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Q. I keep gaining the weight back after dieting. Is there a way to check the root cause of my obesity?

A.

Yes, you can self-check using this TKM-based checklist: 1. **Appetite & Cravings** – Severe hunger, especially for sweets? → Possible Liver Qi Stagnation or Spleen Deficiency. 2. **Fatigue & Weakness** – Easily tired, daytime sleepiness? → Spleen Deficiency and Qi-Blood deficiency. 3. **Digestion & Constipation** – Bloating, gas, loose or hard stools? → Spleen Deficiency with Phlegm-Fluid accumulation. 4. **Coldness & Edema** – Cold hands/feet, puffy face in morning? → Kidney Deficiency and Water-Dampness retention. 5. **Stress & Emotions** – Binge eating when stressed, chest tightness? → Liver Qi Stagnation type. If two or more apply, your body may need systemic balance, not just calorie cutting.

📝 Detailed Answer

Recurring yo-yo weight gain signals that your body is holding onto a 'starvation memory.' In Traditional Korean Medicine (TKM), this is viewed as a dysfunction in how your body stores and uses energy. The causes can be broken into three main axes: **1. Spleen Deficiency (脾虛, Bi Heo)** – Impaired digestion and absorption. The Spleen extracts Qi from food and distributes it. When weak, food turns into material waste (Phlegm-Dampness) instead of energy, accumulating as fat. Key signs: not eating much but having a protruding belly, slow digestion, loose stools, frequent gas. Often seen after crash dieting. **2. Phlegm-Fluid (痰飮, Dam Eum)** – Metabolic waste disorder. Chronic Spleen Deficiency leads to Dampness buildup that thickens into Phlegm-Fluid. This clouds the blood and misdirects nutrients into fat cells, causing hard, dense fat on the belly, thighs, and arms. Evening bloating worse than morning is typical. Fasting or excessive exercise in this state triggers a defensive response, worsening yo-yo cycles. **3. Liver Qi Stagnation (肝鬱, Gan Ul)** – Stress response dysregulation. The Liver governs Qi flow; stress, sleep deprivation, or emotional suppression block it. This disrupts appetite hormones (leptin, ghrelin), making it hard to resist sweets and fatty foods. Features: 'bored mouth,' night bingeing, chest tightness. **4. Kidney Deficiency (腎虛, Shin Heo)** – Homeostatic collapse. Declining Kidney function disrupts water metabolism and adrenal hormones. Common in aging or after repeated extreme diets. Signs: cold hands/feet, morning facial swelling, lower back soreness, frequent urination, poor sleep. **Self-check method:** Start with the five-item checklist in the short answer. If 2–3 or more items apply, a systemic balancing approach—rather than calorie restriction alone—is recommended. An accurate diagnosis, however, requires a TKM doctor’s evaluation including pulse, tongue, and abdominal palpation. The key first step is understanding why your body is holding onto weight, rather than forcing it off.
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Dr. Yeonseung Choe

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Dr. Yeonseung Choe

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