How much apple cider vinegar reduces weight? Meta-analysis points to 30 mL daily

By Priyanjana Pramanik, MSc.Reviewed by Susha Cheriyedath, M.Sc.Sep 22 2025

A systematic review reveals apple cider vinegar as a promising, accessible aid for weight and metabolic health, but larger long-term studies are needed to confirm its safety and effectiveness.

Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Image Credit: AtlasStudio / Shutterstock

Apple Cider Vinegar and Body Composition

In a recent meta-analysis in the journal Nutrients, researchers in Italy reviewed randomized controlled trials (RCTs) that evaluated the use of apple cider vinegar supplementation aiming to improve body composition in adults.

Vinegar intake was associated with modest but significant reductions in waist circumference, BMI, and body weight, especially in adults with obesity, overweight, or type 2 diabetes (T2DM), highlighting its potential for improving body composition.

Background

Obesity and T2DM represent urgent global health challenges, with over one billion people currently living with obesity and projections suggesting more than half of the world’s adult population could be affected by 2035. These conditions not only increase the risk of T2DM but also contribute to cardiovascular disease, cancer, and premature mortality.

While established treatments, such as dietary changes, physical activity, medications, and bariatric surgery, can promote weight loss, many patients struggle with maintaining their weight in the long term. Moreover, drug therapies and surgery carry risks, side effects, and accessibility barriers. This has led to growing interest in plant-based products as safer, more affordable alternatives for managing obesity and its complications.

Apple cider vinegar, produced by fermenting apple juice into acetic acid, is widely used as a condiment and natural remedy. Beyond its culinary role, these vinegars contain bioactive polyphenols and acetic acid, which may improve insulin sensitivity, glycemic control, lipid profiles, and oxidative stress. Small-scale studies have suggested that apple cider vinegar may reduce body weight and fat mass, but results remain inconsistent. For example, a recent meta-analysis reported no significant effect on BMI, though it excluded other key anthropometric outcomes.

About the Study

To address these uncertainties, researchers conducted a systematic review and meta-analysis that followed established guidelines, screening major databases up to March 2025. RCTs lasting at least four weeks and comparing vinegar consumption with placebo or other controls were included. Primary outcomes were changes in body weight, BMI, and waist circumference, with additional analyses examining subgroup effects by dose, duration, and participant characteristics.

Study Selection and Characteristics

Out of nearly 3,000 studies initially identified, only 10 RCTs, published between 2009 and 2024, met the inclusion criteria. Together, these trials involved 861 adults, mainly from Asia, North Africa, and the Middle East.

Participants were generally overweight, obese, or had T2DM, with average BMIs ranging between 26.5 and 32.1 kg/m². Interventions lasted between 4 and 12 weeks and typically involved daily intake of apple cider vinegar (5–30 mL, either as liquid or tablets), sometimes combined with dietary or exercise advice. Control groups received water, a placebo, metformin, or lifestyle guidance alone.

Effects on Body Weight, BMI, and Waist Circumference

The meta-analysis found that apple cider vinegar significantly reduced body weight and BMI compared to the control group. On average, participants lost approximately 7.5 kg. They experienced a 2.0 kg/m² reduction in BMI over 12 weeks, a pooled estimate with substantial heterogeneity, indicating that vinegar may be a promising adjunct for weight management.

These effects were consistent across both overweight/obese individuals and those with T2DM. Subgroup analysis revealed a dose-dependent effect, with modest reductions occurring at 5–15 mL/day, while the strongest benefits were observed at 30 mL/day. Both shorter (4–8 weeks) and longer interventions showed significant improvements.

Apple cider vinegar consumption also led to a modest reduction in waist circumference (about 3 cm). However, the effect was not consistent across all subgroups, as reductions were significant only among participants with T2DM. In sensitivity analyses excluding high-risk-of-bias studies, the impact of waist circumference was not significant. In contrast, no meaningful changes were observed in waist-to-hip ratio (WHR), regardless of dose or intervention length.

Risk-of-bias assessments revealed mixed methodological quality: two studies had a low risk of bias, three were unclear, and five carried a high risk, primarily due to issues with blinding. Nevertheless, sensitivity analyses that excluded high-risk studies still confirmed significant benefits of vinegar on body weight and BMI, supporting the robustness of these findings.

Conclusions

This meta-analysis demonstrates that apple cider vinegar supplementation can significantly reduce body weight, BMI, and waist circumference in adults, highlighting its potential role in managing obesity and type 2 diabetes mellitus (T2DM).

The reductions were most pronounced at a daily dose of 30 mL and were observed in both overweight/obese adults and those with T2DM. Importantly, sensitivity analyses confirmed the robustness of the effects of weight and BMI, even after excluding lower-quality studies, whereas the effects of waist circumference did not remain significant in these analyses.

Proposed mechanisms include slower gastric emptying, improved satiety, modulation of glucose and lipid metabolism, activation of adenosine monophosphate-activated protein kinase (AMPK) pathways, and possible effects on gut microbiota.

Strengths of this meta-analysis include the exclusive use of randomized controlled trials and the focus on relatively homogeneous populations, improving reliability. However, limitations include high study heterogeneity, short intervention durations, varied apple cider vinegar formulations and dosages, and possible publication bias.

In conclusion, apple cider vinegar appears to be a promising and accessible adjunct for obesity management, but larger, longer, and more standardized trials with systematic safety monitoring are needed to confirm its long-term effectiveness and safety.