Weight Loss Medication: What's the Difference Between Herbal and Western Medicine?
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Last month, Ms. Sujin (pseudonym) showed me her phone screen as soon as she entered the consulting room.
"Doctor, this is a drug called Wegovy. My friend lost 12 kilograms in three months. I was thinking of trying it too, but I don't know how it differs from traditional Korean medicine, so I came here."
I get these questions very often these days. To be honest, when I first saw the clinical data for GLP-1 class drugs, I found it quite impressive.
What GLP-1 Drugs Have Shown
In the STEP 1 clinical trial (2,539 participants) administering 2.4mg of semaglutide (Wegovy's active ingredient) for 68 weeks, participants experienced an average body weight reduction of 17.3%. This means someone weighing 100kg became close to 83kg. This figure is overwhelmingly superior compared to any existing non-surgical weight loss method.
However, when I explain this to Ms. Sujin, I always share the subsequent data as well.
One year after discontinuing the treatment, approximately two-thirds of the lost weight was regained. The proportion of participants maintaining a weight loss of 5% or more decreased from 86.4% to 48.2%. Furthermore, nausea occurred in 43.9% during the treatment period, which is quite high compared to 16.1% in the placebo group. The initial 20 weeks of dose escalation are particularly challenging.
Ms. Sujin asked.
"So, do I have to take it for life?"
I replied, "That's highly likely."
How Traditional Korean Medicine Approaches Weight Loss Differently
At this point, I bring up traditional Korean medicine. However, I'm not trying to say "traditional Korean medicine is better." I aim to explain that the mechanisms of action are fundamentally different.
Taking Bangpungtongseongsan (防風通聖散) as an example, it's a prescription that helps reduce heat and eliminate waste products. A comprehensive analysis of 7 randomized controlled trials involving 679 participants showed an average BMI reduction of 0.52 (P=0.003) and confirmed visceral fat reduction after 24 weeks of administration. No serious side effects were reported.
Looking purely at the numbers, the weight loss is smaller compared to GLP-1. This is true.
However, what I observe in the consulting room isn't just numbers. Patients receiving traditional Korean medicine treatment typically experience changes in their digestion first. Many report "my appetite has changed" or "the bloating is gone" around weeks 2-3. The body's rhythm changes before the scale's numbers do.
I don't simply view this as a "side effect." I understand it as a process where a prescription tailored to one's constitution adjusts the cycle of digestion, metabolism, and sleep.
Comparison Summary
Here's a summary for easy comparison:
| Category | GLP-1 Medication (Semaglutide) | Traditional Korean Medicine (Bangpungtongseongsan-based) |
|---|---|---|
| Average Weight Loss | 17.3% (68 weeks) | BMI -0.52 (24 weeks) |
| Maintenance after Discontinuation | 2/3 rebound (1 year) | Easier to maintain when linked to lifestyle changes |
| Main Side Effects | Nausea 43.9% | No serious side effects reported |
| Mechanism of Action | Appetite suppression (GLP-1 receptor) | Adjustment of digestion and metabolic cycles |
| Administration Method | Once-weekly subcutaneous injection | Oral administration (decoction/pills) |
| Personalization | Dose adjustment | Prescription tailored to constitution and symptoms |
Which Option is Right for Whom?
This is not something I can decide for you. However, there are patterns I have repeatedly observed in the consulting room.
Check yourself:
- You often experience indigestion or frequent swelling/edema.
- Weight rebound (yo-yo effect) has recurred after stopping diet medications.
- You have a sensitive stomach.
If two or more of these apply to you, a constitution-based approach might be worth considering first.
Cases where GLP-1 might be suitable: Individuals with severe obesity (BMI 30 or higher) who have an urgent risk of metabolic diseases. Situations where rapid weight loss is medically necessary.
Cases where traditional Korean medicine might be suitable: Individuals accompanied by indigestion, swelling/edema, and chronic fatigue. Those who struggle to lose weight even when reducing food intake. Individuals who have already experienced weight rebound after discontinuing medications.
Ms. Sujin had a BMI of 26 and severe indigestion. After a constitutional diagnosis, I suggested traditional Korean medicine treatment, and Ms. Sujin agreed.
Frequently Asked Questions
Does traditional Korean medicine for weight loss also cause a yo-yo effect?
Honestly, traditional Korean medicine alone cannot completely prevent the yo-yo effect. However, because digestive power and metabolic patterns change together, I observe in clinical practice that the maintenance rate increases when combined with dietary adjustments.
Can Western medicine and traditional Korean medicine be taken together?
Whether co-administration is possible varies by case, so you must inform both your prescribing physician and traditional Korean medicine doctor.
Conclusion
I meet people like Ms. Sujin every week. They come with the name of a trending medication and ask if it's right for them. Each time, I tell them, "There isn't one right answer." However, understanding your body's condition accurately – that's where you should start to minimize regrets, no matter what choice you make.
If you're curious about the direction best suited for your constitution and current condition, Baekrokdam Korean Medicine Clinic will assist you with a consultation.
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