The role of electromyostimulation in obesity management: A systematic review and meta-analysis

Background: Obesity remains a major global health concern, affecting over 650 million adults and 340 million children worldwide, and is associated with increased risks of cardiovascular disease, diabetes, and cognitive decline. While lifestyle interventions such as diet and exercise are central to obesity management, many individuals with severe obesity or musculoskeletal limitations are unable to participate in conventional exercise programs. Electromyostimulation (EMS) has emerged as a potential alternative, using electrical impulses to induce muscle contractions and improve muscle strength, metabolism, and body composition. This review aims to evaluate the effectiveness of EMS in obese individuals by examining its impact on anthropometric measures (body mass index [BMI], total lean mass [TLM], skeletal muscle mass, body fat percentage, and waist and hip circumferences), functional capacity, and lipid and cardiovascular profiles based on currently available comparative studies. Methods: We retrieved relevant articles up to March 2025 from PubMed, Scopus, Web of Science, and Cochrane Library. Data were extracted from eligible studies by two independent reviewers, including baseline information, age, gender, body mass, BMI, TLM, skeletal muscle mass, body fat percentage, hip circumference, waist circumference, 6-minute walk test (6MWT), basal metabolic rate, O2 consumption, systolic blood pressure (SBP), diastolic blood pressure, and maximal heart rate, as well as their biochemical profiles. The risk of bias (RoB) for all included randomized controlled trials was assessed using the RoB 2 tool by two independent reviewers. All analyses were conducted using R version 4.3.3. Results: After searching four databases, we collected 2704 records. Removing 1276 duplicates left us with 1428 unique records. After the eligibility assessment, 30 trials were included. This analysis highlights the value of EMS in reducing BMI (mean difference [MD] − −0.54, P = 0.0104), body fat percentage (MD − −1.25, P = 0.0026), P = 0.0049). Moreover, EMS increased skeletal muscle mass (MD high-density lipoprotein (MD 2.53, P = 0.0336). Conclusion: EMS is associated with modest reductions in BMI and body fat percentage and increases in skeletal muscle mass in individuals with obesity, particularly those unable to engage in conventional exercise. However, evidence regarding its effects on overall body mass and waist and hip circumferences remains inconsistent. Further high-quality randomized controlled trials are needed to define its clinical relevance and optimal application.