Obesity and its treatment in Ayurveda
Ayurveda is a science which deals with life, its measurement and description. Life span is a continuation of consciousness; it is the act of keeping alive, Ayu is combination of body, sense organs, mind & soul. The objectives are to maintain the health of individual and to cure the diseases of patient.
A person who has excessive increase of fat and muscles up to the extent that the hips, abdomen and breast becomes pendulous, there is lack of enthusiasm, and disturbed metabolism is termed as Atisthula/Atistolya (Obese).
Aharaj hetu: Intake of excessive quantity of food, intake of guru, sheeta, sneeghdagunatmaka food, and excessive madhura rasa food is responsible for sthaulaya.
Viharaj hetu: lack of physical exercise, abstinence from sexual intercourse, sleeping during day time.
Mansik hetu (Psychological causes): uninterrupted cheerfulness, lack of mental exercise.
Bijaswabhava i.e. hereditary, chromosomal or genetic abnormalities causing obesity
Ashtadoshas/ eight defects or deficits of Atisthaulaya are as follows:
- Reduced lifespan
- Difficulty in breathing
- Find difficult to indulge in sexual
- Intercourse Weakness
- Body odor
- Excessive sweating
- Increased appetite
- Increased thirst
By hetusevan i.e. gurumadhuraahara intake leads to nourishment of medadhatu only, rest of the dhatus remain malnourished that‟s why the life span is reduced. There is looseness and delicacy of the body, as the medas is heavy and the deposition of fat causes heaviness which makes breathing difficult, also the body movements are swift. Sukradhatu is scanty and the channels are blocked by the medas making sexual intercourse difficult. As only medodhatu is well nourished and other dhatus remain undernourished and generalized weakness is present. Medodhatudusti leads to excessive sweating and body odour. Medodhatu and kaphadosha has similar properties of being „Vishandi‟, heavy than other dhatus and are excess in quantity, makes body heavy and the physical strength is less. There is feeling of distress when sweating occurs. Digestive fire is good and vayu is in excessive quantity, causes increase in appetite and thirst. As the body channels are obstructed by medas, vayu circulates in kostha Pradesh, further stimulating the digestive power and the food ingested is quickly digested. If appropriate amount of food is not taken then the agni and vayu burns the body like the fire burns the forest. As a result of increase in fat, various complications may arise and person may die early.
Shlesmal food i.e. with the properties responsible to increase kapha, excess quantity of food intake, lack of physical exercise, habit of sleeping during day time causes excess of madhura- snigdhaahara rasa formation. The ahara rasa in turn increases body fat which leads to Atisthaulaya. When person becomes excessively Sthula clinical features developed as follows:
- Shortness of breath
- Excessive thirst
- Increased appetite
- Excessive sweating
- Body odor
- Sudden apnea
- Body pain or lassitude
- Body becomes delicate, so the physical activity is decreased
- Blockage of Sukravahastrotas by kapha and medas causes difficulty in sexual intercourse.
- Medodhatu is nourished and the rest of dhatus remain malnourished because of which immunity is decreased and life span is reduced.
Complications of Atisthaulya:
Reduced immunity leads to prameha, pramehapidika, Jwara, bhagandara, vidradhi and vatavyadhi in atisthaula person. These complications are severe in nature.
Disabilities with Sthaulya:
Ayu rhasa: Only medodhatu is nourished, rest of dhatus remains undernourished, so there is weakness. The body channels get obstructed by medas, the physical strength is less and all these factors affect the longevity.
Javoparadha: As the body becomes heavy because of excess deposition of medas, the movements are swift or are hampered causing easy fatigue.
Krucha vyavaya: Difficulty in performing sexual act due obstruction of genital passages by medas and kapha, there is paucity of semen.
Daurbalaya: Whatever food taken is converted into medas and only medodhatu is nourished, disturbing the equilibrium of the dhatus, causing weakness.
