October 2021 Issue
Focus on Fitness: Tai Chi and Weight Loss
By Jennifer Van Pelt, MA
Vol. 23, No. 8, P. 56
In the United States, interest in tai chi has been growing for more than 10 years. A 2019 Harvard Medical School report referred to it as “medication in motion” and listed its many therapeutic benefits.1 These benefits include improving balance, reducing fall risk, strengthening muscles, relieving stress, alleviating chronic pain, and improving symptoms of chronic conditions such as COPD, Parkinson’s disease, and multiple sclerosis. Tai chi is especially beneficial for older adults and those with movement limitations.
However, one benefit that previously hasn’t been attributed to tai chi in the media is weight loss. In June 2021, that changed, when the results of a randomized clinical trial comparing tai chi with conventional low-impact aerobic exercise were published—and tai chi proved to be just as efficacious at reducing weight for overweight adults older than 50. This finding was surprising to those focused on traditional aerobic activities and resistance training for weight loss, primarily because tai chi is considered a less strenuous and slower-paced activity. This recent study—and several others—support tai chi as an exercise alternative to aerobic training for losing weight and improving other health measures that may be related to weight, such as high cholesterol and high blood sugar.
Tai chi is a shortened form of the phrase t’ai chi ch’uan, which loosely translated means “internal martial art” or “supreme ultimate fist.” Originating centuries ago in China, individuals can practice it as a faster-paced sport or martial art with or without weapons, or more slowly for its health benefits. Typically, when compared with other exercise modalities, tai chi is classified as a mind-body exercise, along with qigong (pronounced chee/gung) and yoga. It involves slow, continuous whole-body movements linked together in sequences called “forms,” which are integrated with controlled breathing and mental focus.
According to traditional Chinese medicine, movements and breathing are designed to stimulate the flow of qi (pronounced “chee”), or life energy, thereby improving health and vitality. (Qi is different from “chi” in the word tai chi.) Tai chi is a type of qigong, translated as “energy work,” that involves coordinated breathing, slow movement, and awareness.
The two types of practices are closely related and may be performed separately or together. Elements of qigong are included in tai chi training. However, qigong, when practiced separately, focuses more on meditation, breathing, and healing, and includes exercises performed seated or lying down. Tai chi movements are all taught from a standing position, though movements can be modified for a seated chair practice for older adults with movement limitations.
An estimated 250 million people worldwide and 3.76 million Americans of all ages practice tai chi for its mind-body benefits.2,3 The smooth, flowing upper and lower body movements performed during tai chi are easy on the joints while simultaneously strengthening muscles in the upper and lower body, as well as the core. This engagement of the whole body may contribute to the weight loss observed in recent studies.
The June 2021 study that was widely covered in the media randomized 543 adults aged 50 and older with central obesity to perform either a combination of aerobic (brisk walking) and strength training or tai chi for one hour, three times weekly for 12 weeks; a control group of participants who didn’t exercise also was included for comparison. Body weight, waist circumference, cholesterol, triglycerides, fasting blood glucose, and blood pressure were measured at baseline, 12 weeks, and 38 weeks.4
At 12 weeks, the tai chi group and aerobic/strength exercise group both showed similar improvements in weight loss, reduction in waist circumference, and improved cholesterol and triglyceride measurements compared with the control group. At 38 weeks, approximately 10% to 15% of each exercise group no longer were diagnosed with obesity.4
Additional published meta-analyses evaluated tai chi for improving health and weight in adults with metabolic syndrome and diabetes. In a July 2021 systematic review of 20 randomized controlled trials (RCTs) of adults with metabolic syndrome, tai chi was found to reduce waist circumference, BMI, and blood glucose levels, and increase HDL cholesterol in adults with type 2 diabetes and obesity. In study participants who also had hypertension, tai chi improved blood pressure, blood lipids, anxiety, and quality of life.5
A March 2021 meta-analysis evaluated tai chi benefits reported in 14 RCTs of middle-aged and older adults with diabetes, many of whom had overweight or obesity. The researchers found that tai chi significantly improved blood glucose and lipids. Although weight loss wasn’t reported as an outcome, the effect of tai chi on diabetes is noteworthy.6 A 2018 meta-analysis of 24 RCTs found that tai chi and qigong significantly lowered BMI.7
The most commonly practiced form of tai chi in research studies was the Yang style, which consists of 24 distinct movements, or forms. For longer practices, additional forms can be added to total 88 different movements. Some researchers studied the duration of tai chi needed to produce beneficial effects, finding that sessions of at least 50 minutes performed three or more times weekly for at least 12 weeks produced significant improvements in weight loss, blood glucose, and lipids.
In comparison with other exercise modalities for weight loss, tai chi and qigong are easier to adapt for participants who are deconditioned and have limited mobility, as movements can be followed seated or standing. Tai chi also has been adapted for aquatic exercise. Due to its lower intensity and slower, flowing gentle movements, individuals likely can exercise for longer durations than when doing aerobic or strength training.
In addition, tai chi and qiqong don’t require any special equipment, can be performed anywhere in a small amount of space, and, once the forms are learned, instruction isn’t necessary if individuals are comfortable practicing on their own. Another benefit is mindfulness and stress reduction, which are incorporated into the entire session due to emphasis on controlled breathing and focus.
Tai chi/qigong classes are offered at many community centers and senior living facilities, as well as at some yoga studios and gyms. Online and DVD tai chi instruction for all levels also is available. Tai chi is worth a try, based on this new research demonstrating its benefits for weight loss, coupled with its already-established health benefits for many chronic conditions and for fall prevention.
— Jennifer Van Pelt, MA, is a certified group fitness instructor and health care researcher in the Lancaster, Pennsylvania, area.
1. The health benefits of tai chi. Harvard Health Publishing website. https://www.health.harvard.edu/staying-healthy/the-health-benefits-of-tai-chi. Updated August 20, 2019.
2. Scutti S. Tai chi health benefits: 250 million people know what’s good for them. Medical Daily website. https://www.medicaldaily.com/tai-chi-health-benefits-250-million-people-know-whats-good-them-246916. Published June 18, 2013.
3. Lange D. Participants in tai chi in the U.S. from 2008 to 2018. Statista website. https://www.statista.com/statistics/191622/participants-in-tai-chi-in-the-us-since-2008/. Published February 22, 2021.
4. Siu PM, Yu AP, Chin EC, et al. Effects of tai chi or conventional exercise on central obesity in middle-aged and older adults: a three-group randomized controlled trial. Ann Intern Med. 2021;174(8):1050-1057.
5. Chau JPC, Leung LYL, Liu X, et al. Effects of tai chi on health outcomes among community-dwelling adults with or at risk of metabolic syndrome: a systematic review. Complement Ther Clin Pract. 2021;44:101445.
6. Liu YN, Wang L, Fan X, Liu S, Wu Q, Qian YL. A meta-analysis of the effects of tai chi on glucose and lipid metabolism in middle-aged and elderly diabetic patients: evidence from randomized controlled trials. Evid Based Complement Alternat Med. 2021;2021:6699935.
7. Larkey LK, James D, Belyea M, Jeong M, Smith LL. Body composition outcomes of tai chi and qigong practice: a systematic review and meta-analysis of randomized controlled trials. Int J Behav Med. 2018;25(5):487-501.