What 8,665 Hangzhou Adults Reveal About Body Constitution: A Composite, Shifting Picture

When people hear the phrase "what is my body constitution," they often picture filling out an online quiz, receiving a label, and then hunting for a matching diet list. The value of this Hangzhou study is precisely the opposite: it steps back and looks at how an entire city's adults are distributed across constitutional categories, rather than diagnosing individuals.

For a reader who is simply curious, the study answers group-level questions such as "roughly how common is each type" and "who tends to fall where," not "what should I personally do." Treating constitution as a statistical tendency rather than a personal verdict is the first step in reading this kind of research well. The data also come from a single Chinese city, where climate, diet, and economic conditions all shape questionnaire responses, so the numbers are clear but cannot be copied onto every reader's circumstances.

One more point worth stating upfront: this study tells us which constitutions appear more often in which groups, but it does not establish that any constitution "causes" any disease. The researchers did not follow these participants to see whether they later became ill, nor did they compare health outcomes between constitution types. The right lens is distribution and association, not cause and effect.

Among the 8,665 Hangzhou adults, the first key number is that constitution is rarely singular: 74.2% of participants were classified into one or more constitution types, meaning they carried traits strong enough for the questionnaire to record, while the remaining 25.8% showed only "unbalanced tendencies," where scores did not reach the formal threshold but still leaned in certain directions.

The second key number is that the Balanced constitution is not, in fact, the majority: 22.3% of all participants fell into this category, making it the most common single type but still far from a majority. Even under the most favorable classification, only about one in five people was sorted into the "more coordinated" group.

The third set of numbers belongs to the eight unbalanced types. Qi Deficiency was the most prevalent at 16.4%, followed by Phlegm Dampness at 11.0% and Yang Deficiency at 9.4%. The remaining five unbalanced types had lower prevalence, which the abstract does not list individually. The study also notes that over half of those classified as unbalanced simultaneously carried other types, which is the heart of the "composite constitution" finding. Common composite combinations included Qi Stagnation with Qi Deficiency, Blood Stasis with Qi Deficiency, and Damp Heat with Phlegm Dampness, abstract labels that suggest one person can carry, for example, both "insufficient energy" and "sluggish circulation" tendencies at once.

The fourth set of numbers describes how the distribution changes. The study makes clear that constitutional distribution varies significantly by age, sex, and BMI. Specifically, younger adults aged 18–39 were classified as Balanced only 13.1% of the time, well below the overall 22.3% average, and they showed a higher prevalence of composite unbalanced constitutions. By sex, men were more likely to show Phlegm Dampness or Damp Heat, while women were more likely to show Yang Deficiency or Yin Deficiency. For BMI, after adjusting for age and sex, individuals with obesity had a higher prevalence of Phlegm Dampness and a lower prevalence of Balanced, Yang Deficiency, or Yin Deficiency.

Read together, these numbers paint a picture more interesting than "which type is most common." Constitution, in real populations, behaves less like a clean either-or category and more like a set of tendencies that can appear simultaneously. More than half of those with an unbalanced constitution were composite, and only 25.8% of the sample had no constitutional trait strong enough to cross the questionnaire threshold, suggesting that a "single, clean" constitution is actually the rarer case in this population.

The age difference is also worth noting: only 13.1% of younger adults were classified as Balanced, compared with the overall 22.3%, which does not mean young adults are "less healthy" but may simply reflect that younger people carry more traces of recent life pressures, such as sleep, emotion, and diet, which make it easier for the questionnaire to trigger multiple constitutional lines at once. The BMI pattern offers a more intuitive correspondence: people with higher weight showed a higher prevalence of Phlegm Dampness, which aligns with everyday observation, but the study describes only an association and does not claim that body weight "causes" Phlegm Dampness.

Sex differences echo patterns often discussed in traditional Chinese medical literature, with men leaning toward dampness and women toward deficiency. The role of this study is to describe the phenomenon, not to validate ancient gender categories. Its contribution is showing that these differences can be quantified and seen in a concrete urban sample, and that they offer a baseline future studies can compare against.

The easiest trap with large surveys like this is reading "association" as "cause." This study only tells us that people of different ages, sexes, and BMI categories show different constitution distributions; it does not prove that a constitution makes people gain weight, age in a certain way, or develop any condition. Without longitudinal follow-up, the direction of cause and effect simply cannot be answered.

A second limitation is the sample scope: all 8,665 participants came from a single Chinese city, so the numbers do not directly represent China as a whole or the world. Urban diet, climate, and industrial structure all shape questionnaire responses, and these data are best read as a reference for urban Chinese adults rather than as a universal map.

Third, while the CCMQ is widely accepted, the questionnaire itself has thresholds and design choices that shape its results. The 25.8% categorized as having only "tendencies" are not necessarily people who "have no constitutional traits at all," but rather people whose scores did not cross the threshold for a formal classification. Reading "tendency" as "score leans a certain way but stays below cutoff" is closer to the intended meaning than treating it as a separate category on its own.

Finally, this study does not provide a tool for self-assessment and is not meant to serve as the basis for personal health advice. Constitution classification still has many open questions in medical research, and treating it as a statistical way of knowing oneself, rather than a label that needs correcting, is the more appropriate way to use it.

If body constitution is best understood as a long-term tendency that traditional Chinese medicine uses to describe how a person tends to feel, respond, and adjust, then a large community survey functions less like a diagnostic tool and more like a map drawn from above. The Hangzhou study, published on 2025-11-28, asked a simple but unusual question: when you look at thousands of adults at once, what does the landscape of constitution actually look like, and does it shift by age, sex, or body weight?

The team used the 2016 version of the Constitution in Chinese Medicine Questionnaire, a standardized 54-item instrument that sorts respondents into nine constitution categories. One category, called Balanced, is meant to capture a relatively coordinated state; the remaining eight are considered unbalanced types, named Qi Deficiency, Yang Deficiency, Yin Deficiency, Phlegm Dampness, Damp Heat, Blood Stasis, Qi Stagnation, and Special. The questionnaire is also designed to register tendencies that fall just short of a full classification, so the same person can carry several labels at once.

The headline number is this: among 8,665 adults aged 18 to 80, the Balanced constitution was the most common single type at 22.3%, yet well below half the sample. Among the eight unbalanced types, Qi Deficiency led at 16.4%, followed by Phlegm Dampness at 11.0% and Yang Deficiency at 9.4%. A combined 74.2% of participants fell into at least one full constitution category, while the remaining 25.8% registered only tendencies below the formal threshold. Most strikingly, over half of those with an unbalanced constitution carried additional constitutions at the same time, producing the composite patterns the study highlights: Qi Stagnation paired with Qi Deficiency, Blood Stasis with Qi Deficiency, and Damp Heat with Phlegm Dampness.

Zooming in, the map tilts in recognizable ways. Younger adults aged 18 to 39 were classified as Balanced only 13.1% of the time and more often displayed composite unbalanced patterns. Men clustered toward Phlegm Dampness and Damp Heat, while women clustered toward Yang Deficiency and Yin Deficiency. After adjusting for age and sex, individuals with obesity showed a higher prevalence of Phlegm Dampness and a lower prevalence of Balanced, Yang Deficiency, and Yin Deficiency types. These shifts are statistical associations, not causal claims, and the figures describe one Chinese city rather than a universal rule, so they should be read as a snapshot of a population rather than a verdict on any individual.