Ayurveda final year class on Sthaulya (Obesity)

1. Prof Sriram Chandra Mishra
Kayachikitsa Department
VYDS Ayurved Mahavidyalaya,
Khurja

2. (Cha. Su. 21/9, M.N.)
Definition of Medoroga
• Excess growth of Meda and Mamsa dhatu
• Chala Sphik Udara Sthana - Pendulous movement of Buttock,
Abdomen and Breast
• Ayatha Upachaya – Altered Configuration
• Anutsaha (A-Utsaha) – Lack of enthusiasm

3. Nidana of Medoroga
(M.N)
(C.SU. 21/4)

4. Aharatmaka Nidana
• Atisampuram - Excess intake of food
• Guru ahara sevana – Heavy to digest
• Madhura ahara sevana – Sweet foods
• Sheeta ahara sevana – Sheeta Virya / Cooling
• Snigdha ahara sevana – Unctuous (oily) food
Viharaja Nidana
• Avyayama – Lack of physical exercise
• Avyavaya – Abstinence from sex
• Diva swapna – Day time sleeping
Manasika Nidana
• Harshanityatvat – Uninterrupted cheerfulness
• Achinthanat - Lack of metal exercise
Beeja svabhabat

5. Samprapti of Medoroga
(M.N)
(Cha. Su. 21/4)
(Cha. Su. 21/5-8), MN

8. Poorvarupa of Medoroga
(M.N)

9. Rupa of Medoroga
(M.N)
(C.SU. 21/4)
8 dosha (symptoms) elaborated by Maharshi Charak
1. Ayoshohrasa – Deficiency of longevity
2. Javoparodha – Slow in movement
3. Krichra vyavayata – difficulty in sexual
act
4. Daurbalya –Weakness
5. Daurgandhya – Foul body odor
6. Sveda-abadha – Excess
sweating
7. Kshudha atimatra – Excess
hunger

10. (C. SU. 21/4)
Causes for 8 doshas (symptoms)

12. Charak
(C. Su. -
10/6)
Sushruta
(S. Chi -33/14)
Vagbhatta
(A. S. Su. - 24/13)
• Sthula
• Atisthula
• Sthaulya
• Medoroga
• Hina Sthaulya
• Madhya Sthaulya
• Ati-sthaulya
Bheda of Medoroga
Medamamsa ativridhhi –
Atisthaulya – one among Asta
nindaniya purusha

13. Upadrava of Medoroga
(M.N)
(MN, C. SU. 21/8)

14. Sadhyasadhyata of
Medoroga
(C. SU. 21/17)

15. OBESITY
"Obesity" refers to an excess of fat (Latin word ‘Obedere’ -
Over eat, ‘Obesitas’ - Being very fat)

16. Definition of Obesity
Obesity may be defined as an abnormal growth of
adipose tissue due to
• Enlargement of fat cell size (Hypertrophic obesity) or
• Increase in fat cell number (Hyper plastic obesity) or
• Combination of the above two. (Perk)
The W.H.O. definition
• BMI ≥ 25 is overweight
• BMI ≥ 30 is obesity.
Whatever may be the definition, it is due to fat deposition in the
body results from the discrepancy between energy consume and
expenditure.

17. Etiopathogenesis of Obesity
Obesity doesn't occur overnight. It develops gradually over
time when there is discrepancy between energy consume and
expenditure.
• Genetic factors
 Genetics may play a role in conversion of food into energy
and how body burns calories during exercise.
 Genes may affect the amount of fat storage and distribution
of fat in body.
 A few rare single gene disorders have been identified
 Melanocortin-4 receptor (MC4R)
 Prader-Will Syndrome
 Mutations in the Leptin gene.

18. • Family history
 Obesity frequently runs in families, not just because of
genetics but family members tend to share similar eating
and activity habits.
 Children’s choices, diet and physical activity habits are
influenced by their surrounding environment.
• Unhealthy diet
 Diet rich in calories (fast foods)
 High calorie beverages
 Oversized portions
 Bad eating habits (eating between meals, preference to
sweets, refined foods and fats)
 Diet lacking with fruits and vegetables

20. • Sedentary life style
 Due to Sedentary occupation and inactive recreation more
calories are stored in the body every day than used
through exercise.
 If there is any associated medical problems such as
arthritis can lead to decreased activity; that contributes to
more weight gain.
• Emotional / Psychosocial factors
 For some people, eating habits are influenced by emotions
such as sadness, stress, boredom or anger and they react
by eating excessively.
 Excessively obese individuals are usually withdrawn, self-
conscious, lonely and secret eaters.

