The Practical Value of Traditional Chinese Medicine's Classification of Obesity and its Relationship with Modern Syndrome Classification

However, a fleshly person cannot be entirely equated with the masses: "The masses are those whose skin, flesh, fat, bones, blood, and qi are all..."

Character is inherent, therefore it cannot be added together, nor can it be increased; similarly, its size and form are merely proportionate, not comparable.

"Addition" refers to the harmony of Qi and blood. In this state, the skin, flesh, and fat cannot accumulate and cause obesity. The relative depth and superficiality of Qi and blood...

Each has its own fixed place, and cannot be found among the wind and fat of flesh. Skin, flesh, tendons, and bones each conform to their own body, therefore their shapes are not...

It's neither too big nor too small. "This shows that most people have a normal weight, with both fat and muscle mass within the normal range."

The state of health.

A fat person is obese with loose skin and flesh; a fat person is obese with tight skin and flesh; a fleshy person is obese with firm muscles.

The classification of obesity into three types in the *Huangdi Neijing* (Yellow Emperor's Inner Classic) uses the distribution of fat as the main diagnostic principle, which differs from Western medicine.

Using fat distribution as the key classification point and research hotspot aligns with this approach.

Regarding the ancient Chinese medicine classification of obesity

Based on the understanding of this type and modern obesity medicine, it is generally believed that people with abdominal obesity belong to the category of "abdominal obesity" in Western medicine.

"Obesity" is commonly seen in wealthy and privileged individuals who are described as having "piles of gold and jade, and bellies like hanging baskets"; lack of exercise leads to fat accumulation.

The main cause of fat accumulation in the abdomen. Fat accumulation in this individual is similar to "homogeneous obesity" in Western medicine, belonging to a category of...

Obesity due to body fat. A fleshy person is large and robust, and while not entirely a sign of illness, it is similar to "balanced" or "uniform" obesity.

This type of obesity shares similarities with "sexual obesity"; its excessive weight is mainly due to well-developed muscles, and it is commonly seen in athletes.

Mobilize heavy and manual laborers, etc. Some also correspond fat, grease, and meat to: abdominal obesity, short stature, etc.

Type 1 obesity and generalized obesity.

(3) The practical value of the three fierce men in the Secret Cavity

Obesity is essentially caused by excess body fat, and the classification of obesity into three types in the *Huangdi Neijing* (Yellow Emperor's Inner Classic) is a formal starting point.

Ultimately, the distribution of fat deposits was used as the primary principle for diagnosis and the standard for classification. This aligns with modern obesity medicine's focus on fat distribution.

The distribution serves as a clue, aligning with research hotspots from a prognostic perspective. It can be considered that the *Huangdi Neijing*...

The three types of obesity described in the *Neijing* (Inner Canon of Medicine) are likely the earliest classification of obesity in the world based on the principle of "fat distribution."

This method, also known as the "prevention of disease" approach in Traditional Chinese Medicine, combines classification and syndrome differentiation to achieve therapeutic effects.

A scientific classification method that is consistent with prognosis.

Currently, people with abdominal obesity are considered to have "abdominal obesity" in Western medicine.

The main reason for fat accumulation in the abdomen is lack of physical activity. This is different from the "uniform obesity" described in Western medicine.

Similar to obesity caused by overall body fat, this type of person is obese and physically imposing, which, while not necessarily pathological, is...

It shares similarities with "uniform obesity"; the main reason for its excessive weight is well-developed muscle mass.

It is commonly seen in athletes and manual laborers.

(4) Characteristic external body shape features of the three types of obesity in the Yellow Emperor's Inner Classic

Based on extensive clinical observation of numerous obese cases in China and long-term experience accumulation, the initial determination of the paste...

The physical characteristics of humans, fat people, and flesh people.

People with this body type have fat mainly concentrated in the abdomen, resulting in a large protrusion of the abdomen, while their limbs and buttocks are relatively thin.

Small. Spider-shaped. More common in the elderly, with a poor prognosis.

A person with a high fat content has fat evenly distributed throughout their body. They have small shoulders, well-proportioned limbs, small bones, and small hands and feet.

The skin is smooth and dense. Males have sparse facial hair, armpit hair, and body hair. The body shape is narrower at the top and wider at the bottom.

Body type. Commonly seen in mental laborers. Prognosis is generally poor.

A fleshy person, with well-developed muscles and little fat. Broad shoulders, thick back, large hips and thighs, relatively large bones, and large hands.

Large feet, relatively rough skin. Men have denser beards, armpit hair, and body hair. Women have...

Some secondary sexual characteristics are more masculine. Body shape is inverted triangle. Commonly seen in manual laborers. Prognosis

better.

In daily life, besides the typical obese individuals (those with thick skin, fat, or flesh), mixed-type obesity is also very common.

common.

Classification of obesity by physicians throughout history and modern TCM scholars

Modern TCM scholars classify obesity primarily based on syndrome differentiation. (National Academic Conference on Obesity Research)

Obesity is classified into five types: spleen deficiency with phlegm and dampness, stomach heat with dampness, liver stagnation with qi stagnation, and spleen and kidney deficiency.

