Review Article
Year: 2023 |Volume: 4 | Issue: 02 |Pages: 16-20
Systemic Review and Analysis of Research on Obesity (Sthoulya).
About Author
Correspondence Address:
Vd.Apeksha Prakash Pawar PG Scholar, Dept. Of Kayachikitsa, GACH Nanded. Email: apekshapawar236@gmail.com
Date of Acceptance: 2023-02-02
Date of Publication:2023-02-15
Article-ID:IJIM_217_02_23 http://ijim.co.in
Source of Support: Nill
Conflict of Interest: None declared
How To Cite This Article: Pawar A., Kulkarni P., Gogate V., Dongare P. Systemic Review and Analysis of Research on Obesity (Sthoulya). J Ind Med 2023;4(2):16-20
Abstract
In 21st Century, With its Continuous Changing Lifestyles, Environmental and Dietary Habits have made man the victim of many Diseases. Sthoulya is one of them and it affects Someones Social, Physical and Mental features. Obesity is a common metabolic disorder. It occurs due to vitiation of Kapha and Vata. Frequent and increased intake of food which increases Kapha and Medodhatu. it is a chronic disease, Prevalent in both developed and developing countries. As obesity not only reduces life span of an individual but also lead to life threatening complications like Stroke, Ischemic Heart Disease (IHD). Sthoulya vyadhi explained by Acharya Charaka in Santarpanjanya Vyadhi and it is considered as one of the Ashtoninditiya Purusha. The actual Pathology in Sthoulya Patient is due to Obstruction of all Strotasas by Meda, There is Vriddhi of Koshtasthita Saman Vayu which in turn causes Atisandhukshana of Jatharagni leads to Rapid consumption of food. Acharya Charaka has Prescribed Apatarpana Chikitsa as the main Chikitsa of Sthoulya. Lekhana is the treatment which can removed abnormally increased Sama Medodhatu. Pathya Apathya and Lifestyle Modification play important role in the management of Obesity. In modern science there is Appetite Suppressant, Lipid reducing drug and surgical procedures are also available but they have more sideeffect and limitations also so there is need of treatment modality with fewer Sideeffect. Prevention of this condition is the need of the hour. So here an attempt has been made to analyze the research work about to manage Obesity(Sthoulya). In this Article Systemic Review of 4 Research ( held at Government Ayurved college and Hospital Nanded) had been carried out.
Keywords: Sthoulya, Obesity, Rukshana, Lifestyle Disorder.
Introduction
The World Health Organization has defined Obesity as a condition with excessive fat accumulation in the body to the extent that health is adversely affected.(1) it result from a positive energy imbalance expressed by Body Mass Index (BMI) of 25-29.9 and >30 kg/m2 respectively. WHO labelled Obesity as a most visible but most neglected health problem worldwide(2)(3). It has become a major public health problem in both developed and developing countries.
According to Ayurveda, Obesity can be correlated with Sthoulya that originated from Kapha and Medodushti. Sthoulya is one of the major Disease under Santarpanjanya Vyadhi caused due to Dushti of Medovaha Strotasa. It is an Abnormal and Excessive accumulation of Meda Dhatu in the body (3).Acharya Charaka considered Atisthula as one among Ashtonindita Purusha.(4)
Medas increased in the body due to lack of Physical Exercise, Sleeping during the daytime and consuming food which increases Kapha Dosha. All the channels that continuously supply nutrient to other tissues are blocked by Medas (fats). So further tissue are not properly formed and only Medas get accumulated because of these unequal distribution of fat in the body. The Person is called Sthula. In Sthoulya Acharya Charaka describes Ayushorhasa, Kshudhadhikya, Pipasadhikya, Nidradhikya, Swedadhikya and Ayasena Shwaskashta(5) which affect Someones Social, Physical and Mental Status. Prevalence rate of Sthoulya in india is 10.95%.(6)
There are different treatment modalities described by modern science for Management of Obesity like various Appetite Suppresant, lipid reducing drug, Physiotherapy, Surgical procedures but they have sideeffects and limitations. therefore it is necessary to search for simple but effective treatment modalities in Ayurveda. Ayurveda helps to follow better and healthy lifestyle.
Acharya had mentioned Gurucha Apatarpana as a line of treatment in Sthoulya. Rukshana, Udvartana, Sadyavamana, Basti are some of treatment modalities of Apatarpana described by Acharya Charaka(7).
At GACH Nanded different studies were carried out to rule out there significance in management of Sthoulya. In this Article Systemic Review of 4 Research work held at GACH Nanded (1990 – 2022) had been carried out.
MATERIAL AND METHODS :
Post Graduate Thesis Work done in Post Graduate Department at GACH Nanded.
Study 1 – Vd. Ravindra Kute (2011)
In this Study, There are total 60 number of Patients which were Randomly divided into 2 groups.
Group A Trial Group
Drug Triphala Kwatha with madhu (internally) with Musta churna Udwartana along with Pathya- apathya for 60 days
Dose 40 ml Triphala Kwatha and 10 ml madhu BD in the morning and Evening on Empty stomach
Musta churna Udwaratana applied in the morning for 21 days.
Group B Control Group
Drug Triphala Kwatha with madhu with Pathya- apathya.
Dose 40 ml Triphala Kwatha and 10 ml madhu BD on Empty Stomach.
By Study result, it is suggested that Group A shows better result in reducing the BMI of patient.
Study 2 - Vd. Kishor Patil (2015)
In this Study there are total 60 no. of pt. which were randomly divided into 2 groups.
Group A Trial group
Drug Triphaladi Kwatha was given along with Pathya - apathya for 90 days.
Dose 40 ml Triphaladi Kwatha twice a day empty stomach.
Group B Control group
Drug Pathya – apathya for 90 days.
