Menopausal Weight Gain and Metabolic Decline — Weight Loss by Tonifying the Kidney and Strengthening the Spleen (補腎健脾)
Table of Contents
Why weight increases during menopause
Women in their late 40s to 50s often experience weight gain even without eating much more. As estrogen decreases, multiple metabolic changes occur simultaneously.
- Decline in basal metabolic rate: Estrogen is involved in muscle maintenance and energy expenditure, so its decline lowers BMR by about 2–3% per year.
- Shift in fat distribution: Storage shifts from subcutaneous fat (hips and thighs) to visceral fat (abdomen).
- Increased insulin resistance: Blood-sugar regulation becomes less responsive, making the same food more easily converted into fat.
Tonifying kidney and strengthening spleen (補腎健脾) — the Korean medicine principle of menopausal weight loss
Menopausal obesity is not simple obesity but a combined deficiency in which kidney deficiency (腎虛) and spleen deficiency (脾虛) coexist. The kidney (腎) is the foundation of hormonal balance and metabolism, while the spleen (脾) is the hub of nutrient metabolism and water transport. Treatment therefore requires a dual strategy: tonifying the kidney (補腎) to stabilize the hormonal environment, and strengthening the spleen (健脾) to normalize water-damp metabolism.
Prescription strategy
- Kidney-yin deficiency + spleen deficiency type: Jwagwi-eum combined with Sagunja-tang — tonifies kidney yin while strengthening spleen qi. Suitable for those with hot flashes and sweating combined with edema and fatigue.
- Kidney-yang deficiency + damp-phlegm type: Ugwi-eum combined with Ijin-tang — warms kidney yang while removing damp-phlegm. Effective for those with cold hands and feet, body heaviness, and a protruding abdomen.
- With concurrent liver-qi stagnation: A modified Gamisoyo-san as the base, with kidney-tonifying herbs added. Used for those with mood swings and stress-induced overeating.
Constitution-based weight loss — losing fat while preserving muscle
The most important point in menopausal weight loss is to reduce only fat without losing muscle. Perform strength training (squats, lunges, resistance band) at least three times per week, and eat at least a palm-sized portion of protein (20–30 g) at each meal. Calcium and vitamin D are essential for maintaining bone density. Combining herbal medicine with exercise and diet for 3–6 months can produce 5–8% weight loss along with simultaneous improvement in metabolic markers (blood sugar, cholesterol).