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Q. I've heard that the causes of obesity differ by constitution. What criteria are used to analyze this?
A.
Digestive function: If you feel bloated after eating and are often tired, suspect Spleen Deficiency (脾虛). Fluid metabolism: If your body easily swells and you rarely sweat, it may be Phlegm-Fluid (痰飮) or Dampness. Blood circulation: Pale skin or easy bruising suggests Blood Stasis (瘀血). Stress response: If stress triggers binge eating or upper abdominal discomfort, consider Liver Qi Stagnation (肝鬱). Body temperature and sweating: Cold hands and feet with slow digestion indicate Yang Deficiency; conversely, excess heat and sweating point to a different pattern.
📝 Detailed Answer
Yes, the causes of obesity do differ by constitution. I initially thought, 'Just eat less and move more,' but without knowing the underlying cause, weight regain is common. In Traditional Korean Medicine, rather than focusing on constitution itself, we analyze the current state of the body through pattern differentiation (辨證). There are four main patterns. First, Spleen Deficiency (脾虛) — when spleen function weakens, food is not properly digested and absorbed, accumulating as fat. Symptoms include post-meal bloating, lethargy, and loose stools. Second, Phlegm-Fluid (痰飮) — impaired fluid metabolism leads to dampness and phlegm buildup, causing a heavy, swollen body and little perspiration. Third, Blood Stasis (瘀血) — poor blood circulation prevents waste removal, resulting in localized fat deposits, a bluish complexion, and easy bruising. Fourth, Liver Qi Stagnation (肝鬱) — stress disrupts liver qi flow, affecting appetite-regulating hormones, leading to emotional binge eating, upper abdominal stuffiness, and chest tightness. Based on these patterns, we use pulse diagnosis (脈診), abdominal diagnosis (腹診), and tongue diagnosis (舌診) to create a personalized treatment plan. While we do not change the constitution itself, understanding the body's current state is the first step in effective weight management.
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Dr. Yeonseung Choe
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