Obesity is a global health problem characterized by excess body fat. It is commonly associated with a sedentary lifestyle and excessive food intake, but can also be caused by certain diseases. Chinese medicine can be helpful in managing obesity and related health conditions by addressing imbalances in the body. However, it's important to also follow the basic principles of eating less and exercising more. Standard measures of progress in treatment include the body mass index (BMI) and waist-to-hip circumference ratio. A higher BMI is linked to an increased risk of chronic illness.
Obesity is caused by consuming more calories than are burned through physical activity. Poor organ function can also contribute to weight gain by impairing the body's ability to process and utilize the energy from food.
Spleen and Stomach
Weakness of the spleen and stomach can cause poor digestion, leading to the accumulation of fat and fluid in the body. This weakness can be inherited or acquired through poor eating habits. Slimming diets often use purgatives, diuretics, and appetite suppressants that damage the spleen and do little to improve eating habits. This can lead to yo-yo dieting, which depletes spleen and kidney yang. Overeating can also overload the spleen and stomach, causing heat and dampness to accumulate in the body. This can lead to various health problems, including chest pain, blood vessel obstruction, and the formation of tumors.
Chronic liver qi constraint can weaken the spleen and cause the accumulation of dampness and phlegm. Prolonged or severe constraint can also generate heat, which can combine with dampness to form damp-heat or phlegm, or damage fluids and yin. This can also affect the gallbladder and lead to the formation of gallstones, which can impair digestion and cause more dampness to accumulate.
As we age, our kidney yang declines, which weakens the metabolic fire that supports other organ systems. This can lead to the accumulation of dampness, phlegm, and blood stasis, as well as the reduction of yin fluids and heat from deficiency. This can also lead to a sedentary lifestyle and decreased physical activity.
Treatment of obesity is difficult because it often involves complex emotional and social factors. Successful treatment requires a significant commitment from the patient and practitioner and usually takes a long time. Initial weight loss may be dramatic, but it is often mostly water weight. Real weight loss, or the loss of fat deposits, should be gradual and ideally no more than 0.25 kg per week. This allows the body to make the necessary metabolic changes to maintain the weight loss. During treatment, regular support, encouragement, and monitoring of progress are important for success. Acupuncture can provide a good framework for this, and treatment is typically given weekly for 3-12 months.
Food and Activity Diary
A food and activity diary can be useful for assessing the type and amount of food consumed and the energy expended. This can help create a personalized plan and increase awareness of food intake and expenditure. People often underestimate their food intake, but a food diary can become obsessive for those with spleen deficiency. It's important to be mindful of this potential issue.
A diet that reflects the pathology being treated is recommended, but it should be introduced gradually. Radical or sudden changes in diet are not advised since they are generally not sustainable. Some simple dietary guidelines for those wishing to lose weight include reducing the volume of food by 30%, eating more fresh vegetables and moderate amounts of fruit, avoiding refined carbohydrates, processed foods, and excessive amounts of fatty or fried foods, avoiding snacking between meals, and eating a large breakfast and lunch and a small dinner. Chinese medicine can be effective in supporting digestion and regular bowel movements, which are important for weight control. A disciplined and persistent approach is essential, but rigidity is counterproductive, especially for those with spleen deficiency. The 80/20 rule applies: do the right thing 80% of the time and allow for small indulgences 20% of the time.
A regular program of exercise or increased daily activity is essential for any weight loss plan. Exercise burns calories and makes muscle tissue more sensitive to insulin, so the pancreas can produce less and less sugar is stored as fat. The goal should be for at least 30-40 minutes of sustained aerobic activity every day or several times a week. This means getting the heart rate up to around 50% above the resting rate (e.g. to 120 beats per minute if the resting rate is 80) and maintaining it for 30-40 minutes. Walking is ideal, and weight training can also be beneficial. The benefits of aerobic activity accumulate over time and become self-sustaining.