Abstract

Abstract Introduction Non-invasive brain stimulation (NIBS) techniques such as transcranial Direct Current Stimulation (tDCS) and transcranial Magnetic Stimulation (TMS) are safe and simple techniques that have been used to reduce body weight, food cravings and food consumption in patients with obesity. Such strategy, if effective can be used as an adjunct, prior to bariatric surgery. We therefore aim to systematically evaluate current evidence on the efficacy of active NIBS versus sham stimulation in reducing body weight and food cravings. Methods We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) between January 1990 and February 2022. Mean differences (MDs) for continuous outcome variables with 95% confidence intervals (95% CIs) were used to examine the effects of NIBS on body weight and BMI, while the hedges's g test was used to measure the effects on food craving. Results Nineteen RCTs involving 571 participants were included in this study. Active neurostimulation (TMS and tDCS) was significantly more likely than sham stimulation to reduce body weight (TMS: -3.29 kg, P<0.001; tDCS: -0.82 kg, P=0.00) and BMI (TMS: - 0.74, P = 0.00; tDCS: MD= - 0.55, P = 0.54) as well as food cravings (TMS: g= -0.91, P = 0.00; tDCS: g= -0.32, P = 0.04). Conclusion Compared to sham stimulation, our findings indicate that active NIBS can significantly induce a reduction of body weight and food cravings. Hence, these novel techniques may be used as primary or adjunct tools in treating patients with obesity prior to bariatric surgery.

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