Overview

Centella asiatica is a traditional herbal medicine widely used in China and Southeast Asia for treating various conditions. Preclinical studies have shown that madecassic acid glycosides, including asiaticoside and madecassoside, can significantly reduce body weight gain, adipose tissue mass, and serum triglyceride levels in high-fat diet-induced obese mice. These compounds also improve hepatic steatosis and insulin resistance. This exploratory, interventional study aims to evaluate the clinical efficacy of orally administered asiaticoside tablets in adults with overweight or obesity.

Eligibility

Inclusion Criteria:

• Adults aged 18 years or older, male or female.
• Overweight or obesity, defined as a body mass index (BMI) of 24.0-45.0 kg/m².
• Able and willing to provide written informed consent.

Exclusion Criteria:

• Active pulmonary tuberculosis, malignant tumors, human immunodeficiency virus (HIV) infection, or other severe infectious or immunocompromising conditions.
• Severe liver injury (AST or ALT \> 3 times the upper limit of normal) or severe renal dysfunction/end-stage renal disease (eGFR \< 30 mL/min/1.73 m²).
• Severe cardiovascular diseases, including angina pectoris, myocardial infarction, or stroke within the past 6 months.
• Severe gastrointestinal disorders, or a history of gastrointestinal surgery within the past year.
• Secondary causes of obesity, including Cushing's syndrome, primary hypothyroidism, hypothalamic obesity, acromegaly; or drug-induced obesity (e.g., antipsychotics, glucocorticoids).
• Currently receiving other anti-obesity treatments, a previous history of bariatric surgery, or a \>5% reduction in body weight within the past 3 months.
• Current smoker or habitual smoker within the past 3 months.
• type 1 or type 2 diabetes mellitus or currently taking hypoglycemic medications.
• Pregnancy or planning pregnancy, or breastfeeding.
• Unable to complete a 3-month follow-up due to health conditions or relocation.
• Participation in any clinical study within the past 4 weeks.
• Other conditions considered by investigators as unsuitable for participation.