A randomized controlled trial of transcutaneous electrical nerve stimulation of T6 for appetite control in obese subjects on a low-calorie diet

Obese patients commonly fail a prescribed low calorie diet because they feel hunger. TENS (transcutaneous electrical nerve stimulation) is a widely used non‐pharmacologic treatment for discomfort associated with knee arthroplasty. Since some afferent pain fibers pass from the stomach through the spinal root T6, we hypothesized that TENS applied to dermatome T6 might alleviate abdominal discomfort accompanying a low calorie diet. We performed a randomized controlled study of TENS to improve dietary control in obese subjects (BMI > 30 kg/m2) on a 1,200 kcal diet. Subjects randomized to Group I (controls) were prescribed this diet. Group II subjects were prescribed the same diet, but also received TENS of dermatome T6 for 20 minutes twice a week for 6 weeks. After 6 weeks, compared to controls (n=8), Group II (n=10) had improved adherence to the diet plan (‐1 (1.1) vs 0.1 (0.9), p < 0.05); felt less hunger (‐1.0 (1.1) vs 0.2 (1.3), p < 0.05); had greater weight loss (‐ 7.7 (3.9) vs 1.7 (6.1) kg, p < 0.01) ; a greater reduction (‐0.6 (0.8) vs 0.4 (0.6) mmol/L, p = 0.01),(‐1.5 (1.6) vs 0.4 (1.2) ng/ml, p < 0.05) in total cholesterol and C‐peptide respectively. There was no significant difference in serum measures of Leptin, Adiponectin, Ghrelin, FGF‐19, FGF‐21, CRP, glucose, cortisol, or vitamin D. TENS appears to improve dietary control by alleviating hunger during a low calorie diet; TENSusing subjects can achieve meaningful weight loss, and a lowering of cholesterol, associated with significantly lower C‐peptide.