Sthoulya and Obesity: An Integrative Approach - Review Article

Obesity is a chronic metabolic disorder characterized by excessive accumulation of adipose tissue due to enlargement of fat cell size (hypertrophic obesity) or an increase in fat cell number (hyperplastic obesity), often exceeding 20% of ideal body weight.1 In Ayurveda, it is described as Sthaulya or Medoroga. The condition arises primarily due to overconsumption of calorie-dense foods, high fats and sugar foods, increased urbanization and a sedentary lifestyle. These factors lead to vitiation of Kapha Dosha and abnormal accumulation of Meda Dhatu. Sthaulya is classified under Santarpanajanya Vikara.2 Sleshma Nanatmaja vikaras.3 Medopradoshaja vikaras.4 and kleda pradhana vyadhi indicating diseases caused by over-nourishment. The pathogenesis involves Medodhatvagni Mandya and Srotorodha, resulting in impaired metabolism and obstruction of body channels. Clinically, patients present with symptoms such as excessive body growth, reduced physical activity, increased hunger, and excessive thirst. In addition, the thrifty gene concept provides a modern genetic perspective to obesity. This concept suggests that certain genes evolved to enhance efficient energy storage during periods of famine, promoting survival. Obesity acts as a predisposing factor for various complications like type II diabetes, hypertension, Osteoarthritis, Hyperlipidaemia, Coronary artery disease, Stroke, Polycystic ovarian syndrome and other metabolic disorders.5 It also contributes to psychological issues such as stress and reduced quality of life. Ayurveda emphasizes a holistic approach for its management. Apatarpana Chikitsa is considered the main line of treatment to counteract over-nutrition. Therapeutic interventions include Shodhana Chikitsa such as Vamana, Virechana, Basti, and Udvartana, selected based on dosha involvement. These procedures help in detoxification, improving metabolism, and reducing excess fat. In addition to Shodana, Shamana also plays a significant role in correcting metabolic imbalance. Dietary regulation i,e Pathya-Apathya is a key component in management, focusing on light, low-fat, and easily digestible foods. Lifestyle modifications, including regular physical activity and disciplined routines, are equally important. Ayurveda also highlights the importance of addressing the root cause rather than just symptomatic relief whereas, Early intervention can prevent the progression of complications. Thus, Sthaulya requires a comprehensive and individualized treatment approach. Ayurvedic management not only reduces body weight but also restores Dosha equilibrium. It ensures long-term health benefits without adverse effects. Therefore, integrating Ayurvedic principles can be highly Effective in the prevention and management of obesity.