Q. I heard that the causes of obesity differ by constitution. What criteria do you use to analyze them?

Yes, obesity causes vary by individual. In Korean medicine, even if weight increases similarly, we analyze why it happens and what accompanying symptoms appear using constitution-based pattern identification. I used to think 'constitution' was vague, but in clinical practice, patterns become clear when examined step by step. First, appetite and digestion: if you binge-eat, have poor digestion, phlegm, and bloating, we suspect phlegm-fluid (dam-eum). This is a condition where stagnant turbidity accumulates in the body, often linked to abdominal obesity. Second, body shape and cold-warm sensation: if weight concentrates on the lower body, hands and feet are cold, and you are very sensitive to cold, qi deficiency (gi-heo) or yang deficiency (yang-heo) are likely. The body lacks energy and warmth, slowing metabolism. Third, stress responses and hwabyung symptoms: if you have chest tightness, facial flushing, and severe menstrual pain, we look at liver qi stagnation (gan-ul) and blood stasis (eo-hyeol). Stress blocks the flow of qi and causes blood to stagnate, potentially leading to obesity. Fourth, fatigue and lethargy: if you experience severe post-meal drowsiness, loose stools, and tire easily, spleen deficiency (bi-heo) is suspected. When the spleen function weakens, it cannot properly process fluids and nutrients, leading to weight gain. By integrating these criteria, we can identify which factor is the main cause for each person. Of course, not everyone fits neatly into one category; many cases involve a mix. Still, this approach provides sufficient guidance for setting a treatment direction.