📝 Detailed Answer
In practice, patients typically fall into two main categories: those who have lost all their energy due to a 'yo-yo effect' after using Western diet medications, and those who worry that severe edema will lead to permanent weight gain.
From a TKM perspective, the former often suffers from Spleen Deficiency (Bi-Heo, 脾虛). When Spleen function weakens, nutrient absorption and metabolism drop, making previous weight-loss methods less effective. In these cases, we prioritize boosting vital energy rather than simply suppressing appetite. The latter often presents with Phlegm-Fluid Accumulation (Dam-Eum, 痰飮), where waste products stagnate in the body and hinder circulation. For these patients, we first prescribe formulas to clear these stagnations.
Some ask if they can proceed entirely via remote consultation. However, to avoid anxiety and ensure safety, it is crucial during the first visit to identify the body's 'overload points' through pulse diagnosis and by checking for Blood Stasis (Eo-Hyeol, 瘀血)—stagnant blood that obstructs circulation.
Since every individual's constitution is different, reactions to the medicine vary. While some feel an immediate lightness, others may require an adjustment period. This is why a 1:1 personalized titration process is essential. Having experienced my own trials and errors during my studies, I strive to meticulously fine-tune the prescriptions to address even the smallest discomforts my patients may feel.