The Saying That Herbal Medicine Makes You Gain Weight

"Doesn't herbal medicine make you gain weight?"

Female patients in particular ask this a lot. And usually they ask having already settled on the answer. It's closer to "I can't take it because I'm afraid I'll gain weight."

I don't answer this with a short "No." Because in some cases weight really does increase. But the reason is different from what most people imagine.

Why did this saying come about?

Three different things are mixed into the single sentence "I took herbal medicine and gained weight." I think we have to separate these out.

First, mistaking swelling for fat

Not every rise on the scale is fat. When the body holds on to water, weight goes up immediately.

As I mentioned earlier in the story about licorice, some medicinal herbs make the body hold on to sodium and water. Then the face swells, the legs feel heavy, and weight can rise by 2–3 kg. (Herbal medicine has side effects too — the story of licorice)

This isn't fat gained — it's water retained. And I don't take this lightly. Swelling means something is happening with the body's regulation of electrolytes and fluids, and for people with weak blood pressure, heart, or kidneys, it must be read as a warning sign.

So if you suddenly swell while taking the remedy, I don't say "it's fine" — I adjust the remedy.

Second, actually eating well

This is a slightly different story.

There are people whose digestion is poor, who have no appetite, and who eat only a little because eating leaves them bloated. When such a person receives treatment and their digestion begins to work, they start eating well. Absorption improves too. And then weight can rise.

The weight gain in this case is the result of recovery. It's the process of someone who had lost weight from not being able to eat returning to normal.

The problem is when it doesn't stop there. If you've recovered but keep eating well while your activity stays the same, weight keeps climbing. So I tell such people in advance: "Your appetite will soon return. From then on, you'll have to watch the amount."

Third, already gaining weight to begin with

While you take herbal medicine for a month or two, life goes on. There are late-night snacks, there are dinner gatherings, and winter comes so you move around less.

If weight rises during that period, what stays in memory is the herbal medicine. It's the only new thing you started, after all. This is a point where cause and coincidence are hard to tell apart.

So I weigh you before prescribing, and check while you take it. Keeping a record of the numbers lets me distinguish these three.

So is there herbal medicine that makes you lose weight?

Here I'm cautious.

There are medicinal herbs that act in a weight-reducing direction. But I think it's dishonest to speak of them as "a remedy you take and the weight comes off."

There's a reason weight doesn't come off. It might be a body where insulin doesn't work well, so it can't burn fat; it might be that a lack of sleep has thrown off the appetite hormones; it might be a thyroid or hormone problem. (Why won't it come off even when I eat less)

If you leave that reason untouched and push with medicine alone, it comes back the moment you stop. I don't work that way.

And remedies that strongly suppress appetite generally put the body into a state of arousal. The heart races, sleep won't come, and you become on edge. Weight may come off, but there's a price for it. It's not that there's never a case where such a remedy is needed, but I always tell you that price and use it accordingly.

And so this is how I answer

"Does herbal medicine make you gain weight?"

"There are cases where the medicine causes swelling. That, I can prevent, and if it happens, I adjust."
"There are cases where digestion improves and you start eating well. That's a good sign, but from then on you have to watch the amount."
"And we go while weighing you. That's how we know what it's due to."

That is the honest answer I can give.

When you should go to the hospital first

Among weight changes, there are some whose cause must be found first.

• If in a short period you swell rapidly and gain weight, and you're short of breath or have trouble lying down — the heart, kidneys, and liver must be checked.
• If you keep losing weight for no particular reason — thyroid, diabetes, and tumors must be checked first.
• If your neck thickens, if you're unusually sensitive to cold or heat, or if your pulse is off — a thyroid examination is needed.
• If your face swells round and only your belly protrudes while your arms and legs grow thin — a hormonal disease must be ruled out.

Finally

Weight is a signal the body sends. Evaluating the body by a single number is dangerous, but asking why that number moved is important.

I don't sell "herbal medicine that doesn't make you gain weight." Instead, I look with you at why that number moved. Whether it's swelling, recovery, or some other reason. If the answer differs, so does what needs to be done.