Q. Why is it possible to get a non-face-to-face (telehealth) herbal prescription for weight loss even if I live in a small local city?

From a Western medical perspective, weight loss is a chronic management process involving appetite control, basal metabolic rate, insulin resistance, and gut microbiota. Patient self-reports (diet logs, bowel frequency, fatigue) and vital signs (weight, blood pressure) are key, making remote management feasible. Many patients who have used Western drugs like Wegovy or Saxenda discontinue due to side effects (nausea, gastroparesis), and herbal medicine can be adjusted via telehealth for follow-ups. In Traditional Korean Medicine, weight loss disorders are primarily classified as spleen deficiency (脾虛, impaired digestion and absorption), phlegm-fluid retention (痰飲, excess water and fat), and blood stasis (瘀血, poor circulation). These pathologies are identified through pattern differentiation using appetite, bloating, tongue marks or coating, and stool form—information that can be obtained 70–80% accurately from facial and tongue photos, voice, and detailed questioning, even without pulse diagnosis. While the lack of pulse palpation is a limitation, a specialized telehealth intake form (covering appetite patterns, thirst, cold/heat sensitivity, sleep) combined with video consultation compensates effectively. The advantages of telehealth include freedom from time and location constraints, enabling consistent medication adherence and real-time dietary feedback. Disadvantages are the inability to physically assess body changes and difficulty monitoring compliance, so the first 1–2 weeks are safer in person. At Baeknokdam Korean Medicine Clinic, we require an initial in-person consultation, followed by remote follow-ups every 2–4 weeks. While I cannot disclose specific herbal costs or weight loss numbers, our focus is on analyzing the root cause of why weight is not decreasing.