Sweda Dourgandhya: Excess of sweating occurs as sweat is mala of medodhatu, which is in excess and vitiated in Medoroga. That’s why person cannot tolerate physical strain, sweats a lot causing body odour.
Kshudhaatimatram: The body channels get obstructed by medas, so the vayu circulates in udara Pradesh, stimulating the Agni, thus person is bound to eat more and more food.
Pipasaatiyoga: Vitiated medas and vayu stimulates thirst.
The treatment for Medoroga (Obesity) is described in “Brihatrayee”
Langhana dravyas advised in Medoroga have following properties
Laghu dravyas are vayu – Agnigunapradhana, which improves the state of Agni & help in metabolism of body fat& does not cause any dosha vitiation.
Yavagu or soups made up of roasted cereals added with honey, helps in weight reduction. The person who wants to get rid of medoroga should indulge in remaining awake, sexual act, physical and mental exercises.
For reducing sthulata (rigidity due to obesity) of person following are suggested by Charaka :
- Diets and drinks pacifying vata and kapha which can reduce fat.
- Enema with drugs that are sharp, unuctous and hot in nature.
- Powders of guduchi, musta, and triphala should be advised to take.
- Takraarista administration is advised.
- Honey intake is suggested.
- Vidanga, nagara, yavakshara, black iron powder along with honey and powder of yava and amalakiis to be given.
- Shilajitu formulations
- Agnimantha juice should be administered.
- Intake of prashatika, priyangu, shayamaka, yavaka, junarva, kodrava, mudga, kullatha, chakramudgaka, adhaki, patola, amalaki as food items along with honey water.
- Arishtawhich help to reduce fat, muscles and kaphamaybeadvised to drink after food.
The treatment of Medoroga (Obesity) is mentioned in Sushruta Samhita:
- The causes responsible for medoroga should be avoided. The person suffering from medoroga should be advised preparations made of shilataju, guggulu, gomutra, triphala, lohabhasma, rasanjana along with honey.
- Food items made from yavak, mudga, koradushaka, shyamaka, uddalaka etc which create dryness and clears the obstructed channals should be used by the person.
- The person should indulge in various types of physical activities and use of lekhana enema is recommended.
The principle of treatment and treatment advised for medoroga (obesity), mentioned in Astanga Hridaya:
- Food which is heavy to digest should be given in fewer amounts to the patient of suffering from Medoroga to get rid of it.
- Patient should be advised to have various preparation made up of wheat and barley.
Medicinal preparations advised for Medoroga are as follows:
Medicines, food and regimen which are helpful in pacification of viatiated medas, vayu and shleshma are advised for the patient of medoroga.
- Kulattha churna, shayamaka, yava, mudga, honey water, curd water in food, mental exercises, body purification should be done, remaining vigil is advised.
- Triphalachurna along with honey, guduchiswarasa with haradachurna mixed with honey should be taken.
- Rasanjana, brihatapanchamula, guggulu, sheelajitu preparations along with agnimantha kwatha are prescribed for long time.
- Vidangadi yoga: vidanga, sunthi, kshara, kalalohabhasma, yava, amalakichurna in similar proportions are to be taken along with honey.
Vyoshadi yoga is a special preparation advised by Vagbhatta for the treatment of diseases caused by Santarpana medoroga being one of them.
Sunthi, maricha, pippali, kutaki, harada, behada, shigrubija, vidanga, ativisha, shalaparni, hingu, saurchalalavana, ajaji.Yavani, dhanakya, chitraka, daruharidra, brahati.
So by the intake of food items like madhura, guru, sneegdha in nature, ahara rasa formed after digestion of food is also madhura-sneegdha which causes increase of medodhatu inside the body. As the food has properties similar to medodhatu, only medodhatu increases and rest of dhatu remain undernourished. When the state of Jatharagni is hyperfunctioning, it is able to digest more amount of food converting it into ahararasa; the dhatvagni of meda is also hyperfunctioning leading to increase of medodhatu.