So What If --

For those of you around the world who practice acupuncture or the "principle" of it, you are acutely aware of the numbers of people you encounter on a weekly basis who, on learning of your involvement with acupuncture, ask, "What about smoking and weight control?"

Perhaps besides the fame associated with pain relief, acupuncture has established itself internationally as an extremely effective approach to dealing with a host of addictive problems including drugs, alcohol, smoking and obesity.

To my knowledge, the applications of acupuncture with these addictive problems are not classic and historic but rather have their origins within the last 25 years. Even though China is most often associated with acupuncture and is the undisputed leader in its development, most of the concepts of addiction control have come from Eastern Europe and North America, where obviously addiction is much more of a problem than would be found in the Peoples' Republic of China.

So what about weight control? Forget It! Unless of course, you have masochistic tendencies.

That seems like a pretty strong statement unless you have seen what I have. In my nearly 20 years of involvement in this work I have witnessed more practices than I care to recall practically or totally ruined because of a DC's insistence in developing a weight control practice.

In an international study conducted several years ago, the statistics of acupuncture and weight control were quite revealing. The study found 90% of those patients who underwent acupuncture for weight loss dropped out of treatment within three weeks of beginning and lost an average of only four pounds.

Acupuncture for weight control is employed through the use of auriculotherapy (ear acupuncture). There is absolutely no question, it is amazingly successful in altering the appetite and even accelerating the metabolism. However, the ultimate success of the program is inherent in the diet the patient is willing to adhere to.

Unfortunately, the average patient who seeks acupuncture for relief of his overweight condition, is usually looking for a "magic button" to press and watch the weight come tumbling off at a physiologically impossible rate. Whereas, the person who seeks the service of organizations such as Weight Watchers, Diet Center, etc., is generally aware before the first visit a specific diet is to be adhered to, and is willing to visit the center on a weekly or daily basis for individual or group counseling sessions.

The only reason I discourage the use of acupuncture for weight control is the time and frustration it creates generally far outweighs any benefit you will see in your practice. The last situation you want to create in your office is a number of failure cases and unfortunately, this is exactly what you will encounter. Granted, there are people who will lose weight with the procedure; however, comparatively speaking, they are the exception and not the rule. Besides that, there are too many companies that specialize in nothing but weight control and are incredibly effective. However, how many people have you known who have lost weight on a program only to regain all and more of the weight back again? When that happens, what at first seemed a success, now becomes a failure. There is nothing in acupuncture which keeps the weight off permanently. That can only be done through behavior modification. If that's your bag, then my advice is "go for it."

Should you be proficient in behavior modification and are nutritionally oriented enough to create a diet program and you are able to spend the time to motivate your patient and the patient can be motivated, then acupuncture can be a tremendous adjunct. In that case, utilizing the ear in auriculotherapy, stimulate electronically or with he ne laser, the points known as hunger stomach, shen men, and mouth.

The points, once stimulated, should then be further stimulated by the patient on an ongoing multi-daily schedule throughout the day especially prior to eating. The best way to accomplish this is to utilize the "acupatch," which is attached to the skin via a flesh colored adhesive (even though I've never seen anyone's skin that particular color and if I did, would be quite concerned). The "acupatch" is a small, 1mm stainless steel ball which gives ongoing stimulation and will generally adhere to the ear for up to one week. A word of caution -- never, under any circumstances, even consider the use of the staple in the ear. The risk of infection is far too great and many practitioners have been involved in numerous law suits because of their insistence in using this extremely dangerous device. I likewise caution against the use of the indwelling needle for continued stimulation. Just because you may know someone who uses them or you have used them yourself with success and no history of infection, it only takes one case of auriculo-chondritis to ruin your day, if not your whole practice.

The acupatch is definitely the method of choice. The foregoing acupoints will speed the metabolism and have a profound effect in altering the appetite. Should the patient not rub them throughout the day, it could have the opposite effect and the patient will most likely eat everything in sight.

Smoking control is another matter. This is a procedure I highly recommend as the success rate is 90% or better even with the three-pack-a-day smoker.

Again, behavior modification obviously plays an important role here as without it, it does not have the same effect. I advise my patients they may continue to smoke through the treatment program. This news is a strong plus to the patient's morale because there appears to be a great deal of fear and anxiety associated with "what if I can't get a fix?" By taking the patient off of the "anxious seat," you will find a much more cooperative patient than to advise them, "Okay, that's it!"

