I have been hesitant to write anything on the subject of weight loss because it is a veritable quagmire of confusion, controversy, and bad feelings. For years my clinic’s policy has been to not treat patients with weight loss as their chief complaint. And yet clinical Chinese herbal medicine treatment can do a great deal to help people struggling with weight loss and weight-related health issues. So why have I avoided it until now? Weight loss is a very complex issue, and there is no simple magic to solve this problem. The way most people go about it is all wrong, and this often leads down a dark road of bad feelings and unsuccessful outcomes.
But if you can take the time to understand all the factors at play, and can engage with them, then Chinese herbal medicine treatment can be a powerful tool to help you along in your health journey. So I’m writing this article as a primer to herbal medicine treatment with my herbal clinic, as required reading for starting the process of weight loss treatment with me. If you read to the end and you’re still on board, we can get started!
Table of Contents
The middle path
Why is it so hard for me to lose weight?
i. Genetics
ii. Microbiome
iii. Thyroid function and metabolism
iv. Psychology and behavior
v. Morality
vii. Timeline
viii. Carbohydrates and energy storage
xi. Sugar cravings
Getting started with Chinese herbal medicine treatment
How does Chinese herbal medicine help with weight loss?
The answer to this question is long, as you’ll find as you read through this article. But I’m going to tease this now so you have an idea. Support with Chinese herbs for weight loss includes:
Regulating microbiome health, or gut flora diversity. Increasing abundance of organisms correlated with healthy weight and suppressing pathogenic flora associated with obesity, sugar cravings, digestive problems.
Supporting metabolic health. This includes addressing subclinical hypothyroidism and other aspects of metabolic function.
Regulating sugar cravings
Using safe and effective methods to deal with lipophilic toxin storage.
Reducing pain and improving mobility to support the ability to exercise.
Supporting mood and emotions to cope with changes throughout the process.
The Middle Path
We live in a culture of extremes, and this is very evident when it comes to looking at weight. Weight is either the most important health metric there is, or weight has no bearing on health at all. These are the popular views around weight loss today, and they are both incorrect. The truth is somewhere in the middle of these things. Every aspect of understanding healthy weight requires that we allow room for nuance. Without nuance, you’ll never find a perspective that makes sense for everyone.
Weight is NOT the most important health metric. I frequently see patients with a host of significant health problems, but the most concerning to them is weight. However, a change in weight will not be likely to affect most of their health complaints. For many patients, losing weight will have little to no impact on how they feel at all. This perspective of over-valuing weight as a health metric is probably born from several factors, but especially these two:
1. Long-standing cultural focus on being thin having the significance of being attractive, valued, good. These are values that society has ascribed to thinness, and they are not a reflection of medical realities. Being thin has no inherent moral value, and being thin does not equal being healthy.
2. Doctors using weight as a scapegoat when they don’t have the tools to help with chronic health problems. Many patients have been told that their X problem is simply a result of being overweight, and that’s the patient's responsibility to deal with. There are times when weight loss is essential to improving a health outcome, but there are many cases where weight loss will have little to no impact on the health concern that a patient saw the doctor for.
Weight is important to consider in overall health, and can’t be ignored as a relevant factor in certain health conditions.
Obesity is clearly implicated in an increased risk of developing cardiovascular disease (heart attack, stroke, high blood pressure, high cholesterol), type 2 diabetes, peripheral neuropathy, and joint problems. There is no question that being significantly overweight can have negative health effects. That still does not make it the only health metric we should be using, or the most important one.
Where do I see weight as an important health factor in my clinic?
In my clinic, I help patients with a wide range of concerns. I have helped many patients with health problems, including patients who happened to be overweight, without ever focusing on weight loss. This is one of the reasons I know that weight should not be the most important health metric.
Where I see weight as a problem that needs to be addressed is most often related to blood sugar problems. Blood sugar being higher than it should be — and this includes pre-diabetes, diabetes, and even “normal range” blood sugar levels in many people — is the main causative factor in heart disease, high blood pressure, high cholesterol and triglycerides, fatty liver disease, and peripheral neuropathy. Blood glucose being higher than it should be is also a driving force in PCOS, uterine fibroids, infertility, fibromyalgia, and many autoimmune conditions.
Reducing blood glucose is very simple — though easier said than done — all you have to do is reduce sugar and carbohydrate intake. You can’t have high blood glucose if you don’t feed sugar and carbs into the system. But blood glucose is a reflection of overall energy storage in our body. Carbohydrates are high-energy foods, and when we consume more than we need, the body will store this extra energy as glycogen stores or as fat. If we eat more carbohydrates than we need over a long period of time, the body can accumulate significant fat energy stores.
If a person is overweight and wants to reduce blood glucose to address a health condition (like high cholesterol or infertility), they can reduce sugar and carbohydrate intake. However, the reduction in carb intake will not automatically lower blood glucose — because the body will start metabolizing fat stores and turn it into more glucose. In order to achieve and maintain healthy blood glucose levels, the excess fat stores have to be used up. This can be done through diet and exercise, but it takes a long time. This is where Chinese herbal medicine can help support the process, as well as by supporting additional factors which we’ll cover below.
