Q. I've heard that the causes of obesity differ depending on one's body constitution. What criteria are used to analyze this?

In analyzing the causes of obesity by body constitution, we use four main axes. First, digestive function: if you feel bloated after meals, experience alternating constipation and diarrhea, or have poor digestion, it is usually rooted in Spleen Deficiency (bi xu). The spleen fails to properly digest and absorb food, leading to qi deficiency, and the unused energy tends to accumulate as fat. Personally, in my early days, I didn't recognize this pattern and tried dieting by eating less, which only worsened my stomach and led to yo-yo effects. Second, body temperature and cold sensation: those with unusually cold hands and feet, and a cool sensation in the lower abdomen when touched, are likely of Kidney Deficiency (shen xu) or Yang Deficiency (yang xu) constitution. The body's metabolic 'fire' is weak, so fat burns poorly, and water metabolism is sluggish, often accompanied by edema. Third, abnormal water metabolism: if you wake up with a puffy face, feel heavy throughout the day, or have a sensation of phlegm bubbling, the main cause may be Phlegm-Fluid (tan yin) or Damp-Phlegm (shi tan). In such cases, simple dietary control has little effect; instead, herbal medicine to eliminate dampness is needed to resolve fat metabolism. Fourth, stress response patterns: if you experience sudden binge eating or persistent craving with nausea when tense or angry, Liver Depression (gan yu) is contributing to obesity. Stagnant liver function disrupts stress hormone regulation and is strongly linked to abdominal obesity. We cross-validate these four criteria through pulse diagnosis, tongue diagnosis, and inquiry, and also consider the individual's Sasang constitutional predisposition (e.g., Taeyang, Soeum types) to form a complete picture. The key is not to pinpoint a single 'constitution,' but to assess the current direction of the body. For example, if Spleen Deficiency is predominant, we focus on fortifying the spleen; if Phlegm-Fluid is mixed in, we add herbs to expel phlegm (qu tan) — personalizing the approach accordingly.