Abstract Obesity
Obesity is a complex metabolic disorder that is intricately linked to dysregulation of the microbiota–gut–brain axis (MGBA), a key pathway also targeted by nutritional interventions. Acupuncture, as a non-pharmacological and integrative approach, has shown promising effects in weight control and metabolic improvement, yet its underlying mechanisms remain to be systematically clarified from a nutritional and metabolic perspective. This review outlines an integrative framework by which acupuncture modulates obesity through the MGBA, emphasizing shared targets with diet-based interventions such as short-chain fatty acids (SCFAs), glucagon-like peptide-1 (GLP-1), and G protein-coupled receptors (e.g., GPR43). We discuss how acupuncture improves microbial diversity, enhances gut barrier integrity, and regulates nutrient-derived signaling molecules, thereby influencing energy metabolism, appetite control, and inflammatory responses. Furthermore, we explore the convergence of neural, endocrine, and immune networks within the MGBA, positioning acupuncture as a systemic metabolic modulator analogous to nutritional therapeutics. This conceptual model provides novel insights into multi-targeted interventions for obesity, suggesting that acupuncture may serve as a complementary strategy to nutritional modulation in restoring metabolic homeostasis.
Introduction
Obesity is a multifactorial metabolic disorder driven by the intricate interplay between dietary habits, gut microbiota, neuroendocrine regulation, and systemic inflammation. Nutritional interventions, such as high-fiber diets, probiotics, and short-chain fatty acid (SCFA) supplementation, have emerged as effective strategies to restore energy balance and metabolic health by targeting the microbiota–gut–brain axis (MGBA) (1). The MGBA acts as a bidirectional communication network in which gut-derived signals—like SCFAs, glucagon-like peptide-1 (GLP-1), and peptide YY (PYY)—modulate central appetite regulation, glucose homeostasis, and immune responses.
Parallel to dietary interventions, acupuncture has gained increasing recognition as a non-pharmacological approach capable of engaging similar gut–brain pathways. Rooted in traditional Chinese medicine, acupuncture has been widely employed in weight management, with recent studies revealing its influence on gut microbial composition, intestinal permeability, neuroinflammatory markers, and hypothalamic activity. Notably, both acupuncture and nutritional therapies appear to converge on shared biological targets within the MGBA, including G protein–coupled receptors (e.g., GPR43), gut peptides, and vagal signaling pathways.
The MGBA has become a central focus in obesity research, given its role in linking peripheral metabolic inputs with central nervous system outputs. Disruptions in this axis have been implicated in increased gut permeability, endotoxemia, hypothalamic inflammation, and altered appetite signaling—all of which contribute to obesity pathophysiology. Acupuncture’s ability to modulate this axis—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.
Despite growing interest, the mechanisms by which acupuncture exerts systemic metabolic benefits via MGBA modulation remain underdefined within a nutritional science framework. Few reviews have explicitly contextualized acupuncture’s effects through the lens of gut-derived nutritional signals or compared its mechanisms to those of diet-based interventions.
This review aims to construct an integrative mechanistic framework that links acupuncture to MGBA-targeted metabolic regulation, drawing conceptual parallels with nutritional modulation strategies. By synthesizing current evidence on microbial metabolites, gut hormones, immune signaling, and neuroendocrine networks, we propose that acupuncture can serve as a complementary or synergistic modality to nutritional approaches in restoring metabolic homeostasis in obesity.
