Q. I eat less than others and put in a lot of effort, so why do I feel like I'm the only one who gains weight so easily?

In a busy professional life, stress and irregular meals can paradoxically lead to weight gain despite a low caloric intake. Western medicine often views this as increased insulin resistance or a significantly lowered basal metabolic rate, where the body enters a 'survival mode' and converts incoming energy into fat for storage. Traditional Korean Medicine (TKM) examines the root cause through the lens of internal balance. First, we look for Spleen Deficiency (脾虛), a state where the capacity to digest, absorb, and transport energy is weakened. This is much like a car with a weak engine; no matter how much fuel you provide, it cannot produce the necessary power. This deficiency leads to the formation of Phlegm-Fluid (痰飮), which is energy that failed to burn completely and turned into sticky metabolic waste. When Phlegm-Fluid obstructs the circulation of Qi and Blood, the body becomes prone to edema (swelling) and heaviness, eventually solidifying into a weight-retention constitution. Furthermore, poor circulation leads to Blood Stasis (瘀血), where the blood becomes turbid and stagnant in certain areas. This stasis can trigger low-grade inflammation, which further accelerates fat accumulation. In clinical practice, many patients express frustration that they gain weight even on a strict diet. In such cases, the priority should shift from 'eating less' to 'burning better.' It is not simply about cutting calories; it is a vital process of clearing out internal waste and replenishing the body's weakened metabolic functions to restore overall balance.