Objective To analyze the effect of acupuncture combined with acupoint catgut embedding on physical anxiety and body contouring effect in overweight and obese female patients. Methods A total of 86 overweight and obese female patients admitted to the Department of Preventive Medicine, Liyang Hospital of Traditional Chinese Medicine from March 2021 to August 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 43 patients in each group. The control group was treated with acupuncture, and the observation group was treated with acupuncture combined with acupoint catgut embedding. The physical anxiety, body contouring effect, blood lipid indexes and glucose metabolism indexes were compared between the two groups. Results After intervention, the scores of NE, SP and SC in the observation group were lower than those in the control group (P <0.05). The BMI, body fat percentage and waist-hip ratio in the observation group after intervention were lower than those in the control group (P <0.05). The TC and TG in the observation group after intervention were lower than those in the control group (P <0.05). The FPG and FINS in the observation group after intervention were lower than those in the control group (P <0.05). Conclusion Acupuncture combined with acupoint catgut embedding is helpful to relieve the physical anxiety of overweight and obese female patients, enhance their body contouring effect, and play a positive role in regulating blood lipid and improving glucose metabolism.