By Study result, the treatment of Trial group was found more significant than control group.
Study 3 – Vd. Pooja Bhagwan Bidade(2017)
In this Study, There are total 104 no.of patient which were randomly divided into 2 groups.
Group A Trial group
Drug Triphaladi taila was given along with diet and exercise for 30 days.
Dose 30 ml Triphaladi Taila once a day along with Koshna jala in the morning, empty stomach.
Group B Control group
Drug only diet and exercise was adviced for 30 days.
Table no.3 Effect of therapy according to % Decrease in BMI
% of Decrease in BMI was observed more in Pt. of Group A than in pt. of Group B. According to % decrease in BMI it is concluded that Triphaladi Taila is effective in Sthoulya.
Study 4 Vd. Deepika Arunrao Chakole (2018)
Total no.of Pt. i.e. 60 were divided into 2 groups with 30 Pt. in each group based upon Random selection.
Group A Trial Group
Drug combination of Triphala, Musta and Chitraka Churna with Exercise and diet for 45 days
Dose 9 gm of combined churna given twice a day before meal an empty stomach.
Group B Control group
Appropriate diet with calories restriction and suitable exercise such as brisk walking for 30-45 min for 45 days.
Table no.4 Assessment of Sr.insulin level for improvement in result.
By Study result, The treatment of Trial Group A was found more significant than Group B.
Discussion
Obesity is a metabolic disorder which happens as majority as a result of faulty lifestyle. In Sthoulya abnormal formation of Medodhatu occurs and no other Dhatu gets properly nourished. The Pathology Suggest that the Vata gets trapped inside the stomach which further increases the Digestive fire and the patient feels frequent need of meal and if the meal is not provided the increased Agni will start to digest normal Dhatu.
In the 1st study, There was a use of Triphala Kwatha with madhu with Musta churna Udwartana as a trial drug and only Triphala Kwatha with madhu were used as control drug. Statistical study were showed Trial drug is more effective than control drug shows better result in reducing the BMI of patient due to laghu, Ruksha Guna, Katu Vipaka, Agni mahabhuta dominance. With the help of all these properties Triphala Kwatha and madhu along with Musta churna Udwartana breaks down pathogenesis of Sthoulya.(8)
In the 2nd Study, There was a use of Triphaladi Kwatha along with Pathya – apathya as a Trial group and only Pathya – apathya as a control group. Statistical result shows the total effect of Therapy on BMI shows Significant result in Trial group than Control group. Triphala Kwatha due to laghu, Ruksha, lekhana properties shows Medoghna, Kaphaghna effect which plays important role in pathogenesis of Sthoulya.(9)
In the 3rd Study There was use of Triphaladi Taila with Koshna jala as a Trial Group and only diet and Exercise was adviced in control group, the Statistical result shows there is % of decrease in BMI was observed more in trial group so it is concluded that Triphaladi Taila is effective in Sthoulya .Triphaladi Taila having Kapha – Pitta Shamaka, Deepana, Kledanashaka properties. It also correct Dhatvagni mandya.(10)
In the 4th Study, There was combination of Triphala, Musta and Chitraka churna along with Exercise and diet used as a Trial group and appropriate diet with Calories Restriction and suitable exercise such as brisk walking for 30-45 min as a control group the Statistical result shows treatment of trial group was found more significant than control group. All drug in Rukshana churna have Shothahara property, Deepana, Pachana and Rukshana Karma. This help to remove Sthanika Shotha and thus help to lower the Sr.Insulin level.(11)
Conclusion
In this Article, Four Research Article Studies on the management of Obesity(Sthoulya). All these works had been carried out on Shamana Chikitsa.
Review shows better result along Shamana Chikitsa with following Pathya – apathya in such lifestyle dependant disease like Obesity (Sthoulya).
References
1. D.R.Wagnar and V.H. Heyward, “ Technique of body composition Assesment : A review of laboratory and field methods “ Research quarterly for exercise and sport, Vol. 70 no.2, Pg 135-149, 1999,2014 control CFD Prevention. Overweight or Obesity : adult obesity fact.
2. E.S Kasu , A Ayim and J Tampouri, Assessment health care service among health care workers in holy Karbala governorate, “ Journal of Biology, Agriculture and Healthcare, Vol 5, 2015.
3. World Health Organization, Obesity : Preventing and managing the Global Epidemic, World Health Organization, Geneva, Switzerland, 2000.
4.Vaidya Yadavji Trikamji Acharya, Charaka Samhita, Chaukhamba Prakashana, Varanasi, Reprint 2013, Sutrasthan 21/3.
6. http://www.icjmph.com – Community based study on prevalence of Obesity among urban population of Shivamogga, Karnataka, India, kanchana Nagendra, nandini C. mangala Belur, International Journal of Community Medicine and Public Health.
7.Vaidya Yadavji Trikamji Acharya, Charaka Samhita, Chaukhamba Prakashana, Varanasi, Reprint 2013, Sutrasthan 21/20.
8.Vd.Ravindra Kute,To Study efficacy of Triphala Kwatha and Madhu(internally) along with Musta churna Udwartana in Sthaulya, Department of Kayachikitsa, GACH Nanded.
9.Vd.Kishor Patil, Study of the effect of Charkokta Triphaladi Kwatha in Sthaulya with Special reference to BMI, Department of Kayachikitsa, GACH Nanded.
10.Vd.Pooja Bidade, Study of efficacy of Triphaladi Taila in Sthaulya with Special reference to Overweight individuals, Department of Kayachikitsa, GACH Nanded.
11.Vd.Deepika Chakole, A Randomized, open labelled, controlled clinical Study of Rukshaniya Dravya( Triphala, Musta, Chitraka) in Individuals with central obesity and insulin resistance with special reference to Sthaulya Chikitsa.
