What exactly are obesity medications (like Wegovy) and why are they said to be effective for weight loss?
Obesity medications mimic gut hormones to suppress appetite centers in the brain and slow gastric motility, prolonging fullness. In Western medicine, appetite suppression and delayed gastric emptying are key. In TKM, this process parallels regulating the spleen-stomach (Pi-Wei) function. If spleen deficiency (Pi Xu) is present, fluid metabolism stagnates and weight gain occurs; the drug temporarily affects that pathway but does not resolve the root deficiency, so herbal therapy to supplement the spleen should be combined.
First, from the Western medical perspective: GLP-1-based obesity medications mimic incretin hormones from the gut, stimulating appetite centers in the hypothalamus. This reduces appetite and delays gastric emptying, prolonging satiety and naturally reducing daily calorie intake. In Traditional Korean Medicine, this is viewed through spleen-stomach (Pi-Wei) function. The spleen (Pi) governs food digestion and fluid distribution. Under chronic stress or poor diet, the spleen weakens into a state of spleen deficiency (Pi Xu). This disrupts fluid metabolism, leading to accumulation of phlegm-fluid (Tam Eum) — manifesting as abdominal obesity or generalized edema. Slowing gastric function with Western drugs can be seen as suppressing the Qi of the spleen-stomach. However, the fundamental spleen deficiency remains unresolved. I have often wondered why rebound weight gain is severe with such drugs; it occurs because phlegm-fluid persists and spleen function is not restored. Even if the scale number drops, if the constitution does not change, weight returns once the drug is stopped. Many patients also have concurrent blood stasis (Eohyeol) or qi stagnation (Giche), so individualized herbal medicine can be far more effective. If you are curious about an approach tailored to your constitution, feel free to consult anytime.
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