Do you actually need to lose weight for your health?
This is a really important question to answer. You are probably thinking, obviously yes — that’s why I’m reading this. But I guarantee that many of you reading this do not need to lose weight to benefit your health. So I’ll offer some thoughts on how to differentiate when you do and don’t need to.
When we’re talking about weight, we’re mainly talking about fat — though fluid retention is also an important aspect. We’re not actually talking about weight as mass most of the time. So BMI, or the Body Mass Index, is generally not a useful tool. If you are a shortstack of pure muscle, your mass will be higher, as muscle is more dense than fat. And if you’re shorter than average height, the BMI scale is notoriously inaccurate. While I would not generally use BMI as the way to answer this question, if your BMI is 40 or higher then I think we can safely say that losing weight is likely important to benefit your health.
Here are some common situations you may be in if you are considering weight loss, and how I recommend looking at them in the context of health.
You feel bad, depressed, unattractive, unhappy, have low self-esteem and feel that losing weight would benefit these areas and more.
This does not indicate that you need to lose weight to benefit your health. Mental health therapy is often the best place to start when this is the case, focusing on healing our internal experience is often more productive than hoping numbers on a scale will change how we feel. Working with a therapist who specializes in EMDR and/or eating disorders can be especially helpful. Weight loss may ultimately be part of the journey, but it seldom works well without addressing mental and emotional health first.
You have a chronic health condition and are overweight.
Losing weight may benefit your health, but is not necessarily the most important place to start. Clinical evaluation with Chinese Medicine can help differentiate what is most important to start working on, which may include weight loss.
You are overweight and you have one or more of the following problems: Heart disease, high blood pressure, high cholesterol, high triglycerides, pre-diabetes, diabetes, high blood glucose or A1C, peripheral neuropathy, fatty liver disease, PCOS, fibromyalgia.
Losing weight and maintaining a healthy weight is an important part of managing these health conditions.
The Secret to Weight Loss
The secret to weight loss is that there is no secret. There is no magic bullet. There is no singular cause to excess weight, and no amount of searching or researching will turn up a simple answer that easily solves the problem with the flick or a wrist or a 3 month-long diet. The true answer is always going to be complicated, messy, and require a lot of work. There are many factors that contribute to weight gain and make it hard to lose weight, which we’ll explore in the next section.
The closest thing to a quick fix is modern weight loss drugs like semaglutide. These drugs are very new, with limited research on long-term effects, and they may have their place, but they have very significant side effects and risks. If you’re looking for magic, that’s the best magic there is today. But magic always has a cost, so don’t make a deal with the devil and expect not to get burned.
I could tell you that there is a simple fix with herbal medicine that’s safe and effective. I could tell you that in 6 months of taking my Chinese herbal formulas you will lose X number of pounds. And I could make a lot of money doing that, regardless of the outcome. A lot of people have made a lot of money doing just that, and they continue to do so right now. Weight loss is one of the most exploited conditions in medicine. The intense desire for weight loss means you can sell people just about anything, and the history of this exploitation includes bad actors selling products that have made people very sick, and some have even resulted in death.
That’s not what I’m about. I’m here to provide real help that’s safe, and can result in long term improvement in your health. And when it comes to weight loss, it’s essential to understand the big picture and all the messy complex factors. Because the truth is I can provide clinical herbal medicine support that can help address internal factors that may be making it difficult for you to lose weight on your own. But herbal medicine treatment is not enough on its own. Lifestyle and mind-body integration have to be part of the long term plan.
Why is it so hard for me to lose weight?
In this section, we’ll cover the most important factors that affect weight gain and loss.
Genetics
Microbiome
Thyroid function and metabolism
Psychology
Carbohydrates and Energy Storage
Exercise and Energy Use
Toxins stored in fat
Genetics
The genetic makeup you inherit from your parents plays a significant role in many aspects of your health and physical appearance, whether it’s the shape of your nose, your hair color, your cancer risk, or your body shape and weight. Today we understand that genetics in health is all about the interaction between the blueprint of genes that we’re born with, and the complex way that they interact with the environment that we experience and what we’re exposed to.
We can look at this first with height as an example since it’s a less charged characteristic. If your parents were 6 feet tall, and their parents were 6 feet tall, and their parents were 6 feet tall - there’s a very good chance that you are gonna be 6 feet tall. That is the blueprint that you received. However, say there was a widespread famine when your mother was pregnant. She was malnourished due to lack of available food, and growing up you had barely enough food and nutrients to get by. In this scenario, you might only grow to be 5’ 6” due to the environmental variables. On the flipside, maybe when you were born humans had just invented some kind of supermilk that was more nutritious than anything anyone had ever experienced. Under these conditions, you might grow up even taller than your parents, to 6’ 5”. Our genes give a blueprint, but there is a range of expression depending on the environmental factors we’re exposed to.
