Q. I've heard that the causes of obesity vary according to body constitution. What criteria are used for analysis?

The reason obesity cannot be simply attributed to 'calorie excess' is that the internal state of the body that causes obesity varies greatly depending on constitution. When analyzing constitution at Baekrokdam Korean Medicine Clinic, we examine four main criteria: First, the functional state of the Spleen and Stomach (digestive system). If you feel hungry shortly after eating, or if you feel that residual waste (stool) is not being formed properly, it may indicate Spleen deficiency (Pi Xu). Conversely, if appetite is strong but digestive and absorptive functions are hyperactive, it suggests Stomach Heat (Wei Re), which tends to cause fat accumulation in the upper body, especially around the face and chin. Second, Cold-Dampness (Han Shi) and Phlegm-Fluid (Tan Yin). If your hands and feet are cold, legs swell or feel heavy after sitting for long periods, and weight increases especially in non-exposed areas like thighs and calves, Cold-Dampness constitution is suspected. In Korean medicine, Dampness pathogen obstructs the movement of Qi, leading to accumulation of metabolic waste. Third, Blood Stasis (Yu Xue). If specific areas—especially the lower abdomen, inner thighs, or inner arms—do not lose fat despite exercise and diet control, blood circulation disorder (Blood Stasis) may be involved. This is difficult to improve with simple dieting and requires blood-activating (Huo Xue) management. Fourth, Lower Jiao Yang Deficiency (Kidney energy deficiency). If the lower abdomen protrudes, weight surges in cold weather, and symptoms worsen with fatigue, Spleen-Kidney Yang deficiency is considered. This constitution often has low basal metabolic rate, so dietary management alone is limited; warming the interior and tonifying the Kidney (Wen Li Bu Shen) become part of the treatment direction. In clinical practice, these four criteria are integrated with the patient's subjective symptoms, pulse diagnosis, abdominal palpation, and tongue examination. Rather than self-diagnosing 'what constitution I am,' it is more accurate to consult a professional Korean medicine doctor, because it is quite common for a person to have a mix of two or three constitutional factors. If you are interested, we can provide a simple symptom checklist when you visit; filling it out in advance can make the consultation more efficient.