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Introduction

As an expert it is necessory to understand sthaulya( Obesity) in early stage by knowing sign and symptoms at early stage one can prevent life threatening complication of this disease.In Ayurveda tridoshas (three humors of the body) saptdhatus (seven structural substances that provide support and strength) and mala (waste) by products are the basic elements of body as well as primary elements in disease formation however this factors need to be scrutinize with its principles.Among tridoshas aggrivated kapha, Aggrivated Meda dhatu are similer or among saptdhatu of sthaulya(Obesity) hence this study is aimed at to review kaph vruddhi ( aggrivated kapha doshaa), Medavruddhi(aggrivated of meda dhatu) and sthaulya (obesity) with an objective of prevention of obesity

Aim and Objective

To prevent Obesity at an early stage of manifestation

Material And Methods

Bruhatrayi and Laghutrayi ,

The study was conducted through a detailed screening of the available classical Ayurvedic texts, supplemented with contemporary research papers on Ayurveda and obesity. Key Ayurvedic concepts related to Kaph dosha , Meda Dhatu and Obesity.

Modern Textbooks, reputed Journals and News Paper related to obesity.

Observation

Etiology of Kaph Imbalance

The causative factors for Kapha imbalance include

1) Overeating specially Guru gunatmaka (heavy for digestion), Madhur (sweet), snigdh(oily), shit(cold) foods

2) Poor digestion leading to Ama (undigested food) formation

3)Lack of Physical activity(15)

4) Mental stress and emotional disturbances.(15)

Derangement of Parinama ( Metabolism) of Medas (fat). Agni (digestive fire) is very important thing for physiological activity in the body. Any Dosha, Dhatu and Mala's aggravation or decreases impact on agni. Depending on the form of agni involved, the vitiation of agni has significant health implications at various stages.As Agni is reduced , it contributes at different levels to different metabolic diseases and releases"Ama"(14)( not properly digested food),That is Agni fails to transform the vijatiya (unassimilable) Dravyas(food) into Sajatiya (assimilable) ones, and the Dhatus can not assimilate the end products. These materials are harmful for body and, based on their presence, can induce signs and symptoms at different physiological stages.

If Agnimandya(7) (loss of appetite) is present at the stage of dhatwagni (Metabolism of tissue level) then nutrients present in circulating Ahara Rasa or circulating Poshak Dhatu cannot be assimilated by the individual Dhatus.Thus, in Ahara Rasa (fluid formed from the digested part of food) certain poshak Dhatus will accumulate in irregular amounts and they may accumulate more at abnormal locations. Leenatwa(deep seated) of Ama in Dhatus can be called this kind of method. A verity of disorders may cause Leenatwa of this type. There is no clear connection in Ayurveda to a particular disease agent that can be specifically associated with excess weight, obesity and hyperparathyroidism. such as

1. Rasagat Sneha Vriddhi                                      
2. Raktagata Sneha Vriddhi
3. Medoroga or Medodosha(11)                                         
4. Ama Medodhatu and its advanced stage can be                                                               
5. Shonita Abhishyanda,                                       
6. Kapha Medo Margavarana
7. Kaphaj Hridrog.

Discussion

Aharaj Nidana:-

A) Gunataha: Guru, Madhura, Sheeta, Snigdha, Shleshmala, Atipicchila, Abhishyandi properties in Ahara that dominate prithvi and Aap mahabhuta can cause a direct increase in the Kapha Dosha,Medo dhatu and Pitta Dosha due to the related Bhautika composition.

B) Dravyataha:

Examples of those things that may boost Meda Dhatu are Navanna, Navamadya, Gramya rasa, Mamsa sevana, Paya Vikara, Dadhi, Sarapi, Ikshu, vikara, guda vikara, shali, gohuma, Masha, Varuni madya.

 Bhojan Vidhan:-

1) Aharaj Nidana

Atisampurana,( overeating) results in excess energy storage which exceeds its consumption.As extra carbohydrates are processed in the form of butter, proteins or fats. Excessive calorie intake of any food source with a related weight gain can also contribute to a rise in VLDL overweight. Factors such as Adhyashana, Vishamashana, Samashana result in the creation of Ama. Ama results in more aggravation of the disease caused by Srotorodha.Viruddhashana, Atyaambupana, Jalapana Bhajanoparanta.etc. also impact on proper digestion.

2) Viharaja Nidana:

Avyayam, Avyavay, Divaswap, Asyasukh, Swapnsukh,Bhijanottara snan, Bhojanattara Nidra, etc. Both these factors contribute to lower energy expenditure than input, contributing to corpulence.

3) Manas Nidana:

Achintanat, Harshanityatva is enumerated as the causative factors that are conductive to Atisthaulya by Acharya Charak.

Shatkriyakal:(10)(six stage of Disease progression)

Shatkriyakal is also empowered to accept detailed knowledge of the pathogenesis occurring in every illness, and hence the details are furnished here.

