Qiological Community

Heavy/ dense versus soft/flabby

HI,
I have been considering the heavy dense body type in relation to liver excess.
I am treating a 43 year old obese woman who has been dieting strictly for quite a while and has not been able to lose any weight. She is also exercising.
Even though she is obese she seems to be SJ excess.
SJ excess: doesn’t like bright sun 8+ eyes bright 6+ controlling 8+ needs a shield from mother 8+
Her mother strongly disapproves of her weight and always has. She has been controlling since childhood in pushing her daughter to lose weight.
My client feels that one of the reasons for her extra weight is to shield her from her mother…
This certainly points to SJ excess and the need for a shield.
Her extra weight is not heavy and dense it is more soft and flabby. This has what has allowed me to even consider tonifying liver for her.
Is there a concern however in tonifying liver - which is so yin in someone who already has SO much yin?
But - she is also very focused on how she feels and whether her basal temp is up or down, if she ovulated this month (has always had fertility issues - but not planning to have any more kids - has 2 daughters)… So is that Liv excess?

I’ll include other details just to give a clearer picture:
SI trouble conceiving 9+
kid put together 7+ focused on her issues and helping herself 8+
Sp overweight with normal skin 8+
Bl basal body temp not high enough every month to ovulate 8+ doesnt like cold 7+
SJ controlling 6+ hates mess 7+
Liv overly focused on her body and how she feels 7+

Thanks!

Sounds like a complicated case. What have you done and how has she responded?

Sounds like you have strong evidence for SJ excess. If supplementing Liver hasn’t made significant changes for her you have to look elsewhere.

Could this be more SJ excess self criticism?

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Ah, the twists and turns of clinic!

I have a few thoughts bubble up here.

First, while she does sound like she has some aspect of TB excess (and I suspect her mother does as well), there is also the objective reality of SP excess. So do consider boosting up the LI.

As you point out, the weight might be part of her “shield” against her mom. And with all that watery yin, I’d be a bit careful adding to the yin with boosting up the Liver.

Have you considered tonifying to GB to give her some outward assertive energy which can help to keep mom in her place and give herself some breathing room?

Also I don’t think LV types are overly focused on their body. They aren’t really that tuned in. The TB types would be more focused on body (in terms of function) and the KD types more focused on body in terms of looks.

LV could be helpful, but she might need more sword than shield.

I appreciate your input here. You are saying something very significant - even though her symptoms may point to SJ excess and it may make sense given her story, if someone is obese - whether they are heavy and dense or soft and flabby they are still overly yin and therefore tonifying yin may make things worse. This would mean that one aspect of liver overrides all the other symptoms. Do you agree that this is what you are saying? If so then my initial premise that there is a difference between dense and heavy obese and soft and flabby obese in this case does not apply.

I agree that tonify LI is appropriate.
I have tonified: LI, Ht, SI, and PC
The treatments help her feel good but have not made a huge difference in her ability to lose weight. That being said she only comes once every 2 weeks and I told her that she needs to come more often in order to really see a difference.

That is an interesting approach. She has mentioned that she can get irritable and angry at her family so I think it is too risky. ANd truthfully I am not so sure she needs a sword - why fight when you can just protect yourself in a healthier way? Wouldnt it be better for her to establish a healthy shield for herself rather than need to respond to her mother with a more aggressive approach?

Thanks for your response.
I have done LI, Ht, SI, PC, and SJ
she has not had any negative responses. There were times that she lost a few kilo but gained it back. She also said that she ovulated more this year than in years past.
I did not yet tonfiy Liv. I want to because of the above reasons but am concerned to add more yin to the body.

I don’t agree with this line of thinking. I have plenty of yin xu obese patients who benefit from acupuncture and herbal support of physiological yin production.

If the above is true, these are good indications for trying Liv+. If SJ excess is part of the pathomechanism leading to obesity, then Liver+ is the right strategy. If it is the correct treatment, it will not cause her to gain pathological yin. If you feel protected with physiological yin, you aren’t going to need the makeshift shield you have created. Plenty of SJ excess patients report less emotional eating after Liv+ treatments.

You have to wonder about adults who take others opinions too much to heart, even to the point of feeling bullied by a parent’s opinion. Like Michael, I am also curious about P/GB for her. When you are P excess, you need more healthy up and out to navigate the world and relationships. There are plenty of cases and discussions on this forum about P excess patients who are angry because they are unable to express and stand up for their needs. GB+ helps them do so in a healthy way. This is a different kind of anger than people who are picking fights and aggressively moving through the world.

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Hi Adina,

just to help me understand, why did you list ‘trouble conceiving’ under SI?

“Diminished fertility” is a sign of SI excess in the intro powerpoint.
But in my experience K+ isn’t always the way to go for fertility issues. I’ve used every other channel treatment including SI+ for fertility issues with good results.

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totally concur with this - a perfect implication of ‘anything can be anything’ and how our clinical vision needs to penetrate beneath the symptoms into the dynamic in play.

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