HTML Full Text

Introduction

Obesity, known as Sthoulya, is one of the most common lifestyle disorders worldwide. In Ayurveda, eight types of Nindita Purusha (disapproved or undesirable body types) are described, among which six are Loka Nindita and two are Chikitsya Nindita. Atisthaulya (obesity) is considered under the category of Ashta Nindita Purusha and is characterized by an excessive accumulation of Meda (fat tissue) and Mamsa (muscle tissue) dhatu, resulting in sagging or flabbiness of the hips, abdomen, and breasts. It is classified as a Santarpanottha Vikara, meaning a disorder arising from over-nourishment or excessive calorie intake. Obesity is a condition where the body mass index (BMI) is 30 or above. It involves excessive fat accumulation in the body, which can adversely affect health, shorten lifespan, and increase the risk of various diseases.

BMI (Body mass index): Overweight and obesity are evaluated using the Body Mass Index (BMI), which is calculated by dividing a person's weight in kilograms by the square of their height in meters (kg/m²).

The International Classification of adult underweight, overweight and obesity according to BMI

The following are the nidana (causative factors) that contribute to the development of obesity:

Atisampuranada -consumption of excessive or unhealthy food.

Guru, Madhur, Atisnigdha Dravya – Consumption of heavy, sweet, and excessively oily or fatty foods

Avyayam – Lack of physical activity or exercise

Avyavaya – Absence of sexual activity

Diwaswapa – Habit of sleeping during the daytime

Harshanitya – Living a consistently carefree and joyful life, without stress or mental                             strain

Beeja Swabhavat – Hereditary or genetic predisposition to obesity, passed down from either the mother or father

Discussion

Lifestyle-Related Causes of Obesity:

Unhealthy Dietary Habits

• High-calorie intake: Frequent consumption of calorie-dense foods (junk food, sugary snacks, processed meals).
• Excessive intake of fats and sugars: Diets rich in oily, sweet, and heavy (guru, madhur, snigdha) foods.
• Irregular eating patterns: Skipping meals, binge eating, or late-night eating disrupts metabolism.

Physical Inactivity

• Sedentary lifestyle: Lack of regular exercise or physical movement due to desk jobs, screen time, or urban conveniences.
• No structured physical activity: Not engaging in walking, yoga, or workouts contributes to fat accumulation (Meda Vriddhi).

Poor Sleep Habits

• Daytime sleeping (Diwaswapa): Promotes Kapha dominance, leading to sluggish metabolism and fat buildup.
• Inadequate nighttime sleep: Disrupts hormonal balance (e.g., leptin and ghrelin), increasing appetite and cravings.

Psychological factors play a significant role in the development of obesity. In many cases, overeating can be a response to emotional conditions such as depression, anxiety, or frustration.

Pathophysiology of Obesity-

The accumulation of fatty tissue blocks the body's internal channels, leading to Avarana (obstruction) of Vata Dosha, which in turn causes its disturbance or aggravation. This aggravated Vata primarily moves towards the stomach, stimulating the Jatharagni (digestive fire). As a result, digestion and absorption become more rapid, leading to an increased appetite. This heightened hunger returns more frequently, prompting the person to eat more often. The excessive food intake leads to the overproduction of Ahara Rasa (nutritive essence), which contributes to the abnormal growth of fatty tissue and eventually results in Sthaulya (obesity).

Nidana (Madhura rasa, Avyayma, Diwaswapa)

Medo dhatu vriddhi (Meda dhatu gets increased)

Stroto avarodha by meda (All strotas get avarodha by the meda)

Vata specially Confined to Koshtha and causes Jatharagni Vriddhi

Increased Appetite more food intake

stholya

An excessively obese person is lead to eight specific defects:

1. Ayuso hasah: a reduced lifespan,
2. Javoparodhah: restricted mobility,
3. Krccha vyavayata: challenges with sexual activity,
4. Daurbalam: physical weakness,
5. Daurgandham: pleasant body odor,
6. Svedabadham: excessive sweating,
7. Ksuda Atimatram: heightened appetite, and
8. Pipasatiyogah: intense thirst.