The same is true for weight. You might come from a family of bigger people, which means that the genetic blueprint means it’s easier for you to be big than small. This can be a result of slower metabolism, or simply being very good at storing energy. But there is still a range of how this blueprint will express depending on the environmental factors you’re exposed to. This may mean it’s harder for you to maintain a healthy weight than those from other genetic backgrounds. You may have a friend who comes from a long line of thin people who can eat as many carbohydrates as they want and stay thin (though this is likely to cause other problems), whereas your body is very good at storing energy and gains weight quickly in response to eating a high carbohydrate diet.
We can’t change your genetic blueprint, but we can change the environmental factors that will influence gene expression.
Microbiome
The human body is an ecosystem, also referred to as the human microbiome, with trillions of microorganisms like bacteria, fungi, and viruses calling it their home. Populations of microbes in the human microbiome ebb and flow based on many factors like diet and lifestyle, antibiotics, medications, introduction of new microorganisms, and competition between microbes. Your microbiome is also significantly influenced by the microbiome of your mother, and your environment, as these provide the initial founding populations that begin your microbiome.
Some of the microbes in our ecosystem are obviously beneficial to human health, some are neutral, and some can be harmful or problematic. Microbes in our microbiome are affected by what we eat, the water we drink, how we exercise — but they also exert a return influence on us. Certain microbes will release chemicals to cause us to feel sugar cravings, because they need sugar to thrive. Candida albicans is a great example of this, an organism that has thwarted many attempts to reduce sugar and carbohydrate intake. Candida lives on sugar, and when there is an overabundance of this fungal organism in the body, it will release chemicals into your bloodstream to make you feel awful if you cut back its sugar lifeline.
Essentially, it’s biohacking you, and we need to change that. The gut microbiome, also called the gut flora, can influence nearly all aspects of our health, from how our body stores fat down to the neurotransmitters circulating in our brain.
Scientists studying the effects of the microbiome on human health have found that the balance of microbes in our bodies can affect a wide range of functions, including digestion, sugar metabolism, fat metabolism, immune function, skin health, and mental health. With regard to weight gain and obesity, research has shown an overall lack of diversity of microbial flora in obese individuals. In addition to lack of diversity, abundance of certain microbes and deficiency of certain microbes have been linked to obesity.
High relative abundance of the bacteria Akkermansia muciniphila has been consistently found to be associated with a low risk of obesity. According to a systematic review published in 2021 “randomized controlled trials have shown that A. muciniphila modulates obesity by regulating metabolism and energy hemostasis and improving insulin sensitivity and glucose hemostasis. In addition, studies showed this microorganism enhances low grade inflammation by different mechanisms.”
Many of the Chinese herbal medicines which have been used for centuries to improve digestive function, sugar metabolism, and support health weight and metabolism have now been shown to increase the relative abundance of Akkermansia in modern research studies. There are also Akkermansia probiotic supplements you can take to add more of this bacteria into your gut biome. In my experience, using Chinese herbal medicine to shift the microbiome is more effective than probiotics. This is because Chinese herbal medicines are more complex, and can help to simultaneously suppress the microbes we don’t want, while supporting microbes we do want.
Think about your microbiome like a busy hotel. In general, all the rooms are occupied, all the time. One guest may leave, but another guest is already waiting to take the room. If you fill up the lobby with new guests (taking probiotics) that doesn’t mean there’s a room for them to stay in — and they often don’t stick around. We need to put some selective pressure on the guests that you want to move out (microbes associated with obesity) and make the conditions favorable for new microbes that we want (microbes associated with healthy weight) to move in. Chinese herbal formulas are elegant and complex, and can help facilitate this process whether you do or don’t add probiotic supplements in. They will make taking probiotics more effective, and that’s likely the optimal approach - to do both.
Thyroid Function and Metabolism
The thyroid is a small endocrine gland located in the front of the neck. Your thyroid is the primary gland that controls your base metabolic rate, or your metabolism. Your base metabolic rate is the speed at which your body burns and utilizes energy. So however much or little energy you consume in the form of food, your metabolic rate determines how fast you will use that energy and how much of it your body will store for use later. If the metabolism is slow, the body will not utilize energy from food as fast, and will often have extra energy left over which will be stored as fat.
When the thyroid is under-active, this condition is called hypothyroidism. Symptoms of hypothyroid function include:
Fatigue
Cold intolerance (feeling cold easily)*
Weight gain
Fluid retention
Puffy face (and other body tissue)
Thinning hair
Constipation or low gastric motility
Slow heart rate (bradycardia)
Menstrual periods with heavy bleeding
Dry skin
If you suspect you may have hypothyroidism, talk to your doctor about getting your thyroid tested. A blood test can reveal obvious hypothyroidism, and conventional treatment with thyroid hormone may improve your symptoms — including your base metabolic rate. However, there are two circumstances where conventional testing and treatment may not be helpful for you: subclinical hypothyroidism and Hashimoto’s thyroiditis.
