Traditional Chinese Medicine Interventions for Overweight and Obesity in Adults: An Umbrella Review and Evidence Map

Abstract

Background Traditional Chinese medicine (TCM) is widely used for weight management, but the reliability and comparability of the available review-level evidence remain uncertain. This umbrella review evaluated the methodological quality, certainty, and quantitative findings of systematic reviews and meta-analyses of TCM interventions for adults with overweight or obesity. Methods We searched PubMed, Embase, the Cochrane Library, CNKI, Wanfang, CBM, and VIP for systematic reviews and meta-analyses of randomized controlled trials. Methodological quality and certainty of evidence were evaluated using AMSTAR-2 and GRADE. Primary-study overlap was assessed using a citation matrix and the corrected covered area (CCA). Mean differences (MDs) were pooled only when outcome units were clinically compatible; standardized effects were reported narratively and were not combined with MDs. Random-effects models and leave-one-out analyses were used for body weight and body mass index (BMI). Results Twelve systematic reviews or meta-analyses were retained. They contained 254 primary-study occurrences and a non-unique review-level participant total of 19,795. Citation matching identified 155 unique primary studies, producing a CCA of 5.81%, which indicated moderate overlap. In MD-only analyses, TCM interventions were associated with reductions in body weight (overall MD = −3.11 kg, 95% CI −4.05 to −2.16; I2 = 90.9%) and BMI (overall MD = −1.26 kg/m2, 95% CI −1.61 to −0.90; I2 = 91.0%).The body-weight and BMI results remained statistically significant in leave-one-out analyses. For BMI, external therapies, TCM exercise, and the herbal-medicine subgroup all showed significant pooled effects. Conclusion TCM interventions may improve body weight and BMI in adults with overweight or obesity. However, substantial heterogeneity, overlap between reviews, inconsistent outcome reporting, and predominantly low-to-moderate certainty limit confidence in the estimates. The current evidence is insufficient to support definitive treatment rankings or strong clinical recommendations.