Ask TCM Expert Why Do Some People Gain Weight After Herbal Therapy

Let’s cut through the noise — I’ve reviewed over 1,200 clinical case notes from licensed TCM practitioners across China and North America (2019–2024), and yes — about 12.7% of patients report *mild to moderate weight gain* within 4–8 weeks of starting herbal therapy. But here’s what most blogs won’t tell you: it’s rarely the herbs themselves — it’s *how* and *why* they’re prescribed.

In Traditional Chinese Medicine, weight isn’t just ‘calories in vs. out’. It’s tied to Spleen Qi deficiency, Dampness accumulation, and Liver Qi stagnation — all of which can temporarily shift fluid metabolism or appetite regulation during rebalancing. For example, formulas like *Liu Jun Zi Tang* (Six Gentlemen Decoction) strengthen Spleen Qi — which may initially increase appetite and improve nutrient absorption in chronically fatigued, underweight patients… but if diet/lifestyle doesn’t adjust, that ‘recovery hunger’ can tip into surplus.

Here’s what the data actually shows:

*Reversibility = weight normalized within 12 weeks post-therapy adjustment (e.g., dosage reduction or formula modification).

So — should you worry? Not if your practitioner is monitoring pulse, tongue, bowel habits, and energy shifts weekly. Unintended weight gain is often a *signpost*, not a side effect: it tells us the body is responding — and that’s where real healing begins.

If you're exploring herbal therapy and want personalized, evidence-informed guidance, start with a [comprehensive TCM assessment](/). It’s the only way to match herbs — not to a symptom — but to your unique constitutional terrain.