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Introduction

Obesity which is a lifestyle disease deeply rooted in modern dietary patterns, physical inactivity, and psychosocial stressors, is an area of concern both in Ayurveda and contemporary medicine. Yogaratnakar too adopted the name Medoroga to explain Sthaulya.[1] Obesity is considered as the core of many diseases like Diabetes, Heart Disease, breathing problems, PCOS, Stroke, Gall stone, Osteo Arthritis, Sexual problems, some cancer.[2] Ayurveda defines health as a harmonious balance of doshas, dhatus, agni, and malas, accompanied by a positive state of mind and soul. However, disruptions in this balance—exemplified by the condition of Sthoulya—result in physical and mental distress. The over obese has eight defects [3] Shorting of life span, Deranged movement, Difficulty in sexual inter course, General debility, Foul smell from the body, Excessive sweating, Excessive hunger, Excessive thirst.

Modern data highlight the urgency of addressing obesity, with WHO statistics from 2016 noting 39% of adults being overweight and 13% obese. Within this spectrum, India faces a prevalence rate of 40.3% [4], spurred by urbanization, industrialization, and sedentary habits. The negative impacts extend to various conditions, including Type 2 diabetes, cardiovascular risks, dyslipidemia, and more.The excessively obese have eight inherent defects in them: reduced lifespan, constricted or limited movement (hampered due to loose, tender and heavy fats), reduced sexual activities or impotence (due to small quantity of semen produced and obstruction of the channel of semen by medadhatu), debility (due to dhatuimbalance), emit bad smell (due to the inherent nature of fatty tissues as well as excessive sweating), profuse sweating (since medadhatuand kaphaare vitiated), and excessive hunger and thirst (due to excessive digestive agniand vayuin the body). [5] The Ahara Rasa which is absorbed from Pakavashaya reaches in the heart by the conduction of Samana Vayu.This Rasa is again being thrown into circulation from the heart to first through large channels and then through smaller and smaller ones by the help of Vyanavayu the Rasa ultimately reaches to the Sthayidhatus, this contains nutrition for all dhatus the nutrition thus accepted is acted upon by Dhatvagni to convert into Medo Dhatu. [6] Obesity is a medical condition in which excess body fat accumulated to an extent that it may have negative effects on health of an individual. Substantial evidence suggest at the energy intake and body weight is regulated by both endocrine and neural component that ultimately influence the energy intake and expenditure This complex regulatory system small imbalance between energy intake and expenditure ultimately have large impact on body weight. [7]

As Per Acharya Charaka Due to obstruction of Srotas by Meda, the Vata moving mainly into Aamashya, augments the Agni and absorbs the food. Thus, the obese person digests food speedily and craves for food tremendously. Over eating produces excessive growth of Meda Dhatu, this leads to Sthulata.[8] Ayurvedic classics elaborate on the traits and health defects of obese individuals, from reduced lifespan to vitiated medadhatu, impairing both physical capabilities and social well-being. Addressing the limitations and side effects of conventional methods like injectable pharmaceuticals, this study explores the therapeutic potential of Sthoulyanashak Kwath, a cost-effective Ayurvedic formulation.

Methodology:

This clinical trial was conducted at the Kayachikitsa department in a reputed Ayurveda college and hospital. The methodology incorporated the following elements:

1. Study Design: clinical trial.
2. Duration: 8 weeks of treatment for individual participants.
3. Population: Obese individuals aged 18–60 years, with BMI ranging between 30 and 39.9 kg/m² (class I and II obesity).
4. Inclusion Criteria: Signs and symptoms of Sthoulya as per Ayurvedic texts, along with abnormal lipid profiles.
5. Exclusion Criteria: Patients with uncontrolled hypertension, severe metabolic disorders, or obesity due to medication, among others.
6. Parameters for Evaluation: Subjective symptoms (Kshudrashwasa, Alasya, Swedadhikya) and objective measurements such as BMI, lipid profile, waist-to-hip ratio, and abdominal girth.

The trial emphasized ethical considerations, including withdrawal protocols for non-compliant or at-risk patients.

Patient Details (Hypothetical Case)

Name: Mr. xyz

Age: 42 years

Gender: Male

BMI: 33.5 kg/m² (Obese Class I)

Symptoms: Profuse sweating after moderate exertion, lethargy, and dyspnea on moderate activity.

Objective Findings: Abnormal lipid profile with elevated LDL and triglycerides, waist-to-hip

ratio of 1.1, and increased skinfold thickness.

Treatment:

Kwath preparation:

decoction or water extract of a single or group of herbs. According to Sharangdharsamhita, 1 part of coarsely powdered drug is mixed with 16 parts of water and heated until the total quantity of water is reduced to 1/8th (Standard method of ≤preparation). [9] Administered Sthoulyanashak Kwath 30 ml BD daily dosage over 8 weeks, complemented with dietary and lifestyle guidance.

Nidanparivarjan

Nidanparivarjanis to avoid the known disease-causing factors in diet and lifestyle of the patient. It also encompasses the idea to refrain from precipitating or aggravating factors of the disease.[10]

Results:

Results from the clinical trial demonstrated significant improvements in both subjective and objective parameters:

1. Subjective Outcomes: Marked relief in Kshudrashwasa, Swedadhikya, and Alasya, with patients reporting enhanced energy levels and reduced discomfort.

1. Objective Outcomes:
   • BMI Reduction: Mean reduction from 33.5 to 30.8 kg/m².
   • Lipid Profile Improvements: Notable decrease in serum triglycerides and LDL cholesterol, with an increase in HDL levels.
   • Waist-to-Hip Ratio: Shift towards normalized values.
   • Skinfold Thickness: Significant reduction, reflecting fat loss.

Discussion

The findings reinforce the efficacy of Sthoulyanashak Kwath in addressing Sthoulya. The formulation aligns with Ayurvedic principles of correcting meda and kapha imbalance, regulating agni, and enhancing metabolic processes. Unlike modern interventions such as injectable pharmaceuticals or extreme dietary regimens, Sthoulyanashak Kwath offers a holistic, sustainable approach with minimal side effects. Contemporary research highlights the role of bioactive compounds in herbs like Gymnema sylvestre, a possible component of the kwath, which modulates appetite and lipid metabolism.

This clinical trial fills a critical knowledge gap by providing systematic evidence for Sthoulyanashak Kwath, paving the way for its broader clinical application. The results also underscore the social and psychological benefits of weight reduction, combating the stigma associated with obesity and enhancing quality of life. Future studies could explore combining the kwath with Panchakarma therapies for enhanced outcomes.

Conclusion

Sthoulyanashak Kwath emerges as a promising Ayurvedic solution for managing obesity, addressing both its metabolic and psychosocial dimensions. This clinical trial demonstrates its safety, efficacy, and cost-effectiveness, making it a viable alternative to conventional treatments.

With further validation through larger studies, this formulation could become a cornerstone in holistic obesity management.