Traditional Chinese Medicine for Weight Loss: Etiological Analysis and Commonly Used Formulas (such as Shugan Qingshen Decoction and Haizao Qingshen Decoction)

In ancient my country, although obesity was considered a sign of good fortune and weight loss was not a primary concern, many medical texts still offer insightful discussions on the causes and prevention of obesity. As early as over 2000 years ago, the *Suwen* (Plain Questions) chapter "On the Assessment of Deficiency and Excess" stated, "Obese and wealthy people suffer from diseases caused by excessive consumption of rich foods." This clearly indicates that obesity is caused by overnutrition. It also states, "Such people are fat and do not live long," highlighting the health hazards of obesity.

Traditional Chinese medicine (TCM) weight loss methods are based on the etiology and pathogenesis of obesity, using compound TCM formulas or single herbs to treat the condition. These formulas aim to regulate the functions of the five internal organs and lower blood lipids and other pathological factors, thereby achieving weight loss. It is generally believed that obese people often have phlegm and dampness, so herbs that primarily resolve phlegm and promote diuresis should be selected. In recent years, TCM's understanding of the etiology of obesity has gradually improved. Most TCM treatments for obesity work by regulating the metabolism of substances and energy such as fat and carbohydrates, increasing fat breakdown and reducing weight. Some compound formulas for treating obesity are now available as prepared Chinese medicines; caution must be exercised when choosing these medications, and contraindications must be noted. Some medications may cause increased urination and defecation, and loose stools; this is a normal reaction, and consistent use will yield results. However, if the reaction is strong or the symptoms worsen, immediate medical attention is necessary.

Causes of obesity

The causes of obesity are complex, and are mostly related to genetics, physical condition, age, emotions, and congenital factors. Secondly, dietary structure and eating habits also have a significant impact on the development of obesity.

Furthermore, obesity is also related to prolonged sitting, lying down, and insufficient physical activity. The *Xuanming Lun* states, "Prolonged lying down injures Qi," meaning that prolonged sitting or lying down leads to Qi deficiency (a pathological phenomenon of insufficient central Qi or weakened primordial Qi). Qi deficiency results in impaired digestion and transportation, causing fat accumulation and weight gain.

In addition, emotional distress is also a cause of obesity. It affects the function of the five internal organs, especially the liver, spleen, kidneys, and gallbladder, and imbalances in these organs are a major factor in obesity. Long-term mental stress and emotional distress can lead to stagnation of liver qi, spleen and kidney qi deficiency, and impaired liver and gallbladder function. This also affects the spleen's ability to function properly, preventing the conversion of excess fat into energy for excretion, thus causing fat accumulation and weight gain.

Finally, external pathogenic factors can also cause weight gain. These factors invade the body's internal organs, leading to weight gain. For example, kidney dysfunction disrupts the body's fluid regulation and waste excretion processes, causing water retention in the skin and exacerbating weight gain. Similarly, spleen deficiency disrupts the body's ability to transport and distribute nutrients and regulate fluids, resulting in the accumulation of fat and water in the skin, also contributing to weight gain.

Therefore, obesity is often a condition characterized by deficiency in the root and excess in the branch. The root and branch are interconnected and coexist. Deficiency in the root is primarily Qi deficiency, sometimes accompanied by Yin deficiency and Yang deficiency, mainly affecting the spleen, followed by the kidneys, liver, and gallbladder, and may also involve the heart and lungs, but spleen and kidney Qi deficiency is most common. Excess in the branch is primarily phlegm and dampness, but Qi stagnation and blood stasis may also occur. Obesity often presents in five types: liver Qi stagnation, spleen deficiency with dampness, Yin deficiency with internal heat, stomach heat with dampness, and spleen and kidney deficiency.

Formulas for treating obesity

Liver-Soothing and Body-Slimming Soup

Prescription: Bupleurum 6g, White Peony Root 10g, Poria 10g, Mume 10g, Lotus Leaf 10g, Alisma 10g. For women with amenorrhea, add Motherwort 25g, Angelica Root 10g, Cyperus Rhizome 5g. For women with excessive leukorrhea, add Atractylodes Rhizome 9g, Phellodendron Bark 6g. If there is excessive liver fire and irritability, add Moutan Bark 9g and Fried Gardenia Root 6g.

Indications: Primarily used to treat obesity caused by liver dysfunction. Pharmacological Action: Clears liver function, strengthens the spleen and eliminates dampness, promoting the transformation and transportation of fluids to achieve weight loss. Usage: Decoction of the above formula, taken twice daily, one dose per day. Once weight has decreased and is close to normal, prepare the above formula into pills, each weighing 9 grams, and take 2 pills daily, once in the morning and once in the evening. Continue taking the medicine for one year; significant weight reduction will be observed. Example: The *Beijing Journal of Traditional Chinese Medicine* reported that among 50 patients taking this medicine, 17 lost less than 2.5 kg, 11 lost 3-5 kg, 10 lost 5.5 kg, 6 lost 8-10 kg, 3 lost 13-17.5 kg, and 1 lost 24.5 kg, with a total effective rate of 96%.