Subclinical hypothyroidism refers to when you have the clinical signs and symptoms of hypothyroidism but your blood test indicates normal levels. In the scheme of medicine, blood tests for diagnosing hypothyroidism are relatively new. And they simply are not that accurate for understanding the condition of the thyroid. This is an area of medicine where it’s very important to spend time with a patient, observe them, and make a diagnosis based on their signs and symptoms and not only based on a blood test. Many people have a normal thyroid blood test, but exhibit all the signs of hypothyroid function.
In the clinical practice of Chinese Medicine, my view is that if a condition looks like a duck, quacks like a duck, and has a confounding blood test — logic dictates that it’s still most likely a duck. However, even when it is clear that a patient is experiencing subclinical hypothyroidism that does not mean that conventional treatment with thyroid hormone is the best option. Thyroid hormone treatment can be very helpful in overt hypothyroidism, but it’s fairly simplistic treatment. With Chinese herbal medicine treatment, we don’t simply replace hormones. We use herbs that work on the mechanisms that are another layer deeper - we look at why the thyroid is under-functioning and address those causative factors. This makes Chinese herbal medicine safe, and also it gives us effective options to treat subclinical hypothyroidism when conventional treatment offers little to nothing.
*It’s important to note that cold intolerance is a very important sign of hypothyroidism. However, this can be confounded if you are significantly overweight - as fat stores can make you feel warm due to their insulating effects.
Hashimoto’s thyroiditis is an autoimmune condition where the immune system is attacking the thyroid gland, and over time this results in hypothyroid function as the immune system destroys tissue and disrupts normal function. In the early stages, people experiencing Hashimoto’s will not show abnormal thyroid levels on blood tests. As the condition advances, the thyroid function declines enough to show on blood tests, and typically the patient will then be put on thyroid hormone to treat the hypothyroid function. Conventional treatment of Hashimoto’s is not very effective, because the problem here is not simple hypothyroidism. The problem is autoimmune activity, and if that is not addressed, the thyroid destruction will continue and the thyroid function will continue to deteriorate regardless of how much thyroid hormone medication is used to combat it.
Chinese herbal medicine treatment is important in Hashimoto’s because we have effective strategies to regulate the immune system’s overreaction without suppressing it. Chronic infections can be the cause of Hashimoto’s autoimmune activity, but in most cases that I have seen it is typically extreme or prolonged stress, anxiety, or fear that is at the root of the immune system dysfunction. For this reason, patients dealing with Hashimoto’s do not exhibit the standard list of hypothyroid symptoms. Their signs and symptoms usually resemble a mix of hyperthyroid and hypothyroid symptoms.
Symptoms of Hashimoto’s can present like:
Fatigued, but intermittently adrenalized and energized during moments of stress and anxiety. “Tired and wired”
Feeling cold, or hot, or alternating
Heart rate can be slow (bradycardia), but often is intermittently fast (tachycardia) or irregular
Weight gain, fluid retention, and puffiness are common but not always present in Hashimoto’s
Thinning hair
Can have constipation and low gastric motility, but diarrhea and loose stool is also common
Menstrual periods with heavy bleeding, but can also have irregular periods, and occasionally amenorrhea or scant bleeding
Dry skin
Psychology and Behavior
One of the biggest obstacles people face with weight loss is our own psychology. How we think about weight loss, what it means to us, and the moral judgments we have around weight all have significant impacts on our behavior — and they often make us do the most counterproductive things we possibly could do. In this section I’m going to touch on morality, the starvation reflex, and timeline.
Morality
In our current culture, we have some widely held beliefs that can be crippling to our psyche when it comes to weight loss. One is the belief that health is merit-based. It is a highly prevalent belief, whether conscious or not. We tend to believe that people who are healthy have done something “right”. This could be that we think they “behave well” or simply that they are favored by God, or karma, or some unseen forces. And people who are unhealthy, we tend to think that somehow they did something “wrong” even if we can’t put a finger on what. This is the most evident when it comes to things that we can immediately see about a person in their appearance — like the quality of our skin, or size and weight.
Of course, none of this is true. As you’ve read in the sections on genetics, the microbiome, and thyroid function — many aspects of weight have nothing to do with behavior at all. But even the aspects of weight that do involve behavior — they don’t have anything to do with goodness or badness. And here’s the catch. If we continue to cling to the belief that our weight defines our goodness, we will not be able to make the “good” behavioral choice. A therapist or psychologist could explain the reasons why much better than I can, but it’s just the reality. The root of so much suffering and disordered eating comes from believing our choices around food, eating, exercise (and how we believe they affect our weight and appearance) is related to whether we are good or bad.
The reality is that successful long-term weight loss does involve behavioral changes, in addition to working on the physiologic drivers of weight gain like metabolism and gut flora diversity with Chinese herbal medicine. And changing the way we think about weight, eating habits, and our supposed goodness or badness is essential to long term health and success. So I recommend working with a therapist as part of this process. Ideally this is a therapist who works with mind-body tools like EMDR, or someone who works with eating disorders. And whether you believe it or not, believing that how we eat is a reflection of “being good” is by definition a pattern of disordered eating.
