 9, but a planned systematic review notes that head-to-head trials against other interventions are still lacking 1. This means ACE may help, but it is not yet proven as a standard treatment.
What the research says
A 2024 randomized controlled trial tested ACE specifically for abdominal obesity. Ninety-six patients received either real ACE (catgut implanted in the fat layer at acupoints like Zhongwan and Qihai) or a sham procedure (same needling but no catgut). Both groups also received lifestyle advice. After 12 weeks of treatment (six sessions every two weeks), the ACE group had significantly greater reductions in waist circumference, body weight, BMI, and waist-to-hip ratio compared to the sham group. Importantly, ACE also improved markers of insulin resistance: the HOMA-IR index (a measure of insulin resistance) decreased more in the ACE group, along with fasting insulin and fasting blood glucose 9. These benefits were still seen at a 12-week follow-up after treatment ended 9.
However, this is a single trial, and its results need to be confirmed. A planned systematic review (protocol published in 2024) aims to gather all randomized trials on ACE for abdominal obesity with insulin resistance. The review will compare ACE against other treatments like lifestyle changes, medications, or other acupuncture methods. The authors note that because head-to-head trials are scarce, the comparative effectiveness of ACE remains unclear 1.
Other sources in this set do not directly test ACE but provide background on insulin resistance and obesity. For example, one review discusses how fat distribution and inflammation drive insulin resistance 2, and another highlights adipose tissue macrophages as key players in obesity-related inflammation 4. These studies help explain why reducing abdominal fat (as ACE may do) could improve insulin resistance, but they do not evaluate ACE itself.
Overall, the evidence for ACE is at an early stage. The single trial shows positive results for both abdominal obesity and insulin resistance, but larger, longer-term studies with more diverse patients are needed before ACE can be recommended as a standard treatment.
What to ask your doctor
- Based on my waist circumference and insulin resistance levels, could acupoint catgut embedding be a reasonable option for me?
- What does the current research say about the safety and side effects of ACE, especially compared to other treatments for abdominal obesity?
- Are there any acupuncturists or clinics in our area that offer ACE and have experience treating metabolic conditions?
- How would ACE fit into my overall treatment plan, including diet, exercise, and any medications I am taking?
- What should I watch for after an ACE procedure, and how would we know if it is working for me?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.