Update of Korean Medicine Clinical Practice Guidelines for Obesity Management: An Evidence-Based GRADE Approach

OBJECTIVE: Obesity is a major health challenge associated with multiple chronic diseases. Korean traditional medicine (KM) offers diverse therapeutic approaches for obesity management. This study aims to update the Korean Medicine Clinical Practice Guidelines (KMCPGs) by incorporating recent evidence to improve the effectiveness of KM-based obesity care. METHODS: The KMCPGs were updated through systematic searches of eight databases for studies published up to December 31, 2022. Evidence quality and recommendation strength were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. RESULTS: The updated KMCPGs present 20 clinical recommendations, including 7 for KM monotherapies and 13 for KM combination therapies. The recommendations include herbal medicine (A/high), individualized ephedra-containing prescriptions (GPP), acupuncture (B/low), auricular acupuncture (C/low), electroacupuncture (B/low), pharmacopuncture (B/moderate), TEA (C/low), and 13 combination therapies ranging from grade B to C or GPP. Most recommendations focus on anthropometric outcomes, including body weight, BMI, WC, and body fat-related measures. CONCLUSIONS: The update of the KMCPGs underscores the clinical value of KM interventions in obesity management while emphasizing the need for further high-quality studies to strengthen the evidence. Addressing implementation barriers and ensuring regular guideline updates are essential for optimizing clinical application and improving patient outcomes in obesity care.