The Starvation Reflex
The starvation reflex is actually more physiology than psychology — but it’s under this section because it’s usually our psychology that drives us to encounter it, and it’s one of the best examples of our psyche driving us to do the absolute worst thing we could if our goal is weight loss.
What’s the best way to lose weight? Stop eating. Your body will consume your energy reserves, you’ll lose weight. And when the energy reserves run out, or when you develop enough nutrient deficiency or electrolyte imbalance, you’ll die.
What’s the best way to lose some weight, but then make it extremely difficult to lose weight in the future? Stop eating. But then start eating again because you don’t actually want to die.
This is the starvation reflex in a nutshell. Your body has 6 million years worth of evolution-driven physiology that prioritizes your survival. Your body doesn’t give two shits that being thin has been popular since the 1800s and you’re trying to lose weight. And your body has not had time to evolve appropriate strategies to deal with living in a world where unlimited carbohydrate access makes heart disease more likely to kill you than starvation.
The starvation reflex evolved to keep us alive when we didn’t have enough food. If our intake of food reduces, our body senses this and drops our base metabolic rate. You could think of it like the human version of metabolic hibernation. So if you decide to stop eating or dramatically reduce your calorie intake, your body will think you’re starving — like so many of our ancestors really did — and to keep you alive it compensates by reducing your energy metabolism so you burn that energy more slowly.
The more you engage in “dieting”, and the more times you trigger the starvation reflex, the better your body gets at storing energy aka storing fat. It thinks you’re living in the great depression and once a year you’re going to starve for a while, so it’s doing its best to help you out. If you’ve struggled with this, you’re probably not thinking “thanks body, I really appreciate what you’re doing.” But understanding this is essential for success with long-term weight loss, and also to understand how your psychology may be taking you in the wrong direction.
Timeline
You might be wondering, how the heck am I ever going to get around the starvation reflex? The answer is all about the timeline. Humans are notoriously bad at long-term thinking. Some might seem better than others, but the truth is we just aren’t wired for it. And in recent times, modern conveniences and our culture of instant-gratification has made this considerably worse.
The starvation reflex is a problem for people trying to lose weight because they’re not acting on a realistic timeline. Even though there are many complex physiologic factors, weight is still ultimately an equation of energy use and energy consumption. Excess weight is the result of more energy being consumed than the energy being used. This can happen quickly, but most weight gain happens gradually over a relatively long period of time.
When we think in terms of short timelines, it means we want to see weight loss in a week, a month, 3 months. This encourages us to try to make it happen faster, and most often that means reducing the energy intake too dramatically — which kicks off the starvation reflex. And even if you do lose weight during this short period of dieting aka starvation, it will most often come rocketing back once you give the slightest bit of a caloric increase.
Another common problem people experience is they eat hardly anything, and yet lose no weight. This comes from the fact that their base metabolic rate has reduced due to the starvation reflex, but also because their body often has a lot of stored energy. If you have significant fat stores, your body can live off this for some time even if you eat nothing. So the timeline is often important here.
The shortest timeline that is realistic for long term success is a year. And it’s not a year of following a diet. Because diets do not work. When researchers have done follow-up studies on a wide range of diet programs for weight loss, they found that 95% of dieters had gained all the weight they lost back within 2 years. This is because diets, by definition, are short term. Diets don’t work, but long term dietary change does. Your diet is what you eat, every day, for the rest of your life.
Carbohydrates and Energy Storage
Understanding how what we eat affects us is essential to making dietary changes that will work for us. And when it comes to weight loss, understanding carbohydrate metabolism is the most crucial. But first, we have to explain what a carbohydrate is — because most people that I’ve worked with didn’t truly understand what carbohydrates are. Pop culture is aware of carbs as the “bad foods” like potato chips, pasta, cookies. It’s true that those are carbohydrate-based foods, but so are carrots, bananas, apples, brown rice, oatmeal, etc. Carbs are not good or bad, they’re just carbs. This comes back to a psychological problem of wanting to categorize foods as good or bad, as healthy or unhealthy. Nature is much more complex than this moral dichotomy, and we have to think beyond the overly simplistic good and bad if we want to have a real chance at understanding things.
A carbohydrate is a nutritional classification of food, one of three major macronutrients which are protein, fat, and carbohydrate. Carbohydrates are further categorized as sugars, starches, and fiber. If you’re trying to figure out whether a food is a carbohydrate — if it’s not predominantly protein or fat, then it’s probably a carbohydrate.
Your body runs on glucose. Glucose, or blood sugar, is your body’s main energy source to power your cells, organs, and tissues. Your body can make glucose from protein, fat, or carbohydrates, but it is easiest to make glucose from the breakdown of carbohydrates. Some carbohydrates, like grains, are already in the form of glucose. Carbohydrates are the best source of easy to access energy, and so our body is most capable of storing excess energy from consuming carbohydrates.
