Introduction
Obesity refers to accumulation of fat in the body due to changes of the biochemical and physiological functions. Clinically body weight increase by 20% more than the standard level is regarded as obesity, usually accompanied by abnormal changes of appetite and sleep, sweating, dry mouth and disorder of stool. TCM believes that obesity is mainly due to disorder of the spleen and stomach as well as dysfunction of defensive qi. The pathological changes are blood sthenia and qi asthenia, exuberance of yin and deficiency of yang as well as disorder of qi and blood. Insufficiency of primordial qi in the triple energizer affects metabolism of water and transformation of qi, consequently leading to obesity.

Syndrome Differentiation
1. Heat in the Stomach and Intestines
Hyperorexia, polyphagia, dry mouth and preference for drinking water, aversion to heat and profuse sweating, irritability and susceptibility to rage, constipation, yellow and scanty urine, red tongue with yellow and greasy fur, slippery and powerful pulse or slippery and rapid pulse.

2. Asthenia of Spleen and Stomach Qi
Pale complexion and lips, poor appetite, abdominal distension after meal, spiritual lassitude and fatigue, palpitation and shortness of breath, somnolence and no desire to talk, loose stool or scanty urine and dropsy, light-colored tongue with tooth prints on the margins, thin and white tongue fur, thin, slow and weak pulse or deep and slow pulse.

3. Insufficiency of Renal Primordial Qi
Bright-white complexion, preference for quietness and aversion to activity, normal appetite or reduced appetite, shortness of breath and asthma, sweating in movement, dizziness and aching loins, or afternoon fever, thirst without much drinking, or aversion to cold and edema of limbs, often accompanied by irregular menstruation in women and impotence in men, light-colored tongue with tender texture and tooth prints on the margins, scanty tongue fur, deep, thin and weak pulse.

Treatment
1. Body acupuncture
Prescription: Quchi (LI 11), Shangjuxu (ST 37), Neiting (ST 44), Yinlingquan (SP 9) and Sanyinjiao (SP 6).

Modification: For heat in the stomach and intestines: Hegu (LI 4), Zusanli (ST 36) and Fenglong (ST 40) are added; for asthenia of stomach and spleen qi, Pishu (BL 20), Weishu (BL 21), Zusanli (ST 36) and Taibai (SP 3) are added; for insufficiency of renal primordial qi, Zhongwan (CV 12), Guanyuan (CV 4) and Sanjiaoshu (BL 22) are added; for constipation, Tianshu ( ST 25 ), Zhigou (TE 6) and Yanglingquan (GB 34) are added; for profuse sweating, Zhongwan (CV 12), Shangwan (CV 13) and Zusanli (ST 36 ) are added; for somnolence, Zhaohai (KI 6), Shenmai (BL 62) and Tianshu (ST 25) are added; for abdominal distension, Xiaochangshu (BL 27), Xiajuxu (ST 39) and Wangu (SI 4) are added; for palpitation and shortness of breath, Shenmen (HT 7), Neiguan (PC 6) and Jugue (CV 14) are added. For thirst with polydipsia, Zusanli (ST 36), Chengjiang (CV 24) and Taixi (KI 3) are added; for edema of lower limbs, Shangqiu (SP 5), Shuifen (CV 9) and Sanjiaoshu (BL 22) are added; for irregular menstruation, Xuehai (SP 10), Diji (SP 8) and Ququan (LR 8) are added; for impotence, Shenshu (BL 23), Mingmen (GV 4) and Guanyuan (CV 4) are added.

nce: Heat in the stomach and intestines is treated with reducing needling technique; asthenia of spleen and stomach qi or insufficiency of renal primordial qi is treated with reinforcing or mild reinforcing and reducing needling techniques. In the early stage 4 - 5 acupoints are selected each time. Eventually ten or more acupoints are selected for each treatment. Deep needling is required for all acupoints except the ones on the limbs.

2. Ear Acupoints
Prescription:  Hunger Point ( External Nose ) ( TG1,2i ), Mouth ( CO1), Esophagus (CO2), Lung (CO14), Stomach (CO4), Endocrine (CO18) and Pancreas and gallbladder (CO11).

Performance: All the acupoints mentioned above are needled with filiform needles once every other day; for embedment of needles and ear pressure with Wangbuliuxingzi (Semen Vaccariae), patients are advised to press themselves three times a day (in hunger, before meal and sleep), each acupoint for 2 - 3 minutes. The two ears are pressed in alternation.