Registered Chinese Medicine Practitioner
Bachelor of Health Science in Traditional Chinese Medicine (UTS)
Bachelor of Science Majoring in Psychology (UOW)
Specialising in pain management and mental wellbeing through Tradition Chinese medicine in combination with modern science in mental health, dieting and nutrition.
I think one of the most frequently asked questions for anyone in the medical and health field is “how do I lose weight?” and modern science and society is on a never ending quest to solve this prevalent problem.
While we are currently still on the topic of food therapy I thought it would be amiss for me not try to at least touch on this subject as it is a very fascinating topic. I would like to devote this article and the next on this topic as it is a very dense subject. In this article I would like to introduce the concept of obesity and how it is viewed in TCM and how different patterns determine methods of treatment. While the next article will focus on how to approach this matter with food therapy.
According to the WHO “Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 25 is considered overweight, and over 30 is obese， BMI is calculated by weight (kg) divided by height squared (cm x 2). The issue has grown to epidemic proportions, with over 4 million people dying each year as a result of being overweight or obese in 2017 according to the Global Burden of Disease.
Rates of overweight and obesity continue to grow in adults and children. From 1975 to 2016, the prevalence of overweight or obese children and adolescents aged 5–19 years increased more than four-fold from 4% to 18% globally.”
根據世界衛生組織的說法：「超重和肥胖被定義為異常或過多的脂肪積累並對健康構成風險。體重指數 (BMI) 超過 25 被視為超重，超過 30 被視為肥胖，體重指數是體重除身高乘2。這一問題已發展成為全球流行病，根據全球疾病負擔報告，2017 年每年有超過 400 萬人因超重或肥胖而死亡。 成人和兒童的超重和肥胖率持續上升。從 1975 年到 2016 年，全球 5-19 歲兒童和青少年超重或肥胖的患病率增加了四倍多，從 4% 增加到 18%。」
There are many causes of overweight and obesity but the most common one are overconsumption of energy dense foods that are high in fat and sugars as well as a decrease in physical activity due to sedentary lifestyle which is promoted by modern conveniences such as ease of transport and fast foods. Other factors include medical causes such as hormonal imbalances as well as genetics and use of medication.
In Su Wen it states that “if obesity occurs in the nobleman and rich people, they must be over consuming heavy and greasy foods” and historically ancient China knew about the links of obesity with other metabolic disorders such as diabetes and stroke.
One difference between the western and TCM perspective of weight is that in from the western theory is to exercise and eat a proper diet to target build-up of excess fat. TCM we do not directly treat excess weight but instead we need to look at the underlying body condition that lead to the weight gain and there is a saying “to treat the root to address the surface”. What this means is at the surface level we can only see the weight gain but the true cause, or the root, may not be a simple as lack of exercise or bad diet and once the body’s balance is restored then the body will function normally and weight will be lost.
According to TCM, fat is classified as phlegm-damp and if you remember from the previous articles, the Spleen governs the transformation and transportation and this includes foods and body fluids, thus dampness. If the Spleen becomes damaged by eating excess of sweet food in combination with inactivity then its function to transform and transport is impaired. This means food and waste will linger and gather into dampness and over time it will congeal into phlegm and eventually fat.
We can further differentiate overweight and obesity into 4 types.
Excess internal phlegm and dampness
As mentioned earlier the spleen is in charge of moving dampness and when it is unable to it congeals into phlegm and turning into fat. The excessive internal phlegm manifests itself as excess weight, accompanied by tiredness, body heaviness, chest and stomach distension as well as poor appetite. To treat this pattern we need to harmonise the spleen and stomach to aid digestion with foods such as Hawthorn or using Yi Yi Ren and Fu Ling to make a soup or congee
Stagnation of Qi and blood
When Qi and blood is stagnant this leads to stasis in the vessels and blood thickens and the flow is impeded and over time can lead to arteriosclerosis or the thickening of the vessels and obesity. People suffering from this pattern may experience dizziness and numbness in the four limbs as well as low motivation, chest or breast fullness, insomnia, a dreamy state, menstrual disorder or amenorrhea and infertility. Red dates and Dang Gui are perfect for moving Qi and Blood.
Yang deficiency of Kidney and Spleen
The spleen’s main function of transformation of foods to Qi is largely dependent on the Kidney Yang and conversely the Kidney Yang is dependent on the Spleen Yang. Without going into the intricacies of the spleen and kidney, we can summaries that if the kidney is weak then the spleen will be unable to provide Qi to the body and unable to move and transform the dampness. Congee with some easy to digest red meat is perfect to tonify the Spleen and Kidney Yang.
Finally when the Liver Qi is stagnate this can lead to prolong periods of strong negative emotions such as anger and depressive symptoms. As the Liver Qi stagnates it will harm the Spleen and cause turbidity of Qi flow thus hindering the removal of dampness in the body. Tumeric, Ginger and sour foods such as lemon is great for moving Liver Qi.
There are many more factors that can lead to overweight and obesity and patterns can also be slightly be different between different people but I hope this can provide everyone with a basic understanding of how we can address this issue with TCM. With some of the basics out of the way, next time we can have a look at how we might combat these problems with food therapy.