If you were to go try to survive in the mountains, imagine what foods you’d find. You could find protein and fat from animals like fish, deer, elk, squirrels. You could find vitamins, minerals and fiber from leafy green plants. And you could find a very small quantity of carbohydrates from the occasional fruits, berries, and small tubers. This is what our ancestors survived on for millions of years, and survival was tough. Something like 10,000 years ago humans started cultivating grains like rice, corn, and wheat. This is because carbohydrates are such a good energy source, and they meant survival.
Only in the last century have we been able to industrialize grain agriculture so that we never run out of carbs. So now we have way more access to carbohydrates than we need, and way more than is beneficial for us to eat. But our brains are still wired to consume as many as we can get, because for so long they meant we’d make it through the winter. But consuming too many carbohydrates also means our blood glucose runs too high, rises and falls too dramatically, and we develop a variety of metabolic and cardiovascular problems, and often also gain weight.
For weight loss, following a low carbohydrate diet just works. Even if you don’t change the amount of calories you intake, if you change the calories to protein and fat instead of carbohydrates — your body will be more likely to lose weight. This is because protein and fat are not nearly as efficient for our body to store energy from as carbohydrates are. Again, I don’t recommend “dieting” so I don’t give patients a list of “yes” and “no” foods. This isn’t a short term thing, so you really have to understand what the diet means because it’s going to be how you eat for the rest of your life. You want to be able to go to the grocery store and grab food without checking an app first. If you understand what basic nutritional categories foods fall into, you’re set.
If you want a framework to pull from, you can use the ketogenic diet, or keto diet, to get ideas. What I do not recommend is eating nothing but meat and cheese, as many keto explorers tend to do. Yes, this will work as a low carb diet. But you’re likely to have horrific gas and stools. This issue is easily corrected by including lots of leafy green vegetables along with that meat and fat.
Here are some starting points. In a low carb diet, your diet should consist predominantly of meat, fat, and leafy green vegetables.
Meat. For animals that should eat grass, get grass fed meat - this is beef, lamb, bison, etc. For omnivores like pork and chicken - get pasture raised meat. For fish - get wild caught fish. Eating beef, pork, or fish that’s raised on corn and soybeans will cause its own set of problems.
Leafy green vegetables. The keyword is leaf! If it’s an edible leaf, eat it. Kale, chard, collards, spinach, bok choy (or any of the choys), cabbage, arugula, endive. Broccoli is cool and all, but it’s a flower - not a leaf.
Not leafy green vegetables. Winter squash, summer squash, pumpkin, zucchini, carrots. These are carbs! Eating them is fine, but if this is your idea of vegetables - it’s not what I’m talking about.
Exercise and Energy Use
Physical exercise is one of the most important aspects of maintaining a healthy metabolism, as well as maintaining cardiovascular health. Cardio is king, meaning walking, hiking, running, biking, swimming, activities that have you moving around a lot. Ideally, try to find something you enjoy doing and that’s not likely to injure you. Whenever possible, do your cardio outside, breathe fresh air.
If you want to do strength training, go nuts, but it’s not part of the weight loss plan. In fact, in my clinical experience weight training is more likely to result in injury that will prevent you from moving more - which is what this is all about, moving more. The more good cardio exercise you get, the better your body’s metabolism will be at regulating energy use and blood sugar levels.
Many people who are wanting to lose weight struggle to get enough exercise due to pain and injury. This is an area where Chinese herbal medicine treatment - and acupuncture - can be very helpful since we excel at treating pain and injury.
Lipophilic Toxin Storage
Our body has a complex system of dealing with toxins that we may encounter. Most toxins that we intake will be metabolized by our liver. The liver organ is in charge of breaking down chemicals that may be unsafe for us, a bit like defusing a bomb by separating it into smaller inert parts. It’s a very capable organ and generally does a good job of this. However, when it is overwhelmed by say - too much of one chemical all at once - it can’t handle the volume of work and it has to set some aside for later. The way it does this is by encapsulating the toxin in fatty tissue, a process called lipophilic fat storage.
Ok, so we can say “good job liver” for protecting us from these toxins. However, now imagine the scenario where you are losing weight, and your body is now burning through your fat stores to generate energy. In this process, it may unlock the toxins that were hidden away - and now your liver has to do overtime to deal with metabolizing these toxins. So maybe you already felt challenged by changes in diet, exercise, emotions etc - and now there’s another physiologic reason that losing weight may make you feel terrible.
You have probably heard a million iterations of “toxin” and “detox” when it comes to health and weight loss. Most of the ways people use these words are nonsense, and most of the products and cleanses are nothing but counterproductive. Because they’re created by people who don’t understand herbs, and have no systematic process or knowledge, traditional or modern. Most “detox” programs use herbs that actually damage your body’s digestion and metabolism, causing more harm than good.
Fortunately Chinese herbal medicine has time-tested, systematic methods to support detoxification pathways in a way that doesn’t damage your digestion or metabolism - and they don’t require that you sh*t your pants like every other detox out there.
