Hi everyone! Has anyone tried using Sa’am to help patients with weight loss or weight gain? If yes, what was your experience like?
My first thought would be to regulate internal dampness or dryness using LI/SP/ST/LU, or perhaps regulate “density” using LR/SJ?
On the other hand, recognizing that weight management is often a complex issue, would it be a better approach to focus on addressing the grossest thing in the room to bring the body into a more balanced state, which may then support weight regulation over time?
Any thoughts would be greatly appreciated, thank you!
I am working now with a woman in that typical perimenopausal scenario where they just cannot lose weight and even gain weight despite eating ‘well’ and exercising. Something about their metabolism is hypofunctioning. And in her case, it was clearly UB XS / HT Deficiency. Her pulse is slow - substernal is cold and tight - she is cold all the time . . . So her treatments have revolved around HT+ and right away with the first session, she began to lose weight and continues to as we work further. She is also warmer and feels better in every way.
Thanks for sharing, Daniel! What an interesting case - I hadn’t made the connection between weight gain and hypofunctioning / BL XS / HT deficiency. It makes so much sense. Glad to hear she is making good progress with her treatments. This is a good reminder for me to carefully examine a patient’s constitution, as opposed to jumping to potential channels based on a symptom (e.g. weight gain), which can arise from many different factors.
When I first started Sa’am, I thought to myself that I could push the patient towards weight loss. Bad idea!! First, there was too much intention on my part. There is a fine line between intention that is focused attention and then there is intention where we want to push our/or the patient’s agenda, forcing something to happen. Second, I have learned that due to the ambiguity of the internal/external dampness issue, it is not as clear cut as it seems. When I dried dampness on an obese person with dry skin by using ST+ (as an eager very newbie, though still a newbie but a much more humbled newbie now, I used ST+ 3x in a row - very bad of me indeed), I created a bad gout flareup. Since then I’ve learned that causing ST+ imbalance can cause bad gout flareups, bad hemorrhoid flare. So be careful
Thank you for your perspective, Maria! The delineation you make between these different aspects of intention is very insightful, and I think you have articulated what is an ongoing dilemma for me. I often wonder - is trying to push the patient towards weight loss going to bring a greater state of balance for the body? Is being in a larger body something we should be trying to “fix”? I am still in the process of figuring out how to approach weight loss in a helpful and responsible way.
It is really interesting to learn about your patient’s reponse to ST+ 3x in a row. I am trying to wrap my head around why overdoing ST+ could result in flares of gout and hemorrhoids - do you have any ideas for why this happened?
Currently I am seeing a 28 year old female patient who is quite healthy overall but wants to lose weight. She is mildly overweight (BMI of 27) and presents with some signs of internal dampness such as a thick greasy tongue coat, slippery pulse, no thirst, sweet tooth. She also has lumbar pain at BL 25, firm and fleshy thenar eminence, skin that is not too dry or moist, and it seems to me that she has plenty of Qi and resources (robust constitution, and pays entirely out of pocket for treatments which is uncommon in my area). So far I have given her two weekly treatments, LI+ and ST+, both of which she settled well with, falling asleep on the table. At the second treatment she reported losing 1kg but that could just be normal daily fluctuations, so it is too early to tell. In addition to acupuncture, I have also been providing some dietary and lifestyle counseling to support the weight loss.
As a fellow eager very newbie I appreciate the reminder to be careful and Sa’am responsibly!
I think Gout is damp heat, like acne is. So the dampness is rather superficial. Hemorrhoid can also be a result of damp heat that is superficial and sunken Qi. That has been my take on what happened. I have found that if they are really obese, they can actually have Qi deficiency, so it maybe best to toggle between the two if appropriate. Now that I am a humbled newbie, I only do one treatment at a time I have wondered about toggling between LI+ and ST+ if that could cause problems if we dried dampness too much. Please let me know how you fare. I have learned my lesson. It is not up to me to fix anyone. For me, I just do what is appropriate and leave it to a higher power to fix things.
yes! I think / find a big Sa’Am challenge is a kind of damp heat where there is a lot of dampness but it has been congealed into a thickened form by a lot of heat - almost like a dried dampness. On the one hand, you want to dry the dampness (LI+, ST+) and on other hand you want to moisten the dried / congealed dampness to loosen it up (Sp+, Lu+) and in addition cool things down (all the heat) - with UB+ . . . . and in such cases sometimes I wonder if LIV+ is perfect because it BOTH cools and moistens (kind of like a moderate version of doing a combined more radical UB+ and SP+) - even if the patient has no clear or remarkable SJ XS signs or symptoms . . . . getting out of the deep damp heat hole is a challenge that requires a lot of finessing, it seems . . . .