Q. My upper body is fine, but my legs are always swollen and I can't seem to lose weight there. What is the real cause of lower body obesity?

As a practitioner who stands or sits in the consultation room all day, I often see my own legs swell significantly by evening. Seeing those deep indentations from socks can be quite alarming. You should think of lower body obesity as a form of 'traffic congestion' inside your body. Western medicine explains this phenomenon through the influence of gravity. Blood and fluids pool downward, and if muscle strength is weak or circulation is stagnant, that fluid cannot travel back up. When fluid leaks from vessels and fails to re-enter the lymphatic system, it hardens into chronic edema. This neglected swelling creates inflammation around fat cells, binding tissues together into what we commonly call cellulite. Traditional Korean Medicine (TKM) interprets these changes through the concepts of Blood Stasis (Eohyeol) and Phlegm-Fluid (Dameum). Blood Stasis refers to blood that has become viscous due to poor flow, while Phlegm-Fluid refers to the accumulation of pathological metabolic waste. Specifically, when one falls into a state of Spleen Deficiency (Biheo), the body's ability to metabolize water drops significantly, causing waste to settle in the lower body. This is further exacerbated by 'Lower Jiao Coldness' (Hacho Hallaeng)—a condition where the lower abdomen and legs are cold. Just as oil solidifies in a cold engine, a cold lower body significantly slows down fat decomposition. If your leg fat doesn't budge despite moving more and eating less, it is not due to a lack of willpower. It is often caused by pathological circulation disorders. This is why treatment must focus on restoring warmth to the lower body and unblocking the circulation of Gi and Blood rather than simply starving yourself.