Article 99: Eight Traditional Chinese Medicine Methods and Commonly Used Formulas for Weight Loss
Traditional Chinese medicine (TCM) weight loss is based on the principle of combining disease differentiation and syndrome differentiation, using Chinese herbal medicine. This involves treating both the root cause and the symptoms, strengthening the body's resistance, eliminating dampness and phlegm, clearing heat, promoting bowel movement, nourishing qi and blood, and soothing the liver and relieving depression-all methods to regulate the body's metabolic balance. Therefore, there are many types of Chinese herbs that can be used for weight loss, and their main purpose is the same as Western medicine: suppressing appetite, blocking glycogen synthesis, and promoting energy consumption and excretion. However, TCM's holistic approach, particularly its qi-tonifying and spleen-strengthening effects, is more effective in regulating the overall metabolism of obese individuals than Western medicine. Furthermore, the effects of Chinese herbs are generally milder and have fewer side effects, making them popular among patients. In addition to weight loss, TCM can also regulate blood lipids, lowering cholesterol and triglycerides while raising high-density lipoprotein cholesterol. Some weight-loss Chinese herbs also have the effects of lowering blood pressure, improving heart function, and relieving gastrointestinal discomfort and constipation. Processing Chinese herbal medicines into capsules makes them even more convenient for patients-advantages that Western weight loss methods lack.
Traditional Chinese medicine (TCM) considers obesity to be primarily a condition of deficiency in the root and excess in the branch. The deficiency is mainly Qi deficiency, which may be accompanied by Yin-Yang imbalance, resulting in either Qi-Yang deficiency or Qi-Yin deficiency. The disease affects the spleen, kidneys, liver, gallbladder, heart, and lungs, with spleen and kidney Qi deficiency being the most common clinically, although liver and gallbladder dysfunction may also be observed. The excess is mainly characterized by fatty substances and phlegm, often accompanied by dampness, and sometimes blood stasis and Qi stagnation. The deficiency and excess can be emphasized and intertwined, leading to complex and diverse symptoms. Clinical practice requires a detailed examination of symptoms, tongue, and pulse, focusing on key points, identifying the underlying cause, combining syndrome differentiation with disease differentiation, carefully prescribing medication, and adapting to changing circumstances to achieve satisfactory therapeutic effects.
(1) Dampness-resolving method: used for obesity caused by spleen deficiency and dampness accumulation. Symptoms include abdominal distension, greasy tongue coating, and deep and thready pulse. Representative formulas include Ze Xie Tang, Er Shu Fu Ling Tang, and Fang Ji Huang Qi Tang.
(2) Phlegm-removing method: used for obesity caused by phlegm turbidity. Symptoms include qi deficiency and chest tightness, drowsiness and lethargy, white and greasy tongue coating and swollen tongue, and slippery pulse. For mild cases, use Er Chen Tang, Ping Chen Tang, or San Zi Yang Qin Tang; for severe cases, use Kong Xian Dan or Yi Tan Tang.
(3) Diuretic method: There are two types: mild diuresis and radical diuresis. Symptoms include obesity, edema, oliguria, abdominal distension, white tongue coating, and thready and deep pulse. Mild diuresis is treated with Wupi Decoction, Daoshui Fuling Decoction, and Xiaofenqing Decoction, while radical diuresis is treated with Zhouche Pill, Shizao Decoction, etc.
(4) Bowel-clearing method: mainly using mild purging. It is mostly used for obesity caused by excessive consumption of rich and fatty foods. Symptoms include obesity with excess, large abdomen, dry stool, difficulty in movement, shortness of breath upon exertion, thick yellow tongue coating, and strong pulse. Major Purgative Decoction, Minor Purgative Decoction, Stomach-Regulating Purgative Decoction, or rhubarb tablets alone can be selected.