It’s also important to understand what a toxin really is in this context. Yes, toxins include many of the novel chemicals that humans have created in the last hundred years. Most especially the chemicals designed to kill living things - this is pesticides, herbicides, weed-killer, all the chemical killers. If it’s a chemical designed to make living things not living - it’s probably not good for your health. You may not think you're that closely related to a plant or a bug, but you’d be surprised.
But a toxin is also anything that your liver can’t metabolize at a given time. So a very important example of this is fructose. Fructose is popularly maligned in the form of high fructose corn syrup. And yes, soda will f**k you up, but fructose is also the same exact sugar in your favorite fruits, all of em. Unlike glucose and sucrose, 90% of fructose intake has to be metabolized by your liver’s conversion to glucose to render it usable to you.
Nature has this figured out though. When you eat an apple, the high fiber content slows the fructose metabolism so that your liver can handle it, no problem. But as soon as you juice that fruit, you’ve created a fructose injection that your liver will not be able to metabolize fast enough, and it will treat the excess as toxins and store them in fat cells. To your liver, fructose is fructose, whether it’s from corn syrup or the organic juice bar. Juice “cleanses” are anything but.
Sugar Cravings
Sugar cravings can be driven by your gut flora, for example if you have an overabundance of sugar-loving organisms like Candida. They are also driven by your brain, and by your taste buds. All of these things can be altered.
By using herbal medicine to suppress sugar-loving microbes, we can reduce sugar cravings because those organisms won’t be manipulating your body chemistry to the same degree.
When it comes to taste-buds, this is about training. America has an excessively sweet palette, and it’s a big part of our health problems. But your craving for sweet is a learned behavior. And it can be unlearned. Your tongue has thousands of taste receptors (aka taste buds). They allow you to taste sweet, salty, bitter, sour, and umami. Bitter and sweet flavors are diametrically opposed. The more bitter foods you eat, the less you will prefer sweet. And the more sweet you eat, the less you will like bitter. Many traditional cultures revered the bitter flavor, the more bitter the food the more beloved it was. This happens to be a much healthier taste preference.
In America, we have driven our taste preference more and more towards the extreme end of sweet. In ancient Chinese Medicine texts, rice is the premier example of a sweet food. Plain white rice! Our love of sweet has gotten out of control. The more sweet foods you eat, the more you shift your taste preference towards that. And in the process you also favor all the sugar-loving microbes in your body.
So you have to retrain your taste preferences. Start eating more bitter foods, and less excessively sweet foods. Take digestive bitters with meals. Eat bitter greens like dandelion greens and endive. Go to an Asian market, pick up a bitter melon, find a recipe online and cook it. Only then will you know what true bitter flavor is. Over time this will curb your sugar cravings. Eventually you’ll find extreme sweet foods like cake to be gross, and you’ll come to like the bitter flavor.
The dark side of semaglutide (Ozempic)
When I meet people for the first time and they find out that I practice clinical herbal medicine, one of the most common questions I have heard is “do you have anything to get rid of my appetite?”
And my answer has always been a resounding “No.” Because your appetite is one of the most critical indicators that shows that you are alive. In fact, appetite is a key diagnostic tool to determine if a prognosis is good, or bad. For people in late stage disease, lack of appetite is often one of the signs that they will die soon. Appetite shows that you are metabolizing food, and that your body has the capacity to digest, assimilate nutrients, make energy from food and continue living.
And yet, now we finally have a drug that can obliterate your appetite - the magic of ozempic! I had heard about celebrities using ozempic for a while before I saw the effects of it in my clinic. The first person I saw was dealing with severe side effects from taking ozempic - severe gastroparesis, paralysis of the digestive organs. As a result they were now suffering from severe malnutrition, since everything they ate would just sit in their stomach, and then they would eventually vomit it back up. Sometimes vomiting food they ate 3-4 days prior.
Listen, gastroparesis is not something you want to f*ck around with. Sure, it’s a sign that the drug works really well right? It definitely causes weight loss. But can you stop it from causing so much weight loss and malnutrition that you don’t have serious health problems as a result? Maybe, maybe not.
With all other types of paralysis, the longer that normal nerve activity is absent, the more likely it will be permanent. Most people know about this in the case of sciatica. If there is compression of the sciatic nerve due to lumbar spine injury or degeneration - prolonged pressure on the leg can cause permanent damage to the sciatic nerve which affects the function and sensation of the legs.
So if you take a drug to slow the movement of the digestive organs, which suppresses motor activity via the vagus nerve, you could end up with permanent paralysis of the stomach. Which is a very serious problem.
So common side effects of ozempic are nausea, vomiting, acid reflux, diarrhea, constipation, fatigue, and dizziness. Then there’s cool stuff like how it can cause blurry vision by changing the shape of your eye’s lens, and the more casual pancreatitis and cholecystitis. And then some potentially life threatening side effects like bowel obstruction and thyroid cancer.
