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Ask an expert - general - weight problems

5 questions

Q:  Is acupuncture an effective treatment of Bile Salt Malabsorption? I've put on about 3 stone since I've had this, and there is no cure. I'm desperate to lose weight and get some treatment for this condition, which although isn't life threatening is debilitating. Any advice you can give would be much appreciated.
>
A:  Bile Acid Malabsorption syndrome is one of those conditions which appears to have only recently warranted a name of its own, so there hasn't been a great deal of chance for anyone to research the use of acupuncture under problems with this name. We are fairly sure that you have done a great deal of research on the internet over the time that you have suffered from these problems, so you are probably conversant with the different ways in which the condition can manifest and some of the causes. Unhelpfully, of course, one of the most frequent labels is 'idiopathic', which is a Western medical way of saying 'it just happens and we don't know why'.
 
From a Chinese medicine perspective, though, the disease labels are often very unhelpful. What interests a practitioner of Chinese medicine is the symptoms with which a patient presents, together with the history and sequence of how they developed and the patterns which they form. The Chinese understanding of the body is very different from the Western one, with the concept of 'qi', or energy, being a central one. The quantity, flow and balance of qi determines good health, and the Organs of the body (we always use capital letters because what they do is very different from the way they are understood in the West) have a variety of functions which with a good flow of qi they maintain. When symptoms arise, they point to a weakness of flow in parts of the system. With the help of the patient's description of their symptoms and case history, together with diagnostic signs which are unique to Chinese medicine like looking at the tongue and taking the pulse at the wrist, the practitioner aims to establish where disharmony lies and addresses it.
 
In your case the weight gain, which is commonly reported in this condition, might have one of a number of recognised causes from an Eastern perspective, and if the diagnostic signs and answers to questions about other bodily systems point in consistent directions, there may be something for which a practitioner could offer hope. In Chinese medicine,for example, weight gain can often be tracked back to the poor function in the Spleen (note the capital letter - we are not talking about the western organ, the spleen!), which can cause an accumulation of fluids, especially in the central part of the body. If this is malfunctioning to a significant degree, then other aspects of the Spleen's functions will start to manifest problems. Someone may find they are visiting the toilet more frequently and urgently with looser stools, or they may find themselves bruising more easily, or their short term memory and concentration may be not as good as it was. These are all signs that the Spleen may be off key. The Chinese medicine practitioner would ask many questions to get a sense of what may be going on, and if the tongue and pulse supported this diagnosis, there are clear protocols to follow.
 
The beauty and complexity of Chinese medicine,however, lies in its ability when practised well to go to the heart of the problem, not simply treating where symptoms arise. The complex inter-relationships within the system can mean an Organ under-performs not because it is actually suffering but because it is not being supported by another Organ, and the reason that one can never reduce good Chinese medicine to formula treatments for named conditions is that a single named condition might have any one of a dozen different causes - it is the skill of the practitioner which enables them to go the point which will have the greatest effect in putting things back in order.
 
This may not seem as though it is directly addressing your problem, but what we are saying is that this is one of a number of conditions where the symptom and disease label alone are not enough for us to be able to offer a view at a distance, especially since the variety of possible causes means that there has not even been any targeted research on the basis of the evidence of which we could offer a view. What you need is a brief face to face assessment by a practitioner, hopefully without charge, to establish whether what they see encourages them to offer treatment with some hope of success.
 
That is not to say that there has to be a distinct and visible cause from a Chinese medicine perspective; the oldest systems still in use were broadly asymptomatic, treating people rather than diseases in the straightforward belief that a system in balance did not generate symptoms. However, even within this system, a practitioner can usually give an honest appraisal of the possible value of treatment before committing your time and money.
 
You can find a list of all the BAcC members in your area by using the practitioner search function on the BAcC's home page.    
    


