Acupuncture has been anecdotally reported to induce weight loss in obese patients. This pilot study examines its efficacy in a randomised, placebo-controlled clinical trial. Forty (33 F, 7 M) obese (BMI > 30 kg/m2) outpatients were randomised to either placebo or acupuncture (12 weekly sessions of minimal acupuncture and somatic moxibustion-acupuncture associated with auriculopuncture respectively). BMI, eating attitudes (BES), anxiety (STAI), depression (BDI), and obesity-related quality of life (ORWELL 97) were measured at the beginning and end of the treatment. Six (30%) patients in the treatment group and 12 (60%) in the placebo group dropped out. Intention-to-treat analysis did not show any significant effect of acupuncture on BMI and obesity-related quality of life; eating attitudes improved in both groups, possibly because of the placebo effect. A significant improvement in anxiety and depression was only observed in the acupuncture group. In conclusion, acupuncture does not promote weight loss and is not recommendable in the treatment of obesity. It may, however, improve the psychological status of obese patients.