Obesity is classified into two types: Yin deficiency with internal heat. *Traditional Chinese Medicine Internal Medicine* further categorizes obesity into stomach heat stagnation in the spleen, phlegm-dampness accumulation, and spleen deficiency.

Four types: deficiency syndrome, spleen and kidney yang deficiency syndrome.

Classification by body constitution is a more commonly used method in recent years. Zhu Yanbo et al. used Logistic regression...

The risk of being overweight and obese is significantly higher in individuals with a balanced constitution, while the risk of obesity is significantly higher in those with a Qi deficiency constitution.

The high levels of these results demonstrate that phlegm-dampness constitution and qi deficiency constitution are the main constitutional factors influencing overweight and obesity.

Professor Wang Qi's Class

Based on ancient literature and theoretical research, the question set categorizes obesity according to constitution into Qi deficiency type, phlegm-dampness type, and...

Phlegm-dampness with blood stasis type. Qi deficiency type obesity is mainly characterized by fatigue, shortness of breath, reluctance to speak, and sweating upon exertion, with phlegm-dampness...

Type I obesity is characterized by heaviness, fatigue, and drowsiness, while type II obesity, characterized by phlegm-dampness and blood stasis, is characterized by forgetfulness and a sallow complexion.

The main characteristic is a darker color, particularly the lips.

Other scholars, based on their clinical experience, classify obesity into other syndrome types: obesity has

Reality and illusion.

(1) Differentiation of reality and illusion and its characteristics

Based on individual endowments, constitutions, and clinical manifestations, from the perspective of the body's qi transformation function...

Based on the understanding that obesity is located in the spleen and stomach and causes abdominal distension, it is believed that clinical obesity involves deficiency, excess, and imbalance.

It actually contains three symptoms.

Obesity in individuals with substantial weight gain is often due to stagnation in the middle jiao (middle burner), resulting in qi stagnation and phlegm obstruction. Clinically, this manifests at a younger age, primarily in young adults.

Primarily characterized by a voracious appetite, lack of self-control in eating, a fondness for sweets, and an outgoing personality. Hair is thick and shiny.

Ze is relatively mildly obese, with minimal abdominal fat, and her chest, abdomen, and hip circumferences are not very large. Her body shape is relatively...

The patient is well-proportioned, has a firm abdomen, is in good physical condition, is energetic, has a greasy tongue coating and a slippery pulse, and experiences various discomforts.

Symptoms are not obvious, and there are few complications.

Those who are overweight due to bloating often have spleen and kidney qi deficiency; "prolonged lying down injures qi, and prolonged sitting injures flesh." Clinical manifestations include age...

The population is relatively large, mostly middle-aged, doesn't drink a lot of water, doesn't have a strong preference for sweets, and is prone to mood swings.

Easily irritable and prone to anger, and easily stressed. The density and shine of their hair are not very good. Weight index...

Large number of people, high degree of obesity, especially abdominal obesity, large chest, waist and hip circumference, and soft abdominal skin.

Thick folds, poor physical condition, and low energy. Numerous clinical symptoms, especially palpitations, chest tightness, and heart palpitations.

Symptoms include lower back and knee pain, shortness of breath, fatigue, heaviness in the limbs, sensitivity to cold and heat, and cold hands and feet. (Tongue)

A pale, greasy tongue coating and a deep pulse often indicate various complications.

The mixed deficiency and excess syndrome is a combination of the two syndromes mentioned above, and is quite common in clinical practice, especially in cases of...

It is a spleen deficiency with phlegm and dampness type. The *Danxi's Essentials of Treatment* clearly states that "fat, white-skinned people often have dampness" and "fat, white-skinned people must..."

Excessive phlegm.

In conclusion, it is believed that clinical diagnosis of obesity should primarily follow two major types (deficiency and excess) and three...

Major syndromes (spleen and kidney qi deficiency, qi stagnation and phlegm obstruction, spleen deficiency and phlegm dampness), and are described as "deficiency, excess, and mixed deficiency and excess".

Using this as a diagnostic point for obesity is concise, easy to grasp, and easy to implement. It simplifies the understanding of obesity.

Differentiation of syndromes can provide a more concise and clear understanding of clinical diagnosis and treatment.

(2) The theory of puffy fat, solid fat and qi transformation

Western medicine considers simple obesity a metabolic disease. Traditional Chinese medicine should also study obesity from the perspective of...

The entire body's material and energy metabolism should be considered, not just limited to a single organ.

In Traditional Chinese Medicine (TCM), the metabolism of matter and energy is considered to be the function of Qi transformation. Qi transformation has both a broad and a narrow definition.

The spleen and stomach's functions of transporting and transforming food and fluids are primarily related to the qi transformation process, which regulates the body's nutrients and...

The specific manifestation of water metabolism is, in a narrow sense, vaporization; while the metabolism of matter and energy in the body...

The scope is broader than that; in a broader sense, qi transformation includes the warming, promoting, defensive, and consolidating functions of qi.

And the function of Qi in each of the internal organs.