title: Comparative effectiveness of electro-acupuncture plus lifestyle modification treatment for patients with simple obesity and overweight: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Acupuncture is considered to be an effective and safe treatment for obese and overweight patients, although high-quality evidence regarding the effects of acupuncture on obesity are not conclusive. The aim of the current study is to investigate the effectiveness of electro-acupuncture plus lifestyle modification for treating obese and overweight patients, in comparison with lifestyle modification alone in China.
  
  
  METHODS
  To compare the effectiveness of acupuncture plus lifestyle modification, a 2-armed, controlled trial with randomization using minimization will be conducted on 150 simple obesity and overweight patients, aged 18-50 years, for a 36-week study duration. All patients will be randomly assigned to one of two groups and will receive either acupuncture plus lifestyle modification or lifestyle modification alone. Outcomes will be evaluated at baseline and at 4 weeks, 8 weeks, and 12 weeks during treatment as well as at 6-week, 12-week, and 24-week follow-up. The primary endpoint is change of body mass index (BMI) during the 12th week. Secondary endpoints are body weight; waist-to-hip ratio; biochemical tests including serum cholesterol (TC), triglyceride (TG) and high-density lipoprotein (HDL) levels; and answers to the Short Form 36 (SF-36) and the Impact of Weight on Quality of Life Questionnaire-Lite Version (IWQOL-Lite). Statistical analyses will be based on the intention-to-treat (ITT) principle. The main endpoint will be analyzed by analysis of covariance (ANCOVA), and the objective outcome results will be analyzed by logistic regression analysis. To avoid potential confounding factors, additional sensitivity analyses will be conducted following these statistical analyses.
  
  
  CONCLUSIONS
  This trial is the first to compare the effectiveness of acupuncture plus lifestyle modification for treating obesity relative to lifestyle modification treatment alone by using a pragmatic study design. We hope that the results of this study will contribute to advancing the current methodology of acupuncture trials for obesity and will facilitate the application of useful acupuncture strategies in real-world clinical settings.
  
  
  BACKGROUND
  ChiCTR-TRC- 12002762 . The date of registration is 31 October 2012.
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. zishang30@sina.cn.
authors.forename: Zishan
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. mickey28282@sina.com.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Yu
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. songzhixu@njutcm.edu.cn.
authors.forename: Zhi-Xiu
authors.initials: ZX
authors.lastname: Song
authors.affiliation: The Third Affiliated Hospital of Nanjing University of TCM, Nanjing, Jiangsu, 210029, China. 353512281@qq.com.
authors.forename: Cai-Rong
authors.initials: CR
authors.lastname: Zhang
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. sino_rosemary@sina.com.
authors.forename: Yao-Shuai
authors.initials: YS
authors.lastname: Wang
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. 451263693@163.com.
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Wu
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. 119442417@qq.com.
authors.forename: Bei
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. shuping.fu@gmail.com.
authors.forename: Shu-Ping
authors.initials: SP
authors.lastname: Fu
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. 1846233307@qq.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. christmas44th@aliyun.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: The Business Administration School, Chengdu University of TCM, Chengdu, Sichuan, 610075, China. 657172145@qq.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. zhubm64@hotmail.com.
authors.forename: Bing-Mei
authors.initials: BM
authors.lastname: Zhu
authors.affiliation: Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China. xuuuux@sina.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry; D002681:China; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D057186:Comparative Effectiveness Research; D015671:Electroacupuncture / Q000009:adverse effects; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050177:Overweight / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012107:Research Design; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult