Q. I keep gaining the weight back (yo-yo effect). Is there a way to identify the fundamental cause of my obesity?

Recurring yo-yo dieting is often not just a matter of willpower; your body may be constitutionally set to store fat. In Traditional Korean Medicine, obesity causes are broadly divided into four patterns: **① Liver Depression (肝鬱) — Stress-driven binge eating** When liver qi is stagnated, qi and blood circulation become blocked, emotional swings intensify, and you crave sweets or late-night meals. If you feel tightness in the upper abdomen and eat more when angry, this pattern is likely. **② Spleen Deficiency (脾虛) — Weak-energy central obesity** Weak spleen function fails to transform food into energy properly, storing it as fat instead. You eat little yet gain weight, feel drowsy after meals, and often have loose stools. People who say 'I gain weight just from drinking water' often fall into this type. **③ Dampness-Phlegm (濕痰) — Edematous obesity** Fluids and waste products stagnate in the body. Legs swell more in the evening, the tongue has a thick white coating, and you feel phlegm in the throat. For this type, managing body water is more urgent than reducing fat. **④ Kidney Deficiency (腎虛) — Hormonal / aging-related obesity** After age 40-50, declining kidney function lowers basal metabolic rate and central fat accumulates. Cold lower back and knees, frequent nighttime urination, and cold extremities suggest Kidney Deficiency. These patterns can overlap. In a Korean medicine clinic, the exact pattern is determined through abdominal palpation (복진), tongue inspection (설진), and pulse diagnosis (맥진). Without knowing the root cause, simply fasting or relying on medications leads to repeated weight cycling. A constitution-based approach focusing on pattern correction is the most sustainable long-term solution.