1) Sanchay(8):(Accumulation)

When the doshas are stared accumulate in their own site, it represents the initial stage of the disease during digestion. The endogenous development of cough occurs , that is the first step of digestion; Madhuravasthapak in Aamashay. The prolongation of this process results from unnecessary intake of food products with characteristics such as Madhura, guru, Abhishyandi, Sheeta, etc. that homologous to Kapha dosha. This results in the quantitative rise of the kapha and Pitta accumulating with the kapha and pitta in their own sites. Acharya Charak has claimed that Medo Dhatu excists.

2) Prakop:(outbreak, escalation )

Dalhan has posited that an escalation of doshas is referred to as prakop, manifesting as liquefaction. At this juncture, there is an exacerbation of Kapha Dosha vitiation, contributing to its morbidity at the Medodhatu site. Given the Ashraya-Ashryi sambandha relationship between Kapha dosh and Meda dhatu, a deficiency in Kapha Dosha precipitates impairment of Med dhatu. Doshas previously elevated at this level become morbid in their attributes, with attributes such as Snigdha and Guru increasingly expressed, potentially leading to symptoms including Snigdhangata and Gaurava.

3) Prasar:(Expansion)

In Prasar Avastha, Dosha expansion occurs, affecting other bodily parts, organs, and systems. According to Sushruta, in this Avastha, vitiated Doshas exceed and overflow their respective site boundaries, allowing vitiated Kapha and Pitta Dosha to spread to connected sections and cause disability.

4)Sthan Samshray:(9)(localization of the vitiated Dosha)

The localization of the vitiated Dosha, which marks the beginning of diseases unique to those systems, characterizes this point. In his commentary, Dalhana describes this process as the one in which, due to srotovaigunya or the pathological intervention of the associated srotas(bodys channel) leading to an association between the Dosha and Dushya(body tissue), the vitiated Doshas have expanded and spread to other sections. This takes place at the stage of Srotasa and represents the prodromal phase or the Purvarupa phase.

5) Vyakti:(manifestation)

At this juncture, the signs and symptoms of an infection become fully apparent, allowing for an understanding of the ongoing pathology through observable symptoms of illness. The manifestation of various disease symptoms is influenced by the localization platform and may include signs such as xanthelasmas, xanthomas, corneal arcus, and systemic symptoms like breathlessness, paresthesia, and overweight fatigue, all of which are indicative of circulating lipoproteins. Moreover, the fundamental signs and symptoms of Medo Roga, Prameha, and Dhamani Pratichaya are also apparent.

6) Bheda:(complication)

This stage is distinguished by the chronicity of the condition, in which it becomes sub-acute or incurable. It applies to the ongoing development of obesity, where unmanaged chronicity may eventually give rise to serious diseases, including atherosclerotic conditions, resulting from factors such as myocardial infarction and cerebral strokes.

Chikitsa :

Apatarpan Chikitsa (treatment to remove excess nourishment)

Goal:

To reduce Meda (excess fat), Srotas (clear channels) and Jatharagni (improve digestion)

Therapies:

External: Ruksha Udvartana (dry powder massage), medicated oil massages, Swedana (fomentation).

Panchakarma: Lekhana Basti(13) (reducing enemas with fat-reducing herbs)           and Nasya (nasal application of oils) are key.

Herbal Remedies: Triphala, Guduchi, Haritaki, Madanphaladi Churna.(4)

Pathya (diet):(12) Emphasizes tikta (bitter) and katu (pungent) tastes, yava (light foods like barley), kodrava ( millet ), mudga ( lentils), and avoiding            heavy, fatty foods.

Conclusion

Sthaulya represents the dominant Vyadhi of Dushya, where in the etiological elements cause vitiation of Vata, Kapha, and Meda, thereby enhancing disease severity and its krutchha sadhya (hard to cure) Meda obstruction prevents Vyan Vayu from transporting nutrients to other Dhatu, resulting in increased Medadhatu and uttar dhatu(11) (next dhatu) Sthaulya is the prevalent metabolic disorder identified by Charaka in Ashtou nindita purush.

Sedentary behavior, lack of physical activity, poor eating habits, urbanization, and psychological causes including Harshanitya, manasonivrita, etc.

As per Aacharya Charak

a person suffering from Sthaulya (obesity) is considered to struggle more and is in a weaker position than a person with Karshya (emaciation). This is because Sthaulya is associated with more severe and difficult-to-treat complications.

Kapha Prakriti (constitute) individuals are more susceptible to Sthula, with a higher incidence of obesity observed in women, particularly after marriage, reduced physical activity( excersise), IUCD use, contraceptive pills, post-delivery, and during menopause. The Samprapti of Sthaulya involves Medo dhatvagni mandya, Ama Rasa, and Kapha-Vata Pradhana Tridosha. Treatment strategies should target Meda, Kapha, and Vata, incorporating Lekhana Basti ((reducing enemas with fat-reducing herbs) and Virechana Karma (therapeutic purgation). Basti (enema) has demonstrated improved outcomes by removing Doshas from the body and enabling ingested medications to act at the cellular level.