They may continue to smoke, however they will be advised to stimulate the "acupatches" on the points we will describe throughout the day, especially when the urge strikes. Following this 30-second stimulation to the point, the patient is advised to ask themselves, "Do I really want this cigarette?" Most often the patient will find they can really do without it and the procedure is repeated throughout the day for as many urges as they may have. Should the patient say, "Yes, I want it!" they are allowed; however, they are requested to see if their urge can be satisfied with just a few puffs. Most often it can.

One of the most significant behavior modification situations we create with the patient is, they may smoke, however, they may not smoke with anything over their head with the exception of an umbrella! Meaning, should they wish to smoke a cigarette at home relaxing in front of the T.V., they must step outside during the commercial. The same is true of in an automobile, restaurant or anywhere where a roof is concerned. While at work the patient must take a "smoke break" outside the building. If they want it bad enough, they must pay the price.

The other behavior modification I use is perhaps the most obvious, and that is to ask the patients to modify their habit by storing their cigarettes in a different location than usual and never to have them on their person. An ideal place to keep them is in the trunk of the car, where to get one takes an obvious effort.

The modification I feel is the most significant and the one which I am convinced makes an incredible difference, is the requirement that the patient on leaving the office buy a new pack of cigarettes. They are advised to purchase only one pack at a time and the new cigarettes to buy are the ones you would think the least obvious to stop the smoking habit and that is the unfiltered variety such as Camel, Lucky Strike, Chesterfield, Pall Mall, etc.

The object is not to begin smoking these unfiltered type of cigarettes but to allow the patients to wean themselves from the smoking habit by allowing them to get a little "blast" of nicotine without having to smoke an entire low-tar, filtered cigarette. By the time most people make up their mind to stop smoking it appears they have changed their brand to the lowest-tar cigarette they can find. My observation is they usually end up smoking more or at least inhaling deeper.

The acupoints which are absolutely recommended are: Lung (2 points) Mouth, Tongue, Shen Men, and the Amaro (addiction). These points should be stimulated on the bilateral ears with either electronic or laser, and patched with the acupatch with the exception of the Amaro point, which should be stimulated with the patient's fingertip for ongoing therapy. Needle stimulation is also very effective but not more so than the foregoing suggestion and should only be used by those who know what they are doing. With electronic or laser, even the rankest neophyte can perform this work and expect the same results the masters receive.

It is imperative you add the point known as meelee which is located on the back of the forearm in a distinct hollow approximately two fingers breadth superior (toward the elbow) from the dorsal wrist crease. When palpated, this point will be excruciatingly sore. Treat this point bilaterally in the same fashion with electronic or laser stimulation and, likewise, patch this point for ongoing therapy.

The general rule of thumb regarding success and which is predictable in 90% of the patients regardless of how long or much they have smoked, is a 50% reduction within 24 hours of beginning treatment. The response continues on from there. It is important the patient truly wishes to stop smoking and is not in your office because their spouse is forcing them to be there. Even if a two-packer reduces to nothing more than a cigarette following a meal or with a cocktail, they are obviously far better off and should be considered a major victory.

You will find the majority of patients will stop or be stable at an acceptable level within three weeks which represents three treatments over the same number of weeks. Many practitioners are recommending one visit as a cure; however, I strongly urge the three week approach.

The apparent success comes from the patient's cooperation in stimulating the acupatches for 30 seconds per point to include the meelee point throughout the day especially at the time of the urge.

Oddly enough, the formula suggested here for smoking is the same formula one uses in general drug withdrawal or alcohol cessation. However, I stand quite convicted to the philosophy that the drug and/or alcohol abuser should absolutely seek the services of professional organizations such as Alcoholic's Anonymous which have an incredible success rate, even without the use of acupuncture. When acupuncture is added to these people's regime, the success is quick and painless.

In any addiction it is strongly advised to prescribe or suggest licorice root t.i.d., which will assist the blood sugar swing and promote the adrenals which is vital in this approach. It goes without saying, a well balanced multi-vitamin/mineral complex with additional vitamin C is likewise important.

The points we discussed in this article are all specific points on the ear known as auriculotherapy with the exception of the meelee point. The ear chart was printed in the April 25, 1990 issue of Dynamic Chiropractic which you were asked to save for future reference. If for some reason you failed to keep this chart, first of all, "shame on you" and send a stamped self-addressed envelope to me at P.O. Box 1003, Carefree, Arizona 85377 for your complimentary copy.

Begin putting this system into use immediately; the response in incredible and will boost your practice immensely.