According to Bhavaprakasha, individuals suffering from Medoroga (disorders related to excess fat) are prone to a variety of health conditions. These include:

1. Kustha – skin disorders
2. Bisarpa – tissue necrosis or gangrene
3. Bhagandara – fistula-in-ano
4. Jvara – fever
5. Atisara – diarrhea
6. Meha – diabetes or urinary disorders
7. Arsha – hemorrhoids
8. Sleepada – filariasis
9. Apachi – lipomas or fatty swellings
10. Kamala – jaundice
11. Sweda Daurgandha – foul-smelling perspiration

These conditions are considered complications or associated disorders arising due to imbalanced fat metabolism.

MANAGEMENT

According to Acharya Vagbhata, a Karshya Vyakti (lean person) is considered better than an Sthoulya Vyakti (obese person), as there is no definitive cure for obesity. In Bruhana (nourishing) therapy, the Agni (digestive fire) and Vata decrease, but this results in an increase in Meda (fat). On the other hand, with Langhana (fasting) therapy, meda (fat) decreases, but Agni and Vata increase rapidly.

The treatment of obesity (Sthoulya) can be managed through the following steps:

Shamana Management for Obesity:

The Shamana approach in managing Sthaulya (obesity) involves several therapeutic methods aimed at balancing the doshas and reducing excess body fat:

• Langhana (Fasting): Periodic fasting is recommended to reduce body weight and stimulate digestion.
• Ama Pachana: The use of digestive herbs and formulations helps break down metabolic toxins (Ama) and improves fat metabolism.
• Ruksha Udwartana (Dry Powder Massage): This dry, medicated body massage is highly regarded for its effectiveness. It helps alleviate Vata Dosha, liquefy accumulated Kapha and Meda (fat), tones and firms the body (Angasthirikarana), and purifies the skin (Twak Prasadakara).
• Dietary Modifications: Foods and beverages that pacify Vata while reducing Kapha and Meda Dhatu are encouraged.
• Low-Calorie and Non-Nourishing Foods: Items like raw salads and honey are preferred as they are light and help control body weight.
• Physical and Mental Activity: Regular exercise and engaging in mental tasks are also essential parts of the treatment to support overall health and weight management.

Samshodhana Chikitsa (Purificatory Therapies)

• For individuals with Atisthulata (obesity) who have adequate strength and endurance, purific atory treatments like Vamana (therapeutic emesis) and Virechana (purgation) are recommended.
• Additionally, non-lubricating, warm, and potent Basti (medicated enemas) are advised to help eliminate excess Kapha and Meda from the body.

Single drugs: Certain single herbs are commonly utilized in the management of obesity. These include Guduchi, Vidanga, Musta, Shunthi (dry ginger), Amla, Vacha, Daruharidra, Guggulu, and others.

Compound formulation: Various Ayurvedic compound preparations are recommended for treating obesity. These include Medohara Guggulu, Amritadi Guggulu, Arogyavardhini Vati, Trikatu, Navaka Guggulu, Triphala Guggulu, Vidangadi Churna, and Takrarishta (a fermented buttermilk-based formulation). Additionally, Navayasa Lauha is also advised as part of the therapeutic regimen.

• An herbal preparation made using Vidanga, Nagara (dry ginger), Yavakshara, black iron ash, honey, along with the powders of Yava (barley) and Amalaki is considered highly effective for promoting weight loss.
• Honey water and Aaristha (alcoholic formulations) can be consumed after meals, as they aid in the reduction of excess fat and muscle tissue, while also helping to balance Kapha Dosha.
• hysical exercise not only helps in reducing body weight but also plays a role in counteracting metabolic adaptation by maintaining the body's nutritional balance set point. It is believed that a sedentary lifestyle contributes to increased visceral fat and changes in the brain, particularly in the cerebellar region. In contrast, regular physical activity stimulates synapse formation (synaptogenesis) and the generation of new neurons (neurogenesis) in areas such as the cerebellar cortex and the hippocampal dentate gyrus.
• Yoga practices greatly influence an individual's physical, mental, emotional, and spiritual well-being.

Conclusion

Obesity (Sthaulya) is a multifactorial condition, deeply influenced by sedentary habits, irregular dietary practices, psychological stress, and lack of physical activity, making it a prominent lifestyle disorder.

Its prevention and management lie in adopting a balanced lifestyle, mindful eating, regular exercise, and stress management. Ayurveda emphasizes correcting the imbalance of Doshas and Agni through appropriate Ahara (diet), Vihara (lifestyle), Shamana and Shodhana therapies.