Obesity is a well-known condition. It is often directly or indirectly associated with many diseases, such as diabetes, hypertension, atherosclerotic heart disease, fatty liver, and gallstones, and it also poses a risk of sudden death. Obesity results from changes in the body’s biochemical and physiological functions, leading to excessive accumulation of adipose tissue. In the absence of edema, water and sodium retention, or well-developed muscles, obesity is defined as a body weight exceeding the normal standard for adults by 20 percent; for men, total body fat exceeding 25 percent; and for women, total body fat exceeding 30–35 percent.
I. Health Risks of Obesity
1. Increased Mortality Rate: It is well established that the mortality rate among obese individuals differs significantly from that of people of normal weight. For example, the mortality rate from conditions such as diabetes, gallstone disease, and cirrhosis is 2.06 to 3.83 times higher in obese individuals than in those of normal weight; the mortality rate from chronic nephritis and coronary heart disease is 1.31 to 1.91 times higher in obese individuals than in those of normal weight.
2. Diabetes: The incidence of diabetes is significantly higher among individuals with long-term, persistent obesity. According to some statistics, the incidence of diabetes among obese patients is four times that of non-obese adults. Furthermore, 70–80% of patients with non-insulin-dependent diabetes mellitus (NIDDM) are obese. Why does obesity increase the risk of diabetes? Blood glucose levels in the human body are regulated by insulin secreted by the pancreas. Many scholars believe that the cells of obese individuals—particularly fat cells—are insulin-resistant. To meet metabolic needs, the pancreas must secrete 5 to 10 times more insulin than normal to ensure that glucose is utilized adequately and normally. Over time, the pancreas becomes unable to produce sufficient insulin, blood glucose levels rise, and diabetes develops.
3. Hyperlipidemia: In obese individuals, levels of cholesterol, triglycerides, and other lipids are higher than normal. Consequently, they are prone to atherosclerosis.
Obesity can also lead to hypertension, hyperuricemia (gout), angina pectoris, myocardial infarction, fatty liver, cholecystitis, cholelithiasis, orthopedic conditions (such as lower back pain, intervertebral disc injury, sciatica, age-related bone degeneration, osteoporosis, and degenerative knee arthritis), menstrual irregularities, infertility, breast cancer, chronic nephritis, nephrotic syndrome, venous thrombosis, and hemorrhoids.
II. Benefits of Weight Loss
1. Reduced Risk of Chronic Diseases: Obese individuals are prone to many chronic diseases; weight loss can lower the incidence of various chronic conditions.
2. Extended Lifespan: Gaining weight after middle age is detrimental to health. Since obesity can lead to many chronic diseases, it increases mortality rates and shortens life expectancy; conversely, weight loss can reduce mortality rates and extend lifespan. The old saying, “Even with great wealth, one cannot buy the slim figure of old age,” has a scientific basis.
III. Weight Loss Using Traditional Chinese Medicine
Traditional Chinese Medicine (TCM) views obesity primarily as a condition characterized by “deficiency at the root and excess at the branch.” The “deficiency at the root” is mainly qi deficiency; if accompanied by an imbalance of yin and yang, it may manifest as qi-yang deficiency or qi-yin deficiency. The disease involves the spleen, kidneys, liver, gallbladder, heart, and lungs. Clinically, spleen-kidney qi deficiency is most common, and dysfunction in the regulation of the liver and gallbladder is also frequently observed. The “manifestation” is primarily characterized by excess fat and phlegm-dampness, though cases accompanied by water-dampness, blood stasis, or qi stagnation are also common. Between the “root” and “manifestation,” as well as between deficiency and excess, there may be varying degrees of emphasis or complex interplay, resulting in a wide variety of complex symptoms. In clinical practice, one should combine pattern differentiation with disease diagnosis.
1. Eight Methods of Weight Loss in Traditional Chinese Medicine
(1) Strengthening the Spleen Method: This method is suitable for patients with spleen deficiency and qi weakness, reduced appetite, fatigue, obesity with weakness, a white tongue coating, a pale tongue body, and a fine, weak, and feeble pulse. For obesity, strengthening the spleen and tonifying the kidneys is the primary treatment approach. Formulas such as Shenling Baizhu San, Yigong San, and Wuling San may be modified for treatment.
