Background: and purpose: Adolescent obesity has been increasing globally, and intervention is important. This study examined the effects of auricular acupressure on reducing obesity in adolescents. Materials and methods: Participants were 58 obese adolescents, divided into an experimental (n = 32) and a control group (n = 26). The study design was a randomized controlled trial. Auricular acupressure using vaccaria seeds was administered to the experimental group, while placebo auricular acupressure using vaccaria seeds was administered to the control group. Sessions continued for 8 weeks. Outcome measures included body weight, abdominal circumference, hip circumference, waist–hip ratio, body-mass index, body-fat mass, body-fat percentage, triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, serum glucose, and leptin. Results: Adolescents in the experimental group showed significant improvement in total cholesterol levels and low-density lipoprotein cholesterol levels after 8 weeks compared with those in the control group (p < 0.001). Conclusion: Auricular acupressure using vaccaria seeds was effective in decreasing total cholesterol levels and low-density lipoprotein cholesterol levels in adolescents with obesity.