Abstract：Traditional Chinese medicine （TCM） holds that obesity results from the dysfunction of the spleen-earth system in the middle energizer，failure of the mediating mechanisms of the four wheels to maintain circulation，sinking of water and wood elements， and the accumulation of phlegm-dampness-turbid-fat throughout the body. Thus， regulating qi movement enables early prevention and treatment of obesity. Modern medicine considers the microbiotametabolism- immune axis a complex network mechanism involved in the development and progression of obesity， and the preventive regulation for it represents a new approach to obesity diagnosis and treatment. This article takes the relationship among the TCM theory of "qi circles in the body，" the microbiota-metabolism-immune axis，and obesity as a starting point. Based on existing research， it explores the potential roles of qi movement and the microbiotametabolism- immune axis in the pathogenesis of obesity. It proposes that the diagnosis and treatment of obesity should emphasize fortifying the earth and strengthening the middle （i.e.，the spleen-stomach system） to maintain the normal functioning of the microbiota-metabolism-immune axis， thereby improving overall qi transformation function and achieving weight loss effects. This perspective aims to provide a reference for TCM syndrome differentiation and treatment of obesity and to suggest new research directions for expanding the connotation of the "qi circles in the body" theory.