Seaweed Slimming Soup

Prescription: 40g seaweed, 12g prunella vulgaris, 20g white mustard seed, 2g alisma plantago-aquatica, 6g licorice root, 8g bupleurum chinense, 20g artemisia capillaris, 15g hawthorn, 25g coix seed. Indications: Primarily used to treat obesity in young women. Pharmacological effects: Regulates Qi, resolves phlegm and fat, strengthens the spleen and promotes diuresis. Usage: Decocted in water for 10 minutes, one dose daily, divided into two administrations, for a course of 1-3 months. Example: A female patient, weighing 70 kg and 155 cm tall, exceeding the standard weight by 20 kg, lost 2 kg after one month of taking this medicine. She then took one dose every other day for three months, resulting in a weight loss of 6.5 kg. After a year of continuous use, she finally achieved her weight loss goal.

slimming tea

Prescription: 25g tea leaves, 10g hawthorn, 10g raw Polygonum multiflorum, 10g abalone shell, 10g Prunella vulgaris, 8g Caragana korshinskii, 10g radish seed, 5g Sophora japonica fruit, 5g winter melon peel, etc. Indications: Suitable for treating simple obesity due to spleen deficiency and water retention. Pharmacological effects: Regulates Qi and strengthens the spleen, promotes digestion and bowel movement, eliminates dampness and promotes diuresis, and lowers blood lipids. Usage: First, decoct the above prescription, remove the dregs, and use the remaining liquid to brew tea leaves. Take one dose daily, divided into two servings, for 6 months to 1 year. Clinical case: A 50-year-old male patient, 170cm tall and weighing 97kg, lost weight to 87kg after taking the slimming tea for one month.

A medicine for treating spleen deficiency and dampness – Wu Ling Xiao Fei Tang (Five-Ingredient Decoction for Eliminating Fatigue)

Prescription: Atractylodes macrocephala 10g, Alisma plantago-aquatica 2g, Cinnamomum cassia 6g, Crataegus pinnatifida 15g, Poria cocos 2g, Pinellia ternata 9g, Magnolia officinalis 9g, Zea mays 35g, Glycyrrhiza uralensis 3g, Amomum villosum 6g, etc. Indications: Suitable for treating obesity caused by spleen deficiency, impaired digestion, qi stagnation and blood stasis, and dampness obstruction in the spleen and stomach. Pharmacological effects: Strengthens the spleen, replenishes qi, promotes diuresis, eliminates food stagnation, regulates qi, dries dampness, and removes blood stasis and fat. Usage: One dose daily, decocted in water, taken twice daily, morning and evening.

Yin-nourishing and weight-loss soup

Prescription: 18g Salvia miltiorrhiza, 9g Prunus persica, 18g steamed Polygonum multiflorum, 10g Alisma plantago-aquatica, 15g Crataegus pinnatifida, 30g Nelumbo nucifera leaf, 18g Paeonia suffruticosa root bark, 3g Amber, etc. (14 herbs in total). Indications: Suitable for treating obesity caused by liver and kidney yin deficiency, water retention, and spleen dysfunction. Pharmacological Actions: Nourishes the liver and kidneys, invigorates blood circulation, removes blood stasis, strengthens the spleen, and promotes diuresis. Usage: Decocted in water, one dose daily, divided into two oral administrations. Example: The *Journal of Traditional Chinese Medicine* reported that a 29-year-old woman, weighing 98 kg and 174 cm tall, lost weight to 92 kg after one month of taking this medicine, 87 kg after two months, and approximately 80 kg after six months of continuous use.

A medication for treating edema-type obesity-Fangfeng Tongsheng Powder

Prescription: Rhubarb 15g, Ephedra 12g, Saposhnikovia divaricata 15g, Glauber's salt 12g, Licorice 60g, Gypsum 30g, Platycodon grandiflorus 25g, Atractylodes macrocephala 15g, Scutellaria baicalensis 30g, Mentha haplocalyx 12g, Forsythia suspensa 15g, Schizonepeta tenuifolia 15g, and 17 other herbs. Indications: Suitable for treating patients with abnormal water metabolism, excessive sweating, constipation, and obesity centered around the navel, characterized by both internal and external excess. Pharmacological Actions: Promotes diuresis and reduces swelling, dispels wind and releases the exterior, clears heat and promotes bowel movement, strengthens the spleen and replenishes qi. Usage: For pills, take 10g daily, divided into two doses. For decoctions, decoct in water to 200ml, divided into two doses. Typical Example: A 40-year-old female patient, weighing 72kg, with an abdominal circumference of 96cm, a chest circumference of 110cm, and a height of 154cm, lost 1.5kg after one week of taking Fangfeng Tongsheng San. After one month, her weight decreased to 64kg. After about a year and a half of continuous use, her weight decreased to 59kg.