Objective To compare the efficacy of treating obese patients with abnormity of lipids and serum leptin by dilatational wave or continuous wave of electroacupuncture combined with thunder-fire moxibustion in order to provide a clinical basis for selecting wave types of electroacupuncture for different patterns of obesity. Methods Sixty obese patients with abnormal lipids and serum leptin were randomly divided into a dilatational wave group and a continuous wave group via random number table, with 30 cases in each group. They were divided by TCM differentiation into three types: stomachintestine excessive heat, weakness of the spleen-stomach and spleen-kidney yang deficiency, treated by electroacupuncture on Tianshu (天枢 ST 25), Daheng (大横 SP 15), Zusanli (足三里ST 36), Shangjuxu (上巨虚 ST 37), Fanglong (丰隆 ST 40), Yinlingquan (阴陵泉 SP 9), Quchi (曲池 LI 11), Zhigou (支沟 TE 6) and Hegu (合谷 LI 4) along with thunder-fire moxibustion. The frequency of electro-acupuncture in the dilatational wave group and the continuous wave group was 2 Hz/100 Hz and 2 Hz, respectively. Patients in the two groups were treated once a day, six times a week. The treatment lasted for 4 weeks with 3-month follow-up. Body mass and body fat percentage before and after the treatment, as well as during the follow-up, were compared. The effectiveness rates in the two groups were compared, and the efficacy statistics of patients with different TCM patterns in the dilatational wave group were also analyzed. Lipid levels of the patients in two groups before and after the treatment were measured with an automatic biochemical analyzer, and serum leptin levels were detected with flow cytometry system. Results After the treatment, the patients' blood lipids, serum leptin levels, body mass and body fat percentage were effectively reduced in the two groups; three months' follow-up witnessed continuous decline of obesity indicators (P〈0.01 or P〈0.05), and patients in the di