Obesity is often divided into four syndromes of phlegm and dampness due to asthenic spleen, stomach heat and obstruction of dampness, asthenia of both the spleen and kidney, and internal heat due to yin deficiency according to the causes of the disease and the manifestations in syndrome differentiation. The commonly-seen symptoms of phlegm and dampness due to asthenic spleen include extremely fat body, lassitude, heaviness in the head and body with sleepiness, fullness of abdomen, edema of lower limbs, pale and enlarged tongue with thin and greasy fur, deep and slippery pulse.

The commonly encountered symptoms of stomach heat and obstruction of dampness include extremely fat body, laziness, dry mouth, foul breath, red tongue with greasy and yellowish  fur, slippery and rapid pulse; the commonly-seen symptoms of yang deficiency of the spleen and kidney include puffiness, cold body and limbs, pale and enlarged tongue with pale and slippery fur, deep and slow pulse; the commonly-encountered symptoms of internal heat due to yin deficiency include obesity, dizziness with blurred vision, pain, soreness and weakness of lumbus, dysphoria with  feverish chest, palms and soles, low fever, red tongue and thready and rapid pulse.