Q:  Is acupuncture an effective treatment of Bile Salt Malabsorption? I've put on about 3 stone since I've had this, and there is no cure. I'm desperate to lose weight and get some treatment for this condition, which although isn't life threatening is debilitating. Any advice you can give would be much appreciated.
>
A:  Bile Acid Malabsorption syndrome is one of those conditions which appears to have only recently warranted a name of its own, so there hasn't been a great deal of chance for anyone to research the use of acupuncture under problems with this name. We are fairly sure that you have done a great deal of research on the internet over the time that you have suffered from these problems, so you are probably conversant with the different ways in which the condition can manifest and some of the causes. Unhelpfully, of course, one of the most frequent labels is 'idiopathic', which is a Western medical way of saying 'it just happens and we don't know why'.
 
From a Chinese medicine perspective, though, the disease labels are often very unhelpful. What interests a practitioner of Chinese medicine is the symptoms with which a patient presents, together with the history and sequence of how they developed and the patterns which they form. The Chinese understanding of the body is very different from the Western one, with the concept of 'qi', or energy, being a central one. The quantity, flow and balance of qi determines good health, and the Organs of the body (we always use capital letters because what they do is very different from the way they are understood in the West) have a variety of functions which with a good flow of qi they maintain. When symptoms arise, they point to a weakness of flow in parts of the system. With the help of the patient's description of their symptoms and case history, together with diagnostic signs which are unique to Chinese medicine like looking at the tongue and taking the pulse at the wrist, the practitioner aims to establish where disharmony lies and addresses it.
 
In your case the weight gain, which is commonly reported in this condition, might have one of a number of recognised causes from an Eastern perspective, and if the diagnostic signs and answers to questions about other bodily systems point in consistent directions, there may be something for which a practitioner could offer hope. In Chinese medicine,for example, weight gain can often be tracked back to the poor function in the Spleen (note the capital letter - we are not talking about the western organ, the spleen!), which can cause an accumulation of fluids, especially in the central part of the body. If this is malfunctioning to a significant degree, then other aspects of the Spleen's functions will start to manifest problems. Someone may find they are visiting the toilet more frequently and urgently with looser stools, or they may find themselves bruising more easily, or their short term memory and concentration may be not as good as it was. These are all signs that the Spleen may be off key. The Chinese medicine practitioner would ask many questions to get a sense of what may be going on, and if the tongue and pulse supported this diagnosis, there are clear protocols to follow.
 
The beauty and complexity of Chinese medicine,however, lies in its ability when practised well to go to the heart of the problem, not simply treating where symptoms arise. The complex inter-relationships within the system can mean an Organ under-performs not because it is actually suffering but because it is not being supported by another Organ, and the reason that one can never reduce good Chinese medicine to formula treatments for named conditions is that a single named condition might have any one of a dozen different causes - it is the skill of the practitioner which enables them to go the point which will have the greatest effect in putting things back in order.
 
This may not seem as though it is directly addressing your problem, but what we are saying is that this is one of a number of conditions where the symptom and disease label alone are not enough for us to be able to offer a view at a distance, especially since the variety of possible causes means that there has not even been any targeted research on the basis of the evidence of which we could offer a view. What you need is a brief face to face assessment by a practitioner, hopefully without charge, to establish whether what they see encourages them to offer treatment with some hope of success.
 
That is not to say that there has to be a distinct and visible cause from a Chinese medicine perspective; the oldest systems still in use were broadly asymptomatic, treating people rather than diseases in the straightforward belief that a system in balance did not generate symptoms. However, even within this system, a practitioner can usually give an honest appraisal of the possible value of treatment before committing your time and money.
 
You can find a list of all the BAcC members in your area by using the practitioner search function on the BAcC's home page.    
    


Q: Can acupuncture help with weight lose?

