“Can acupuncture help me lose weight?” I get this question ALOT. The answer is: it depends. Obesity is a disorder of excessive body fat that poses a health risk, and there are a few underlying causes, including lifestyle(overeating and consuming high caloric food and drinks, being sedentary, and so forth), endocrine and metabolic factors, body type, and genes/physiology. In the most basic scenario, or what is known as “simple obesity,” ingesting more calories than burned causes an increase in fat stored in the body. Microbiome, habits, stress, sleep disorders, mental health, and even occupation can affect body weight. Most cases are probably a combination of influences.
Despite its common occurrence, obesity is considered a disease by modern medicine, and it significantly increases the risk for many ailments such as heart disease, diabetes, cardiovascular events, joint problems like arthritis, not to mention serious covid complications. Fat collects not only in visible areas, but also in internal organs, affecting their function. If weight suddenly changes (up or down), it may be a sign of disease. Because it is such a health indicator and predictor, physicians chart it in their patients over time, and may discuss weight management during wellness checks if it has increased beyond the “healthy” range as per height, age, and body type. Extreme weight gain may need to be explored further to rule out serious causes.
Fat is considered an accumulation of internal dampness in Chinese medicine. This situation doesn’t happen overnight, and in alignment with the western medicine view, it might be complicated by genetics, endocrine or metabolic disorders, or other disease processes. If overweight or obesity have straightforward causes, then the pattern is one of two things (or a combination of these syndromes):a deficiency of the spleen (and possibly the kidneys); the accumulation of phlegm damp. This is caused by overeating (especially greasy, sugary, or processed foods), being sedentary, poor sleep, and weakness of the spleen. The spleen is thought to transform and transport the food we consume. Essentially, it transmutates or vaporizes the food we eat into qi and blood that the body can use. If this process falters due to the spleen under-functioning, the food essence will stagnate and linger, forming a damp quality. Dampness in Chinese medicine is described as a wet, heavy, and slow-moving, turbid pathogen. If it condenses, “phlegm-damp,” an even more obstructive mucous-like substance, accumulates interiorly- under skin, in internal organs and in tissue. The kidneys may also be involved in the development of phlegm damp, as they are responsible for eliminating fluids in the body. If the kidneys, which remove fluid waste from the body, are weak, then turbid damp fluid may cause a similar issue. These concepts of constitutional weakness and phlegm damp generation describe how fat is developed and is stored.
A differential diagnosis must be made to determine if the Spleen deficiency is the glaring problem or whether the phlegm damp accumulation is more predominant. With spleen deficiency, a patient might experience lethargy, abdominal distension, a slight swelling in the lower legs and have a weak, thin pulse- and actually a weak appetite. A Phlegm damp case might have a strong appetite, dizziness, shortness of breath, heaviness in the head and a sticky coating on their tongue. Needling points that tonify the spleen, kidneys, and qi in general help the former cases, whereas acupuncture points that resolve phlegm and eliminate dampness are used to correct the latter. Often times, both issues are treated together if the presentation is a more complex combination of deficiency and excess in this way. Some points overlap with both syndromes, and so these are essential to the protocol in most cases. (If excessive weight gain is caused by another process, then that must be determined. The treatment protocol according to that particular pattern of disharmony will follow.)
When patients discuss issues of weight gain with me, the obvious issues must be investigated first: Is lifestyle contributing (including sleep, diet, exercise, and chronic stress)? Are there complications, like endocrine issues or thyroid disorders? Do genetics or medications or other diseases processes have relevance? Are there digestive problems, like irritable bowels or indigestion? Are there coinciding symptoms? How does the tongue appear and how do the pulses feel? Treatment protocols are developed according to these findings, possibly along with Chinese herbal remedies to enhance treatments in difficult cases. Lifestyle modifications are almost always necessary. A slow and steady pace for weight loss is the best, most effective approach.