Ear stapling, a procedure involving the placement of surgical staples in the ear, has gained popularity as a weight-loss method. Some view it as a form of body piercing, while others consider it a derivative of acupuncture. This article explores the procedure, the theories behind its purported effectiveness, and the scientific evidence supporting or refuting its claims.
What is Ear Stapling?
Ear stapling is a pretty straightforward procedure. A practitioner uses a specialized staple gun to pierce a slightly protruding piece of cartilage just above and to the left of the tragus portion of the external ear. A surgical-grade, very thin staple remains in the ear from anywhere from six weeks to three months. Once the body gets used to the staple, it needs to be repositioned, which means returning to the practitioner to have the ear re-stapled in a slightly different location. Practitioners charge anywhere from $35 to $60 per ear, and some recommend stapling both of your ears to achieve the maximum weight loss effect.
Theories Behind Ear Stapling
Proponents of ear stapling suggest several mechanisms for its purported weight loss effects.
Acupuncture and Qi
Most believers point the ancient Chinese practice of acupuncture for the source of the effect, while some attribute it to underlying physical connections in the body. Ear stapling is considered a derivative of acupuncture, which involves stimulating specific points on the body with fine needles. The basis of acupuncture is the concept of "qi," or life force. In ancient Chinese practices (and many modern derivatives of the ancient form), stimulating specific points on the body using needles or finger pressure can open or clear certain channels that run throughout the body that are crucial to overall health and wellbeing. Believers in ear stapling claim that by continuously stimulating the Zero Point location, which is said by some to include the Stomach point presented above, they can curb appetite, reduce stress and increase metabolism, among other benefits. Some people who have undergone the procedure say it also eliminates migraine headaches, nicotine craving and insomnia.
Fetal Development and Nerve Pathways
According to some sources, the outer ear and the abdominal organs are right next to each other during fetal development in the womb, and the physical connection between these body parts remains via nerve pathways even after they are no longer in close proximity. In this explanation, stimulating a part of the external ear also stimulates the abdominal organs, including the stomach.
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Endorphin Release
Other practitioners claim that piercing this particular area of the ear releases endorphins -- chemicals released by the brain during pleasurable activities that make you feel good.
Scientific Evidence: Studies on Auricular Acupuncture and Acupressure
A couple of scientific studies back up the use of auricular acupuncture in weight loss. According to one study conducted at the University of Adelaide in Australia in 1998, "Acupuncture stimulates the auricular branch of the vagal nerve and raises serotonin levels, both of which have been shown to increase tone in the smooth muscle of the stomach, thus suppressing appetite." In this study, a group of 60 obese subjects were split into two groups, with only one of the groups receiving acupuncture treatment. The treatment consisted of a simultaneous stimulation of the Shen Men and Stomach points. The results showed that the acupuncture group was more likely to experience a reduced appetite and to lose weight than the control group.
A systematic review and meta-analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. The protocol aimed at an investigation of the effects of AS on a large array of biomarkers and other objective outcomes. Obese patients have no restrictions on age, sex, ethnicity, or further health conditions. Obesity was defined as a BMI greater than 25 (Engin, 2017). If other ethnic groups are investigated, adjusted BMI will be applied. All RCTs in which AS was used alone or in addition to further weight loss measures were included. All interventions were eligible, including traditional AS (i.e., auricular acupuncture, auricular acupuncture with electric stimulation, and auricular acupressure) as well as related techniques such as transcutaneous electrical stimulation of the auricular nerve (tVNS) [synonym: transauricular vagus nerve stimulation (taVNS)] or cranial electrotherapeutic stimulation (CES, on the ear lobule). All control conditions (sham or placebo stimulation, diets, exercise, routine care, etc.) were included. The main outcomes were body weight and BMI, body fat, waist circumference, hip circumference, waist/hip circumference ratio, blood lipids, cholesterol, and obesity-related blood chemistry (HbA1c, blood glucose, leptin, ghrelin, and homeostasis model assessment index). All biomarkers, that were reported with results were extracted and evaluated. The continuous data were pooled in a meta-analysis, while the non-continuous data were evaluated descriptively.