(2) Soothing the Liver and Promoting Gallbladder Function: This method is suitable for obesity accompanied by costal pain, irritability, dizziness, fatigue, abdominal distension, a yellow tongue coating, a red tongue body, and a string-like pulse. Formulas such as Wendan Decoction, Shugan Decoction, and Xiaoyao Powder may be modified for treatment.
(3) Resolving Dampness: This method is suitable for obesity resulting from impaired spleen function leading to the accumulation of dampness. Patients present with abdominal distension, a greasy tongue coating, and a soft or deep and fine pulse. Formulas such as Fangji Huangqi Decoction or Zexie Decoction may be used with appropriate modifications.
(4) Phlegm-Resolving Method: This method is suitable for obesity caused by phlegm-dampness. Patients present with qi deficiency, chest tightness, drowsiness, reluctance to move, a white and greasy tongue coating, a swollen tongue, and a slippery pulse. Formulas such as Sanzi Yangqin Decoction, Daotan Decoction, or Erchen Decoction may be used with appropriate modifications.
(5) Diuretic Method: This method is suitable for obese patients with edema, oliguria, abdominal distension, a white tongue coating, and a fine, deep pulse. Treatment may involve modified formulas such as Shi Zao Decoction or Wu Pi Decoction.
(6) Digestive Regulation Method: This method is suitable for obesity caused by excessive appetite. Patients present with obesity, reluctance to move, abdominal fullness due to food stagnation, and a white tongue coating. Sanxian Decoction, with appropriate modifications, may be used for treatment (Sanxian Decoction consists of hawthorn, Shenqu, and barley malt).
(7) Bowel Regulation Method: This method is suitable for obesity caused by a preference for rich, sweet, and greasy foods. Patients present with excess-pattern obesity, a distended abdomen, dry and hard stools, difficulty moving, shortness of breath upon exertion, a thick yellow tongue coating, and a full pulse. Treatment involves the modified Da Cheng Qi Tang formula.
(8) Warming Yang Method: Used for obesity accompanied by spontaneous sweating, shortness of breath, breathlessness upon exertion, fatigue, low back pain, exhaustion, and aversion to cold—symptoms indicative of qi and yang deficiency. Treatment may involve modifications of Ling Gui Zhu Gan Decoction or Ji Sheng Shen Qi Pills.
2. Auricular Acupuncture for Weight Loss: The ear is closely connected to the internal organs and meridians throughout the body; auricular acupuncture can regulate the body’s physiological functions. It reduces appetite, regulates absorption and excretion, promotes metabolism, and thereby aids in weight loss.
3. Other Weight Loss Methods
(1) Acupuncture for Weight Loss: Acupuncture has a significant regulatory effect on the functional activities of various organs and tissues in the body.
(2) Exercise for Weight Loss: Sustained, moderate exercise can slow the aging process and benefits the cardiovascular, circulatory, respiratory, metabolic, and endocrine systems. Exercise increases the body’s consumption of fat.
(3) Qigong and Gymnastics for Weight Loss: Practices such as Longyou Gong, Song Shen Gong, gymnastics, and Tai Chi—life lies in movement, and exercise can help eliminate excess body fat.
(4) Dietary Weight Loss
① Control caloric intake to ensure it is lower than expenditure; maintain a balanced diet by reasonably allocating proteins, fats, and carbohydrates to achieve an appropriate low-calorie ratio;
② Pay attention to cooking methods: use less oil and opt for boiling or stewing;
③ Develop good eating habits: avoid sweets and snacks, and do not eat late-night meals before bed. Do not rely solely on fasting to lose weight;
④ Dietary guidelines: keep flavors light; eat until you are 80% full; eat more vegetables and less meat; avoid strong tea and coffee; abstain from alcohol; and eat a light dinner.
(5) Common Weight-Loss Recipes
① Diet to Strengthen the Spleen and Promote Diuresis: For obese individuals with spleen deficiency and excessive dampness. Examples include coix seed porridge, adzuki bean porridge, poria porridge, and winter melon porridge;
② Diet to Lower Lipids and Aid Digestion: For obese individuals with high lipid accumulation. Examples include corn porridge, corn silk tea, radish seed porridge, hawthorn porridge, and stir-fried celery with shiitake mushrooms;
③ Diet to Resolve Phlegm and Lower Lipids: Mustard greens congee, black fungus soup, almond and coix seed congee;
④ Diet to Tonify Qi and Warm Yang: Aconite and lamb soup, raw astragalus cake, etc.;
⑤ Diet to Promote Bowel Movements: Rhubarb rice, senna leaf congee, etc.