When you ask, "Will herbal medicine make me gain weight?"

What follows combines several patients' visits into one composite story. It is not about any one person, and anything that could identify someone has been removed.

How do we answer this question?

Not all herbal medicine is the same. Its direction depends on what it's made for, and it isn't only about building up.

Some people lack energy and need their body supported; others need what's blocked cleared out first. If the order is wrong, you can actually end up feeling heavier.

How do patients usually come to us?

Patients tell us they're always tired and can't sleep deeply. They want more energy, but they hesitated, worried about gaining weight, before coming in.

When we ask, they say they often eat late at night, don't feel refreshed after sleeping, and feel bloated.

What do we look at?

We go over your blood test results together. If your liver enzymes or triglycerides are high, a heavy, building-up approach would be a burden in that state.

We also gently press on the belly to see where it's firm and where it lacks strength. This is to sort out which areas need building up and which need clearing.

We write down when you eat, too. Eating late at night takes away the time your liver and gut need to rest, so we always ask about it.

How do we treat it?

We divide it into steps. First we clear what's blocked, and once the body is ready to take it in, we move toward building up.

We leave out herbs that could be a burden. What not to include, given your current condition, matters as much as what to include.

If your body changes while you're taking the medicine, we change the prescription too. It isn't one formula made once and taken to the end.

How did things go?

Many people say that as the swelling goes down, their body actually feels lighter. Deeper sleep and a more comfortable stomach come along with it.

However, this is the result of clearing out what had built up in the body, and it is different from a prescription aimed at weight loss.

What are the limits of this approach?

This doesn't happen for everyone. People who need a building-up prescription may gain weight, and sometimes that's what they need.

If your liver enzymes are high, a medical checkup to find the cause comes first. If you're taking any medications or health supplements, be sure to tell us.

To people with the same worry

1. Not all herbal medicine is about building up.
2. Some people need what's blocked cleared first — there's an order.
3. If you bring your blood test results, we use them to decide what to leave out.
4. Eating late at night takes away the time your liver and gut need to rest.
5. Be sure to tell us about any medications and health supplements you take.

We don't look only at the number on the scale. Why the weight went up differs from person to person, so we start by finding the reason.

If you keep losing weight and gaining it back, come see us once. Before the number on the scale, we look for why it went up. It's different for everyone.

There are many possible causes, so the same treatment can lead to different courses for each person.