通过对肥胖的中医病因病机特点的分析，以及对现代社会中肥胖的产生原因及肥胖对现代各系统疾病谱影响的整理 与归纳，提出“肥为百病之长”的病因病机观，认为肥胖为引发现代诸多慢性非传染性疾病的主要因素。肥胖的核心病机 为痰湿、瘀浊。“百病皆由痰作祟”，痰可留滞五脏六腑，可走经窜络，其致病变幻多端，故因肥胖所致之痰饮可殃及五脏 六腑及经络百骸；痰湿停聚日久则可生浊毒、瘀毒，对其他疾病的进展及预后影响较大，因此可称肥胖为“诸病之源”。现 代社会中，因肥胖而致的慢性代谢性疾病为主的非传染性疾病已成为主流疾病谱，而因肥胖所致的代谢性疾病同时还严重 影响着诸多传染性疾病的进展和康复，肥胖因而亦成为“百病之长”。“肥为百病之长”的病因病机观的提出，一方面期望 促进民众对肥胖的重视和管理，针对性改良肥胖者“多坐、多思、多吃，少走、少动、少耗”的“三多三少” 不良生活与 饮食方式，加强自身肥胖的防治；另一方面也提醒中医临证者在辨证论治疾病时，应充分考虑肥胖患者的“痰湿壅盛”的 体质基础，以利于疾病的治疗、康复与预后。

Through analyzing the characteristics of the etiology and pathogenesis of obesity in traditional Chinese medicine（TCM），and by reviewing the causes of obesity in modern society and the influence of obesity on the disease spectrum of modern systems， this paper puts forward the view of“obesity being the primary factor of various diseases”in the etiology and pathogenesis，and it is believed that obesity is the main factor causing modern diseases. The core pathogenesis of obesity is due to phlegm-damp and phlegm-turbidity. A lot of disorders result from mischiefs of phlegm. The affection of phlegm becomes changeable for the phlegm can be held in zang-fu organs or goes through the meridians and collaterals. Phlegm retention resulting from obesity is able to affect zangfu organs and meridians and collaterals. The aggregation of phlegm-damp and phlegm-retention over time result in the turbidity toxin and stasis toxin，which have a great influence on the progression and prognosis of other diseases. Therefore， obesity can be named as the source of various diseases. In modern society， non-communicable diseases characterized by chronic metabolic diseases caused by obesity have become the mainstream disease spectrum. Moreover，metabolic diseases caused by obesity also seriously affect the progression and rehabilitation of many infectious diseases. The obesity has become the primary factor of various diseases hence. The presentation of the view of obesity being the primary factor of various diseases in the etiology and pathogenesis will be expected to draw the attention of the public on management of obesity and to improve the unhealthy lifestyle and diet of the obese people in more sitting， more thinking， and more eating while less walking， less moving and less consuming， so as to strengthen the prevention and treatment of obesity. In addition， it will remind the TCM practitioners to take due consideration of the abundant phlegm-damp physical constitution in obesity people when making syndrome differentiation of the diseases，so as to facilitate the treatment，rehabilitation and prognosis of diseases.

R259.892

国家自然科学基金面上项目（编号：81174225）；深圳市科创委面上项目（编号：JCYJ20220531092004009）