Obesity is one of the common lifestyle disorder many are suffering today. It has the deleterious effect both on  body and mind. WHO declared it as a global epidemic disorder. Worldwide atleast 2.8million die every year due to over weight. It is  the root cause for many other aliments like diabetes, cardiac disorders, atherosclerosis, hormonal imbalance, knee joint pains, hypertension etc.

In Ayurveda, it is called as Sthoulya and it is one among Asthaninditha Purusha. If a disease occours to this sthoulya purusha it is difficult to cure. So one has to take care of their weight. The normal amount of fat in tha body said by acharyas is 2 anjali medas and 3 anjali vasa.

Obesity is the abnormal excessive fat accumulation in adipose tissue either due to enlargement of fat cell size or increase in number of fat cells or combination of both.

According to Ayurveda Sthoulya is a Kaphapradhanaja, Medopradoshaja Vyadhi which can be counted as Santarpanajanya Vyadhi(disease caused due to affected anabolism).

Causes: 1. Ahara: Atiasana – intake of more madhura. Amla rasa ahara and kapha  

                                                    aggravating foods.

                             Adhyasana – intake of food before the previous meal is digested.

2. Vihara:  Avyayama – lack of exercise

               Diwaswapna – Sleeping during day time

                And other Psychological aspects like achinta, asoka etc.

Pathogenesis:  These above factors increases kapha and it  makes the vipaka to be a Madhura (abnormal) which in turn causes increase of medas(fat) which obstructs the nutrient channels of remaining tissue depriving them of nutrition. So only fat accumulates in large quantities in body making the person incapable of all activities.

Symptoms:

• Kshudraswasa – difficulty in breathing even on slight exertion.
• Trshna – thirst
• Moha – delusion
• Excessive hunger
•  Sudden catching of breath
• Bad smell of body
• Poor physical and sexual activities gradually develops.

As abdomen and bones are the chief deposits of fat the abdomen gets enlarged in such person.

The International classification of BMI which is widely accepted as follows;

WHO classification	BMI	Risk of Death
Under weight	Below 18.5	Low
Healthy weight	18.5 – 24.9	Average
Over weight(grade1)	25.0 – 29.9	Mild Increase
Obese (grade 2 )	30.0 -39.0	Moderate/ severe
Morbid/Severe obesity (grade 3 )	40.0 and above	Very severe

D0’s and Don’t’s:

Pathya: 1.Ahara: Yava, ragi, Kulutha, amalaki, Mudga, old wheat, brinjal, barley, laja,          

                            takra, ardraka, lasuna, fibre rich foods, radish, honey, Promogranate etc.

2. Vihara:  Vyayama, jagarana, chinta, vyavyi, langhana, atapasevana.

Apathya: 1. Ahara: Naveena godhuma, high caloric diet the foods prepared with masha, fish, mutton, excessive drinking of water after food, oily susbstances, high alcohol consumption.

2. Vihara: Day sleep, lack of exercise, lack of coitus, atiahara sevana, sedentary lifestyles.

            Don’t’s                                                 

  Do’s

Treatment: Drugs which causes apatarpana, sleshmahara, medoharadravyas like guggulu, Kadamba, Atasi, Pippali, Musta, Haritaki etc and other treatment procedures with virukshana and chedaniya dravyas.

Abhyantara sodhanas:  1.Vamana

                                      2. Virechana

                                      3. Lekhana basti – with drugs having Lekhana(Scrapping) Property.

Bahya sodhana – Ruksha udwartana and others treatments according to the symptoms and based on individual’s prakriti.

Sthoulya is the KaphajaNanatmajaVikara. Vamana is the first line of measure. It is indicated in Shelshma and MedaRogas. Vamana karma is considered as the best for KaphaDosha.

Tikshna Sodhana (Virechana) is insisted the line of treatment in Sthoulya.

Basti therapy is considered as Chikitsardha among all therapy. It not only cures Vatika disorders but also Samsarga and Sannipata condition of Doshas, Kaphaja and Pittaja disorder. Bastidravyas  having the property of kaphavatashamaka, lekhaniya, karshana are indicated. In Sthoulya Ruksha, ushna and Tikshnabasti are suggested by Acharya Charaka. The lekhanaBasti by its virtue of its Lekhana property reduces the Meda and simultaneously pacifies the Vata.

Udwartana is a Bahirparimarjanachikitsa, it is identified as one among the Rukshana Karma and the same can be adopted in Sthoulyaas a Purvakarma of Shodhana in order to bring about Rukshana effect which is exerted by its Kaphahara, MedasahPravilapanam and SthireekaranamAnganam, Twakprasadhakara properties. Udvartana  removes the fortid odor, restricts the process of excessive sweating, and alleviates the aggravated Doshas by function. Charaka specifies the TeekshnaRooksha Udvartana for Sthoulya.

VIRECHANA 

UDWARTANA

              VAMANA

VASTI

Diet: Ahara is considered as one of the key pillars (Upsthambhas) of life in Ayurveda. many guidelines are explained in Ayurvedic texts, which are titled as Ahara vidhi, where the laws of do’s and don’ts about diet and drinks are given. Ayurveda also recommends that you drink your water warm, as cold water can weaken your Agni (digestive fire). One should take warm water during and after meals. Water boiled and reduced to one-

eighth, one-fourth or half of the original quantity or simply boiled and removed, all are called ushnodak. This Ushnodaka helps in weight reduction.

It was also said by acharyas intake of water before meals helps to loose weight, in between meals helps to maintain healthy state and intake of water after meals make one obese. As per Vagbhatta half of the stomach is to be filled with solid food, one quarter with liquids, another quarter should be kept vacant for the free movement of Vata – healthy diet.

Eat plenty of fresh fruits, vegetables, whole grains, nuts, soya.

Whole grains-whole wheat, brown rice, barley, and the like, especially in their less-processed forms-are digested more slowly than refined grains. So they have a gentler effect on blood sugar and insulin, which may help keep hunger at bay.

Lower carbohydrate, higher protein diets may have some weight loss advantages. carbohydrate quality is much more important than carbohydrate quantity. diet and lifestyle change study, people who increased their consumption of French fries, potatoes and potato chips, sugary drinks, and refined grains gained more weight over time. People who decreased their intake of these foods gained less weight. These foods are considered as Virudha ahara (incompatable foods) in ayurveda which has to be avoided otherwise leads to many othere disease aliments.

Studies find that eating nuts does not lead to weight gain and may instead help with weight control if taken in required quantity, perhaps because nuts are rich in protein and fiber, both of which may help people feel fuller and less hungry.

There’s growing evidence that many of the foods that are beneficial for weight control also help prevent heart disease, diabetes, and other chronic diseases. Conversely, foods and drinks that contribute to weight gain—chief among them, refined grains and sugary drinks—also contribute to chronic disease.

 So drink plenty of water, eat fresh fruits and vegetables, nuts, take food at regular timimgs, avoid fast foods, alcohol.

Yoga: Surya namaskaras regular practice and other asanas like ardha chakra asana, ustra asana, Naukasana, Pavanamukta asana, chakra asana, Bhujangasana, Parsvakonasana, Veerabadra asana, Garudha asana along with Pranayama Kapalabhati, Bhasrika.

           Dr.Ch.Swetha M.D(Ayu)