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Obesity from Metabolism and its Management

The description of sthaulyam in Ayurveda could be analogous to obesity where disproportionate increase in fat (medas) occurs comparing to other tissue principles. The unctuous fat molecules of post digestive juice derived from diet increasing Kapha gets transported through the particular path ways (srotas) and thus helps increase of fat tissue in the system. In this situation agni (selective enzymes) becomes hyperactive due to vitiated neurological factor (vaata) and partial obstruction of the pathways, facilitating the excess intake of food and ensuing increase of fat tissue (medas). The enzymes which influence the appetite and signal the fat storage reserves in the body through the action on the central nervous system are to be studied in a clinical point of view.

 Susruta emphasizes that the unctuous fraction of the essence food helps increase of fat (medas) due to activities and diet increasing kapha. This leads to obstruction of pathway (srotas) limiting the formation of other tissues, instead fat gets accumulated. Here the tissue fires (dhaatvagnis) become deficient in selective absorption. The abdominal fire (jatharaagni) becomes hyperactive due to vitiated vaata as the sequence of obstruction of pathways and increase of fat. This facilitates excess intake of food and subsequent increase of kapha and medas. [S. Soo. 14. 32 & C.Soo.21/6]

Ayurveda states that this sequence results in functional impairment of selective enzymes (agnis) located elsewhere in the system inhibiting certain pathways and impairing conversion of tissue principles. Here some of the pathways get more activated and others get deficient in transforming and transporting the nutrients to selected receptors. We have yet to find out the objective reasoning behind this mechanism.

Leptin produced by adipose tissue and Ghrilin produced by the stomach have to be considered in this regard. Increased secretion of Leptin may also contribute to macrophage accumulation by increased stimulation of transportation of macrophages to adipose tissue in obesity. The oxidative damage resulting from increasingly lipolytic environment also plays a role in macrophage recruitment which according to Ayurveda could be the triggering mechanism in the patho-physiology in diabetes (prameha) where increasingly lipolytic product (kleda) is formed in the system. Ayurveda states that kapha looses its consistency due to its interaction with pitta (enzymes) under the influence of vaata (neurological factor) and there by resulting in the formation of lipolytic product (kleda) which subsequently Here affect the other tissues leading to patho-physiological changes. The treatment principle should be that which regulates the CNS (vaata), enzymes (agnis), and reduces the fat molecules (unctuous – snigdha – fractions). Here nourishing (guru) as well as leaning (apatarpana) are equally important and the formulations on this basis will be highly desired.

Management of Obesity

• Avoidance of food and activities that increase kapha.

• Remove the obstruction of the pathway.

• Purification of channels.

• Dehydrating (rookshana) / abrading (chedana) procedures.

• Abrasive enema (lekhana vasti – Ooshakaadi)

• Correction of agni and vaata in levels of GIT(koshtha) and tissues (dhaathus)

• Physical exercises (vyaayaamam)

Medicines

• Vilangaadi kashaayam

• Gulgulu-tiktakam kashaayam

• Varaasanaadi kashaayam

• Varanaadi kashaayam

• Vyoshaadi-gulgulu

• Prabanjana-vimardanam

• Varanaadi tailam

Obesity Treatment procedures

• Abrasive enema (Lekhana vasti)

• Powder massages (Udvartanam)

• Dry (non-unctuous) fomentation (Rooksha-svedam)

• Buttermilk irrigation (Takra-dhaaraa)

• Acetic irrigation (Kaati-dhaaraa)

• Coating of paste (Aalepanam)

Diet for Obesity

Diet is recommended to be heavy and reductive. Items such as barley (yava), green gram (mudga), millets like kodo millet (koradooshaka), little millet (syaamaaka), uddaalaka, honey (madhu) etc may be used.

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