Reviewed by최연승대표원장
Why can I receive a diet prescription without actually visiting a Korean medicine clinic?
Non-face-to-face prescriptions are possible because many people seeking weight loss have fairly typical pathological patterns, such as spleen deficiency (脾虛) or phlegm-fluid retention (痰飮). These can often be assessed through symptom inquiry and tongue photos. However, this method cannot replace pulse or abdominal diagnosis, which are crucial for complex cases like blood stasis (瘀血) or liver qi depression (肝氣鬱結). A reasonable approach is to start with a remote consultation but recommend an in-person visit when necessary.
The reason remote prescriptions are feasible is that the pathological mechanisms in many weight-loss patients are simpler than expected. From a Western medical perspective, appetite-regulating hormone imbalances and insulin resistance are common, leading to binge eating or carbohydrate addiction. In Korean medicine, this is often seen as spleen deficiency (脾虛): weakened spleen function fails to properly digest and transport food, generating phlegm-fluid retention (痰飮), which in turn stimulates appetite—a vicious cycle. This pattern can be largely identified through history-taking and tongue diagnosis (舌診); for example, a white coated tongue with loose stools or alternating constipation and diarrhea indicates typical spleen deficiency with phlegm. However, not all cases fit this profile. Those with stress-induced liver qi depression (肝氣鬱結) or blood stasis (瘀血) require pulse and abdominal examination. Therefore, I start with a remote consultation and recommend a visit if I sense the need for a more precise diagnosis. The advantages of a remote approach are time and cost savings, and a low barrier to starting treatment. The disadvantage is the lack of refined diagnostic methods. Based on my experience, many patients achieve satisfactory results remotely, but some need an in-person visit to clarify ambiguous patterns. Thus, rather than insisting solely on remote consultations, the most practical method is to begin remotely and transition to in-person care as needed. I learned this the hard way after initially insisting on remote-only consultations—now I adjust flexibly according to the situation.