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Battle of the bulge

During periods marked by a concerning surge in non-communicable diseases, the looming threat to long-term health becomes evident. Among these health concerns, obesity stands out as a condition where an individual’s weight surpasses what is deemed healthy in relation to their height, leading to an excessive body size. Criteria for obesity typically include measurements such as weight, waist circumference, and arm circumference. The underlying cause of overweight and obesity often lies in the excessive accumulation of fat tissue.

In contemporary settings, overweight is defined as having a Body Mass Index (BMI) above 25, while obesity is classified as a BMI exceeding 30. Ayurveda, the ancient Indian system of medicine, addresses obesity under the classification of sthoulyam.

Sthoulyam—The Metabolic Syndrome

In Ayurveda, the concept of sthoulya encompasses the two biological states of being stout or lean, each with its own implications for health. While being lean (kaarsya) is generally favoured in Ayurveda for its health benefits, being stout (sthula) can lead to various health issues later in life. A person with a sthula constitution typically exhibits symptoms such as excessive sweating with a foul odour, difficulty walking, and enlargement of the abdomen, buttocks, and thighs. Ayurveda warns that sthoulya can predispose individuals to conditions such as heart disease, tumours and dizziness.

How to Tackle Sthoulya

1. Dinacharya (Daily Regimen): Following a daily routine as prescribed in Ayurveda, including waking up early, exercising, practicing abhyangam (oil massage), and maintaining a proper diet plan, can help prevent health issues associated with sthoulya.

2. Familial Background: Recognising the role of genetics in obesity, individuals with a family history of obesity should understand that coercing the body to become lean may not be the ideal solution. Instead, focus on managing weight in a manner that aligns with one’s natural constitution.

Therapies for Obesity

1. Udvartanam: This procedure involves massaging the body with specific herbal powders to reduce accumulated fat. The duration and frequency of udvartanam are tailored to each individual’s needs.

2. Snehapanam: Involves the consumption of medicated oils in a specific dose to help disperse fat content in the body. Snehapanam is often performed as a preparatory step for detoxification (shodhana) therapies.

3. Vamanam: A therapeutic procedure involving induced vomiting with specialised herbal formulations. Vamanam is recommended for individuals with predominant kapha dosha and obesity.

4. Virechanam: Therapeutic purgation performed after snehapanam to eliminate metabolic residues and excess fat. Virechanam is tailored to the individual’s doshic imbalance and disease status.

5. Lekhana Vasti: A specialised colon therapy aimed at breaking down fat accumulation in the body. Herbal preparations such as triphala kashayam are used for colon cleansing and fat dissipation.

Diet and Exercise

To manage obesity effectively, focus on personalised dietary choices emphasising easy-to-digest foods while avoiding inflammatory options. Incorporate regular aerobic exercises like walking, swimming, and yoga, including practices such as suryanamaskara, to burn excess energy and promote weight loss. This combined approach supports a healthier lifestyle and aids in combating obesity.

Ayurveda offers a holistic approach to combating obesity, addressing not only physical symptoms but also underlying imbalances to promote long-term health and wellbeing.

The author is a Professor at the Department of Panchakarma, Ashtamgam Ayurveda Medical College, Kerala

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