Q. I heard that a BMI over 30 is classified as high-degree obesity. What does that actually mean for my body, and why is it so much harder for me to lose weight than for others?

High-degree obesity should be understood as a systemic functional breakdown rather than a simple lack of willpower. From a Western medical perspective, when fat cells expand beyond their limit, they trigger a state of emergency characterized by chronic inflammation. This leads to insulin resistance (A), which prevents the body from burning energy and instead forces it to store more fat (B). Eventually, the brain's satiety signals (leptin) malfunction, creating a vicious cycle of intense hunger and a sluggish metabolism (C). Traditional Korean Medicine (TKM) identifies three core internal causes for this difficulty. First is 'Dameum' (Phlegm-fluid), where bodily fluids become thick and waste-like, blocking the flow of Qi. Second is 'Eohyeol' (Blood Stasis), where stagnant, impure blood hinders healthy metabolism. Third is 'Biheo' (Spleen Deficiency), a state where the digestive system is too weak to convert nutrients into energy, leaving them to accumulate as 'waste' or fat. Imagine a clogged drain; pouring more water in or trying to flush it out with force won't work until the blockage is cleared. For those with high-degree obesity, the priority is not starvation, but rather clearing these internal blockages and lowering inflammation levels. Once the body's circulation is restored and these 'knots' are untied, weight loss becomes a natural physiological progression.