(5) Digestive Method: Used for obesity caused by loss of appetite. Symptoms include obesity, lethargy, abdominal distension, food stagnation, and a white tongue coating. Hawthorn is generally used to eliminate meat stagnation, Shenqu (medicated leaven) is used to eliminate fat stagnation, and malt is used to eliminate food stagnation. Combined, they form the Three Immortals Drink, which has a certain effect on obesity caused by overnutrition.
(6) Liver-soothing and bile-promoting method: Used for obesity, and also for symptoms such as liver qi stagnation or blood stasis. Symptoms include obesity accompanied by hypochondriac pain, irritability, dizziness, fatigue, abdominal distension, yellow tongue coating and red tongue body, and wiry pulse. Commonly selected formulas include Wendan Decoction, Liver-soothing Drink (Bupleurum, Curcuma, Turmeric, Peppermint), Xiaozhang Powder (Amomum villosum, Radish Seed), and Xiaoyao Powder (pills).
(7) Strengthening the Spleen: The primary treatment for obesity is to strengthen the spleen and stomach. Symptoms include spleen deficiency and weak qi, reduced appetite, fatigue, obesity and weakness, pale tongue coating, and weak pulse. Commonly used formulas include Ginseng and Atractylodes Macrocephala Powder, Citrus Aurantium and Atractylodes Pill, and Five-Ingredient Poria Powder.
(8) Warming Yang Method: Used for obese patients with symptoms of Qi and Yang deficiency, such as spontaneous sweating, shortness of breath, wheezing upon exertion, fatigue, lower back pain, exhaustion, and aversion to cold. Commonly used formulas include Jisheng Shenqi Wan, Jiawei Shenqi Wan, Gancao Fuzi Tang, and Linggui Zhugan Tang.
Prescription: 0.3g rose petals, 0.3g jasmine petals, 0.5g bitter orange blossom, 1.5g Sichuan lovage rhizome, 1g lotus leaf, 1g tetrapanax papyriferus, 5g apricot kernel, 5g hemp seed, 12g whole trichosanthes fruit, 12g bergamot, 12g polygonatum rhizome, 1g ginseng and notoginseng. Decoct the ingredients, spray the decoction onto the lotus leaf, dry it, and steep it in hot water. Take 2 packets daily. One course of treatment is 3 months.
Functions: Relieves chest tightness and promotes qi circulation, removes blood stasis and eliminates phlegm, promotes diuresis and reduces swelling, invigorates blood circulation and nourishes the stomach, lowers lipids and refreshes the mind. Suitable for simple obesity.
Prescription: Senna leaf 1.5g, Alisma plantago-aquatica 12g, hawthorn 12g, cassia seed 12g, made into granules, taken in 2 divided doses. One course of treatment is 4 weeks.
Functions: Clears stomach heat, promotes diuresis, and strengthens the spleen. Suitable for simple obesity.
Prescription: 9-12g of prepared Pinellia ternata, 5-12g of dried tangerine peel, 9-12g of stir-fried Atractylodes lancea, 9-12g of stir-fried Coix lacryma-jobi, and 9-12g of Areca peel, made into concentrated pills. Take 45 pills each time, 3 times a day.
Functions: Strengthens the spleen and eliminates phlegm and dampness. Suitable for obesity caused by phlegm and dampness.
Prescription: 10g of prepared Pinellia ternata, 10g of dried tangerine peel, 10g of white Poria cocos, 10g of stir-fried Coix lacryma-jobi, 15g of stir-fried Atractylodes lancea, 15g of stir-fried Atractylodes macrocephala, 10g of Areca peel, 10g of Plantago asiatica (20g if fresh), 10g of stir-fried Alisma plantago-aquatica, 10g of winter melon peel (20g if fresh), 10g of prepared Cyperus rotundus, 15g of Platycladus orientalis seed. Decocted in water and taken orally.
Functions: Strengthens the spleen, dries dampness, and resolves phlegm. Suitable for obesity caused by phlegm-dampness.
People who frequently buy diet pills or slimming foods will find that the main ingredients in the dazzling array of products are just the following few.
