Weight Management

Yan-Kun Chen et al. (2023) · Frontiers in endocrinology

This literature review asks two connected questions: what actually drives obesity and type 2 diabetes at a biological level, and whether Traditional Chinese Medicine has anything to offer in managing them. The two conditions are closely linked — the review notes that type 2 diabetes accounts for roughly 90% of all diabetes cases and is strongly tied to excess weight. There is a practical bind behind the question, too: several standard diabetes drugs, including insulin and sulfonylureas, make weight loss harder rather than easier. The authors searched PubMed, Scopus and Web of Science for work published between 2019 and 2023, covering molecular, cellular and clinical studies of how obesity, diabetes and TCM interact. It is important to be clear about what kind of review this is: a narrative overview rather than a systematic one. There is no count of included trials, no pooled statistics and no formal assessment of study quality, so it maps a field rather than measuring an effect. On mechanism, the review draws a useful distinction between visceral fat — stored around the liver, pancreas and kidneys, hormonally active, and the type that drives insulin resistance — and subcutaneous fat sitting under the skin. This is why apple-shaped fat distribution carries more metabolic risk than pear-shaped. The scale of the problem is stark: the World Health Organization counted 1.9 billion overweight adults in 2016, 650 million of them with obesity, and 38.2 million children under five overweight or obese in 2019. The TCM proposal is that acupuncture, herbal remedies and dietary therapy act on inflammation, oxidative stress, insulin resistance and the balance of gut bacteria. What this review does not provide is evidence of how well any of that works. No effect sizes, no confidence intervals, no trial results for any specific TCM intervention appear. The authors themselves conclude only that TCM may be promising and that well-designed studies are still needed to confirm both efficacy and safety. Read it as a map of plausible mechanisms and an argument for research, not as grounds for choosing a treatment.

Metha Yaikwawong et al. (2024) · Nutrition journal

This 12-month randomized, double-blind, placebo-controlled trial with 272 adults with type 2 diabetes (T2DM) and obesity explored whether curcumin, the active compound in turmeric (Curcuma longa), could protect the pancreatic beta cells that produce insulin. In T2DM, obesity drives insulin resistance (cells responding poorly to insulin), which forces beta cells to work harder until their function starts to decline. Researchers tracked beta-cell function using HOMA-beta, an index calculated from fasting insulin and glucose, alongside HOMA-IR (a related index for insulin resistance) and two hormones made by fat tissue: adiponectin, which improves insulin sensitivity, and leptin, which signals fullness but runs high with excess body fat. Participants, all 35 or older and already taking metformin, were randomly assigned to six capsules a day (1,500 mg total) of standardized curcumin extract or an identical-looking placebo for 12 months, with 115 people in the placebo group and 114 in the curcumin group at randomization. Neither participants nor staff knew who received which capsule. Blood was drawn at baseline and every three months to measure fasting glucose, HbA1c (average blood sugar over about three months), body weight, BMI, insulin, HOMA-beta, HOMA-IR, adiponectin, and leptin. By 12 months, curcumin-treated participants had notably better beta-cell function than the placebo group (HOMA-beta 136.2 vs. 105.2; P<0.01, meaning their beta cells were working more efficiently), a difference that only became significant at 9 and 12 months, suggesting the benefit builds gradually rather than appearing right away. Insulin resistance dropped further with curcumin (HOMA-IR 4.86 vs. 6.04; P<0.001, lower is better), and blood sugar control improved (fasting glucose 115 vs. 131 mg/dL, P<0.05; HbA1c 6.12% vs. 6.47%, P<0.05). The curcumin group also lost more weight (66.1 vs. 69.3 kg, P<0.001) and lowered BMI (25.98 vs. 27.34, P<0.001), while adiponectin rose (14.5 vs. 10.4 ug/mL, P<0.001, more of the "good" fat hormone) and leptin fell (9.4 vs. 20.7 ug/mL, P<0.001, less of the fullness hormone that runs high in obesity). The authors connect these changes to curcumin's anti-inflammatory activity, since inflammation is a known driver of beta-cell decline. Mild side effects, abdominal pain, diarrhea, and headache, occurred in both groups with no one dropping out because of them, and liver and kidney markers stayed normal, suggesting curcumin extract is reasonably safe as a year-long add-on for people already managing T2DM with metformin. Because the trial tested only one dose at a single Thai hospital, it cannot show whether a different dose would work better or whether these results generalize elsewhere. Larger, multi-center trials testing a range of doses would help confirm curcumin's place alongside standard diabetes care.