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Chowiseungcheng-tang (CST) is a traditional Korean herbal medicine (Sasang constitutional medicine) originally described in the classical medical text *Dongeuisusaebowon*. It is specifically classified as an anti-obesity remedy for individuals of the Taeeumin constitutional type. CST is approved by the Korean Food and Drug Administration (KFDA) and is marketed for the treatment of abdominal bloating, post-prandial distention, and leg muscle weakness. In clinical research, it has been evaluated for its efficacy and safety in treating obesity and metabolic syndrome, particularly in Korean obese women. Its mechanism of action involves the modulation of the brain-gut-adipose tissue axis; specifically, it suppresses the expression of orexigenic neuropeptides such as agouti-related protein (AgRP) and neuropeptide Y (NPY) in the hypothalamus, while upregulating anorexigenic neuropeptides like pro-opiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART). Additionally, it modulates adipokines in visceral adipose tissue and alters gut microbial composition.
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