Q. Doctor, I tend to gain weight only in my lower body. Why is that? And why is lower body obesity so much harder to deal with during a diet?

I have personally experienced the frustration of working out and wondering why certain areas simply refuse to slim down, despite extreme calorie restriction. Medically, the lower body is the most prone to blood and lymph stasis due to gravity. When this stagnation occurs repeatedly, unnecessary fluids and metabolic waste accumulate between cells, leading to 'edema.' Over time, this chronic swelling can evolve beyond simple edema and solidify into dense layers of adipose tissue. In Traditional Korean Medicine (TKM), we view this through two primary lenses. First is 'Dam-eum' (痰飮), which refers to the accumulation of metabolic waste and fluid residue resulting from impaired water metabolism in the body. Second is 'Eo-hyeol' (瘀血), or blood stasis. When blood becomes turbid and circulation is obstructed, the lower body loses heat and becomes cold, causing the local metabolic rate to plummet. Furthermore, if a patient suffers from 'Bi-heo' (脾虛)—a deficiency in the Spleen's function of digestion and absorption—nutrients are more likely to be stored in the lower body rather than utilized as energy. Ultimately, lower body obesity is a matter of 'flow' and circulation, not a lack of 'willpower.' Therefore, instead of jumping straight into intensive walking or exercise, the first step should be identifying where the blockage lies. Once the stagnant flow is properly restored, the trajectory and success of your weight loss journey will change completely.