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Background Obesity is a complex chronic disease involving genetic, environmental, and behavioral factors. Traditional Chinese medicine (TCM) non-pharmacological therapies are promising complementary strategies for simple obesity, yet evidence is fragmented and their comparative effectiveness remains unclear. Objectives This study aimed to evaluate and compare the efficacy of different TCM non-pharmacological interventions for simple obesity. Methods A comprehensive literature search was performed in PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, and the China Biomedical Literature Database (CBM) on December 31, 2025. Effect sizes were estimated using standardized mean differences (SMD) with random-effects models, methodological quality was assessed via the Cochrane Handbook version 5.1.0, and network meta-analysis (NMA) was conducted under a frequentist framework using Stata 18.0. Results A total of 37 randomized controlled trials (RCTs) involving 2,832 patients were included, examining six TCM non-pharmacological interventions and two control conditions. NMA demonstrated that all six interventions improved body mass index (BMI) and waist circumference (WC) to varying degrees versus usual care and placebo. Compared to placebo, moxibustion was associated with significantly greater reductions in BMI (SMD = −1.75, 95%CI: −2.68 to −0.83, surface under the cumulative ranking curve SUCRA = 98.8%). Relative to control, moxibustion was associated with significantly greater reductions in WC (SMD = −1.48, 95%CI: −2.31 to −0.64, SUCRA = 90.0%). Conclusion Current evidence indicates that different non-pharmacological TCM interventions may have differential effects on body mass index and waist circumference in adults with simple obesity, with moxibustion showing a possible relative advantage. Owing to low evidence quality and study limitations, findings should be interpreted cautiously. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , PROSPERO ID CRD42024614904.
Wang et al. (Fri,) studied this question.