I think some of our culture’s rabid adoption of dangerous medications is related to our misunderstanding of magic. Modern Americans think of magic as when you get something for nothing - a true fantasy. Real magic always has a cost.
Opioid drugs (oxycodone, hydrocodone, fentanyl, etc) are magic for pain relief, and the cost is powerful chemical addiction and dependency. Corticosteroids (prednisone, cortisone, etc) are magic for suppressing inflammation, and the cost is the potential for permanent suppression of the immune system and adrenal cortex function. Semaglutide is magic for “effortless” weight loss, and the cost is that your digestive system and ability to eat may never be the same again....
Step-by-Step Guide
Support your body with Chinese herbal medicine treatment. Give this process 6 months to 1 year.
Throw away your bathroom scale. Seriously. It is fundamentally counterproductive to thinking on the proper timeline, and it will lead you to make poor decisions. If you need something to weigh your luggage before flights, get one of these simple luggage scales.
Eat a low-carb diet. Eat mainly protein, fat, and leafy green vegetables.
Eat bitter foods. Digestive bitters, bitter melon, endive, dandelion greens.
Cardio exercise. Running, walking, swimming, biking, hiking, etc. Move your body. Forget about weights.
Address pain that’s keeping you from moving. Chinese herbal medicine, acupuncture, yoga, qigong are great tools for resolving pain.
Get mental health support. Therapy is a valuable tool in this journey.
Eat regular meals. No starving yourself. No long periods of fasting. Learn to get in touch with when your body is hungry.
GETTING STARTED WITH HERBAL MEDICINE TREATMENT
Chinese herbs for weight loss
So, what’s the next step?
I have been running an intensive Chinese herbal medicine clinic for over ten years, and have a passion for helping people find lasting, side-effective free, lifestyle affirming treatments for whatever is keeping them down.
I offer highly individualized herbal treatment for a wide variety of health concerns through an online system so anyone in the US can benefit from this medicine.
In my practice I've successfully treated many difficult cases - including atrial fibrillation, heart failure, post-stroke paralysis, and severe diabetic neuropathy. I’ve treated drug-resistant pneumonia, endometriosis, PCOS, Hashimoto's thyroiditis, chronic fatigue, migraines and that’s just naming a few.
If you are wondering if I can help you, the first step is to fill out my New Client Questionnaire.
It is important that you include as much detail as possible, including a photo of your tongue in good lighting. You can include any diagnoses you may have, but also take time to describe how you are feeling. (For example, rather than just saying “Migraines”, you might say something like: I have weekly migraines with pain behind both eyes, vomiting, and intolerance of light and loud sounds and the migraines are triggered by eating cheese” —or whatever the case may be.)
Next, schedule an initial consultation with me.
Consultations can be done in-person, over the phone or through video chat. During this visit, we will go over important details about your treatment plan, including the duration of your treatment, what to expect when taking herbal medicine, and any lifestyle or dietary change that may be important in your healing process.
You can then move forward with your treatment plan by paying for your first herbal formula. Your herbs will be delivered to you within a few days.
This first formula will last for two weeks. At that time, you will fill out the Returning Client Questionnaire with any changes to how you are feeling and an updated tongue photo.
This tells me how the treatment is working, and if anything needs to be adjusted. I will write an updated formula and send out another two week supply of herbs. We continue like that for the duration of your treatment.
Throughout the treatment process, scheduling regular consultations is not necessary for most clients. All you have to do is fill out the Returning Client Questionnaire every two weeks to stay on track. However, if you have a very difficult case, or if you simply want additional support and have lots of questions - you can schedule follow-up consultations as needed.
So how much does Chinese herbal medicine treatment cost?
I’ll be honest with you: my herbal medicine programs are not cheap.
Our initial consultation is $200.
The cost of your herbal medicine is $400/month, for the duration of your treatment plan. Treatment plans will vary in length based on the condition and severity.
Keep in mind that our initial consultation is a one-time cost; most clients do not need to schedule follow-up consultations for a successful treatment plan.
Most treatment plans for weight loss are 6 to 12 months, so $2400 to $4800.
This can sound like a lot, but in my clinic I frequently help patients who had previously spent much more on treatments that did not work. You might save a lot of money by starting here.
A great deal of time, attention, care, and clinical experience goes into analyzing your case and selecting the appropriate herbs for you. On top of that, I use the highest quality herbs that money can buy, rigorously tested for potency and screened for contaminants like heavy metals and pesticides.
It’s also important to remember that we are not treating you indefinitely, so the monthly cost is not a long-term recurring cost. Chinese herbal medicine treatment is focused on reversing the root cause of your condition, not suppressing symptoms indefinitely.
I have had great success using this process to treat patients for a wide variety of complaints. It is convenient for you, and allows me time to deeply consider your case.
Want to learn more about me, my process, or Chinese Medicine in general?
There’s a blog for that!
You’ll find information about me, my practice, Chinese Medicine, herb sourcing, and more in one place on my Herbal Clinic page.
I look forward to hearing from you.
Sincerely, Sean Dugan L.Ac.
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