Objective To explore the effect of tonifying liver and kidney diet combined with the fast diet therapy on improving perimenopausal obesity. Methods A total of 72 perimenopausal obese patients were randomized into a control group and an intervention group, with 36 cases in each group. The control group received online and offline nutrition and diet health education, while the intervention group additionally received the tonifying liver and kidney medicated diet combined with the fast diet therapy, lasting 8 weeks. Results After the intervention, the body weight and waist circumference of the intervention group were significantly lower than those of the control group （P＜0.05 for both）, its scores of four dimensions in perimenopausal quality of life were significantly better than those of the control group (P＜0.01 for all）, and its energy supply ratio of protein, fat and carbohydrate were significantly better than those of the control group (P＜0.01 for all）. Conclusion The therapeutic effect of tonifying liver and kidney diet combined with the fast diet therapy is significant for perimenopausal obese patients, which not only normalizes nutrient intake and effectively reduces body weight, but also has a positive effect on improving quality of life.