 

A:  This question comes up relatively frequently, and one answer we gave was as follows:
 

Q. I am interested to know if acu will help with weight loss.

A. Weight loss was the subject of some critical scrutiny a decade ago, and the conclusion drawn at the time was that acupuncture did not have any significant effect on weight loss. However, trying to test whether acupuncture can help someone to reduce their weight is likely to be a difficult matter; there are dozens of reasons in Chinese medicine why someone's weight may be increasing. Trying to group together a sufficiently large number of patients whose western problem and eastern diagnosis are the same is extremely difficult.

 

In one or two cases there is a very direct correlation between someone's weight and their underlying imbalances from a Chinese medicine perspective. Correcting these may have an immediate impact on, say, the amount of fluid someone is carrying, and that could create a 3-5kg loss very quickly.

 

However, all of the best dietary programmes say that after the initial and often quite dramatic week or two most good weight loss programmes at best will see someone lose only a pound or two every month, and in fact, there is discouragement from trying to do more in order for the body's system to keep pace with the change. Acupuncture may well have been used successfully alongside some fairly strict dietary rules, and from a patient's perspective it would be very difficult to say whether the acupuncture treatment added value to what someone was doing already.

 

The bottom line is that there are are no 'magic' points which reduce someone's weight without effort, and the effect of acupuncture may be no more than to give someone the support and commitment to keep trying with diet and exercise programmes. However, if someone remains motivated as a consequence of acupuncturre treatment that itself would be a very positive outcome.

 

There is nothing that we would add to this advice other than to beware of anyone making promises they cannot keep about what acupuncture treatment can deliver. Some of the less reputable high street shops still appear to be making claims of a fairly speculative nature without any evidence which supports what they claim.

 

 


Weight loss was the subject of some critical scrutiny a decade ago, and the conclusion drawn at the time was that acupuncture did not have any significant effect on weight loss. However, trying to test whether acupuncture can help someone to reduce their weight is likely to be a difficult matter; there are dozens of reasons in Chinese medicine why someone's weight may be increasing. Trying to group together a sufficiently large number of patients whose western problem and eastern diagnosis are the same is extremely difficult.

 

 

In one or two cases there is a very direct correlation between someone's weight and their underlying imbalances from a Chinese medicine perspective. Correcting these may have an immediate impact on, say, the amount of fluid someone is carrying, and that could create a 3-5kg loss very quickly.

 

However, all of the best dietary programmes say that after the initial and often quite dramatic week or two most good weight loss programmes at best will see someone lose only a pound or two every month, and in fact, there is discouragement from trying to do more in order for the body's system to keep pace with the change. Acupuncture may well have been used successfully alongside some fairly strict dietary rules, and from a patient's perspective it would be very difficult to say whether the acupuncture treatment added value to what someone was doing already.

 

The bottom line is that there are are no 'magic' points which reduce someone's weight without effort, and the effect of acupuncture may be no more than to give someone the support and commitment to keep trying with diet and exercise programmes. However, if someone remains motivated as a consequence of acupuncturre treatment that itself would be a very positive outcome.

 

There are a number of experience practitioners in Lincoln, and you can find them all by clicking on the search button. Any of then will be able to advise you whether acupuncture might be worth pursuing in your individual case.

 

Q. Does acupuncture help with weight problems? Going through the menopause and the weight piling on.

 

A. The research evidence for acupuncture and weight loss is not good, but that is at least in part because weight gain can occur for a wide variety of reasons, and standardising treatment to test its value will almost certainly be a very hit and miss affair. Most people trying to lose weight are also not only doing several things besides seeking help from acupuncturists or other therapists, but told categorically by weight watching organisations that progress is likely to be slow and hard fought. Deciding what effects are down to treatment, to diet, to exercise or just luck is difficult.
 
There are a number of explanations within Chinese medicine which are offered for weight gain, and being menopausal may or may not be implicated in what is going on. Although we repeat all the time that Chinese medicine treats the person, not simply the condition, this is exactly one of those cases where the unique balance and constitution of the individual is the key to understanding whether acupuncture can indeed help. The most effective way to establish this is to seek a short consultation with a BAcC member to see whether acupuncture might be appropriate.