Cassia seed, also known as herbaceous cassia or horse hoof cassia, is the mature seed of the annual herbaceous plant *Cassia tora* or *Cassia obtusifolia*, belonging to the legume family. Modern research on traditional Chinese medicine has found that cassia seed can inhibit the rise of serum cholesterol and the formation of atherosclerotic plaques. Because cassia seed contains more than 10 anthraquinone components, including rhein, emodin, aloe-emodin, rheinic acid, emodin anthrone, cassiaside, cassia seed extract, and auranthionein, it has liver-clearing and vision-improving effects, as well as a mild laxative and slimming effect. Therefore, long-term consumption of cassia seed can achieve the effect of lowering lipids and slimming.
Cassia seeds are both a food and a medicine. They can be stir-fried and then steeped in hot water to make tea, which has the effect of clearing heat and improving eyesight. Cassia seeds also have a mild laxative effect and can interfere with the absorption of fat and carbohydrates, making them a commonly used traditional Chinese medicine for weight loss. They can be used in decoctions, powders, and tablets. The laxative effect is stronger when used raw than when stir-fried. The usual dosage for decoctions is 10-15 grams. Crushing the seeds before adding them to the decoction will enhance the effect.
Lotus leaf, also known as lotus root, is the dried leaf of the lotus plant (Nelumbo nucifera), a member of the Nymphaeaceae family. Modern pharmacological studies have shown that lotus leaves contain lotusine, nuciferine, lotus glycoside, quercetin, tartaric acid, citric acid, and tannins. They have slimming, lipid-lowering, and cholesterol-lowering effects. Clinically, they are effective for treating obesity caused by spleen deficiency. Lotus leaves also have heat-clearing and diuretic properties; traditionally, lotus leaf porridge is consumed during the summer to dispel summer heat. Clinically, they are often used for weight loss, especially in summer, or for obese patients with spleen deficiency and dampness-heat syndrome or stomach heat and dampness obstruction.
Fresh lotus leaves are harvested in late autumn and before winter, washed, cut into small pieces, sun-dried, and stored. Alternatively, washed lotus leaves can be chopped, sun-dried or oven-dried, ground into a fine powder, bottled, sealed, and stored for later use. Dried lotus leaves are available in traditional Chinese medicine shops in cities and some towns. Lotus leaves can strengthen the spleen and promote diuresis, relieve summer heat and reduce swelling, and promote fat metabolism. The ancient medical text *Zheng Zhi Yao Jue* records that "consuming lotus leaves makes one thin and weak." Modern slimming Chinese medicine and dietary therapy often use lotus leaves, considering them an excellent product for fat reduction and weight loss. Dried lotus leaves have the same effects as fresh lotus leaves; fresh lotus leaves harvested in summer and sun-dried can be used year-round.
Its effects are to clear heat and promote bowel movement, and to induce urination. It is used for constipation, especially for constipation due to heat accumulation, abdominal pain, and edema. It can be brewed alone with boiling water as a tea, or added to decoctions or powders. For mild purgation, use 1.5–3 grams; for strong purgation, use 5–10 grams.
Pharmacological studies have shown that senna leaves contain sennosides A, B, C, and D, rhein, emodin, aloe, emodin, polysaccharides, etc. It has a laxative effect by promoting intestinal peristalsis and can be clinically used for acute pancreatitis, bacillary dysentery, epidemic hemorrhagic fever, cholecystitis, and postpartum lactation suppression.
Because senna leaves are convenient to use and have a rapid effect, they have become a commonly used traditional Chinese medicine in the treatment of obesity in recent years. They are suitable for obese patients with excess syndrome and those suffering from constipation. However, they are contraindicated for obese patients with deficiency syndrome, those with weak spleen and stomach, loose stools, obese children, breastfeeding and menstruating women, and pregnant women.
When using senna leaves, it is important to pay attention to the appropriate dosage. Excessive dosage can cause nausea, vomiting, abdominal pain, and there have been reports of gastrointestinal bleeding and epileptic seizures.