Impact on BMI
A total of 10 trials with 487 individuals provided data on BMI. Compared to the control methods, AS significantly reduced BMI (MD = −0.38 BMI points, 95% CI (−0.55 to −0.22), p < 0.0001). The strongest BMI reduction of a mean of 1.01 points was achieved in a two-armed trial by Kim et al. (2014). South Korean female obese college students were allocated to ear acupressure or waiting lists. After 1 month of continuous and self-applied ear acupressure with diet or exercise, the acupressure group lost 3.1 kg (SD 0.73) vs. 0.2 kg (SD 1.05) (difference p < 0.001) and 1.23 (SD 0.34) BMI points vs. 0.15 (SD 0.45) BMI points (difference p < 0.001) compared to the control group in the pre-post calculation. The authors explained that satisfying results were connected to self-treatment and an increased feeling of self-efficacy. A similar reduction of weight and BMI was achieved in the sham-controlled trial of Lien et al. Taiwanese obese women received auricular true or sham acupuncture. Regular diets were maintained throughout the study. After 1 month of ear acupuncture with semipermanent needles, the real acupuncture group had a mean of 1.3 kg (SD 2.2) vs. 0.6 kg (SD 1.4) and a BMI of 0.5 points (SD 0.9) vs.
Effects on Body Fat
Data of 6 trials with 317 individuals were included in the analysis of body fat. In body fat percentage, compared to the control methods, AS did not show a significant effect on reducing the amount of body fat (MD = −1.21, 95% CI (−2.47 to 0.05), p = 0.06). Body fat was mostly measured with the method of impedance analysis. Cayir et al yielded the highest body fat percentage reduction from a baseline of 5.6% (SD5.3) with auricular acupuncture vs. 2.0% (SD2.8) with body acupuncture.
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Impact on Waist Circumference
In the analysis of the six trials with data on waist circumference of 276 individuals, compared to the control methods, AS reduced waist circumference significantly (MD = −1.44 cm, 95% CI (−2.69 to −0.20), p = 0.02). The biggest decrease was achieved in the trial by Darbandi et al. (2014), who randomized 80 obese participants in four groups: body electroacupuncture (A), auricular acupressure (C), sham body electroacupuncture (B), and sham auricular acupressure (D). From the auricular acupressure vs. sham auricular acupressure arms (n = 2×20), it was possible to use the data for meta-analysis. All subjects received a 500 kcal low-calorie diet.
Effects on Metabolic Parameters
Regarding the pooled data from four or fewer trials, a positive effect on obesity-related metabolic parameters was observed only in the comparisons of leptin, insulin, and HOMA insulin resistance. Compared to the control methods, AS had a significant effect on reducing leptin (4 trials, n = 295, SMD = −0.40, 95% CI (−0.63 to −0.17), p = 0.0008). No significant effects of AS compared to control methods were found in the meta-analyses of hip circumference, ratio of waist/hip circumference, cholesterol, LDL, triglycerides, adiponectin, and ghrelin. Only one trial examined the impact of glucose levels in obese patients (Costa-Cavalcanti et al., 2018).
Ghrelin Levels and Appetite Suppression
Auricular acupuncture is a common therapy used to control appetite; however, the underlying mechanism(s) of action is unclear. The difference in weight before treatment and after 1 week of treatment was significant for all participants in the acupuncture group (p=0.02). The percentage changes in active ghrelin in the acupuncture group were no significant changes observed in active ghrelin levels at 1 week after acupuncture in any individual participant (p=0.89). By contrast, the percentage changes in active ghrelin levels in the placebo group at 1 week after the start of acupuncture were significant (p=0.04). There was a statistically significant difference in the percentage change in body weight and active ghrelin levels in each individual participant in auricular acupuncture groups.
In a study, they found that the increase in early morning fasting ghrelin levels in the acupuncture group was suppressed after 1 week of acupuncture, whereas all of the participants in the placebo group showed an increase in early morning fasting ghrelin levels. The serum ghrelin level change is affected by blood glucose and insulin levels. The changes in blood glucose and insulin levels were not significantly different between the acupuncture and placebo groups.
The Placebo Effect
Skeptics point out that the placebo effect -- a term used to describe the phenomenon of something working because you believe it's going to work -- is an possible explanation for all of these positive results.
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Risks and Regulations
Whether you think it's going to work or not, there are some things to keep in mind if you're thinking about giving ear stapling a shot. First, piercing anything on your body can lead to an infection, and piercing cartilage increases this risk. Also, piercing can be a big deal if you hit a nerve or other important body structure. So don't take the procedure lightly. Second, ear stapling is not well regulated (if it's regulated at all). Don't just walk into somebody's house who has a medical-looking setup and submit to getting stapled. Find someone who is a certified acupuncturist trained specifically in ear stapling.
Additional Considerations
Traditional Chinese Medicine Perspective
In traditional Chinese medicine, a form of eastern traditional medicine, excessive weight gain is mostly due to the accumulation of “dampness.” Dampness in Chinese medicine occurs when the process of food intake, digestion, absorption and transportation is not balanced. To lose weight, the main strategy in traditional Chinese medicine is to eliminate this dampness.
Lifestyle Changes
And most of all, remember that even the most ardent supporters of ear stapling say it works best if you also eat healthy and keep yourself active.