21. • Age
 Obesity can occur at any age, even in young children.
 About one third of obese adult have been so since
childhood.
 As age increases, muscle mass tends to decrease and
some hormonal changes also occur; these factors along
with less active lifestyle increase the risk of obesity in later
age.
• Sex
 Men were found to gain most weight between the ages of
29 -35 years while women most between 45-49 years of
age.
 Men have more muscle mass and use more calories (even
at rest) than women.

22. • Giving up Smoking
 Quitting smoking is often associated with weight gain
(average weight gain of 2.8 kg in males and 3.8 kg in females).
 However, smoking is a serious health risk, and quitting is
more important than possible weight gain.
• Alcohol consumption
 Alcohol consumption promotes weight gain by providing
substantial energy (7 kcal per gram).
 It can also stimulate appetite and loosen restraint.
• Sleep
 Not having enough sleep or getting too much sleep can
cause changes in hormones that may increase appetite
and craving for foods high in calories and carbohydrates,
which can contribute to weight gain.

23. • Pregnancy
 Woman may develop adiposity increasing the body weight
to about 4 - 5 kg and this may go on increasing in
subsequent pregnancies.
 This may be due to female sex hormone especially the
estrogen.
• Medicines
 Some drugs when taken over a long period can result in
unwanted weight gain. Example –
 Corticosteroids
 Oral contraceptive pills (some agents)
 Antipsychotics (Phenothiazines, Butyrophenones)
 Antidepressants
 Antiepileptics (Sodium valporate, Carbamazepine)
 Insulin and some oral hypoglycemics (Sulphonylurea)

24. • Environment
 Lack of neighborhood sidewalks, parks, and safe places for
recreation prevents people to be physically active.
 People working with long work hours and time spent
commuting don’t have enough time to be physically active.
 Lack of access to healthy foods such as fresh fruits and
vegetables, or, for some people these healthy foods are too
costly.
 Lack of awareness about healthy diet and healthy cooking
practices.
 Food advertisements for high-calorie, high-fat snacks and
sugary drinks promote people to buy them.
 Rich man consume lots of protein, fat and carbohydrate in
their diets.

25. • Health conditions (Obesity due to endocrinal causes)
 Some medical conditions may cause obesity because of
hormonal disturbances
 Hypothyroidism - Lack of thyroid hormone slows down
the metabolism and causes weight gain. Excess weight
is actually edema, which is lost with replacement of
thyroid hormone.
 Cushing’s syndrome – In this, increased production of
cortisol hormone from adrenal glands occurs. Here fat is
accumulated on the trunk, in the supra-clavicular fossa
and over the dorsal-posterior cervical region. The arms
and legs usually are spared.
 PCOS - It is a condition that affects women of child
bearing age. It is often associated with obesity due to
high levels of androgens.

26.  Insulinoma - Insulin promotes the synthesis of fat. The
post-prandial unparallel rise in blood insulin level to
that of glucose is particularly responsible for the
synthesis of excess fat, which is deposited in the fat
depots leading to obesity.
 Hypothalamic Syndrome - Lesions in the
hypothalamus i.e. hypothalamic tumors or injury etc
may give rise to polyphagia and subsequent obesity.

27.  Increased food intake
 Hypothalamic Lesions
 Adipose Cell hyperplasia
 Hyper Lipogenesis
 Decreased Lipolytic
hormones
 Defective Adipose Cells
 Abnormality in
autonomous innervations
 Hyper Lipogenesis
 Aging
 Defective Lipid
Oxidation
 Defective
thermogenesis
 Increased Lipid
Deposition
 Diminished
Utilization
 Diminished Lipid
Mobilization
O B E S I T Y
ETIMOPATHOGENESIS OF OBESITY (Schematic Diagram)

28. Clinical features of Obesity
 Weight gain (usually occurs over time)
 Breathlessness
 Increased sweating
 Snoring
 Back and joint pains
 Feeling tired even with routine activities
 Inability to cope with sudden physical activity
 Psychological problems such as low self –
esteem, low confidence level

30. Assessment of obesity
 Body weight according to Body frame
 Body mass index (B.M.I.)
 Ponderal index
 Brocca index
 Lorentz formula
 Corpulence index
Other measurements (associated with obesity hazards)
 Skin fold thickness
 Waist – Hip Ratio (W.H.R.)
 Waist Circumference

31. Standard Height and Weight for Indian Men & Women
Height (Feet & Metres) Men Weight (kgs) Women Weight (kgs)
5'-0" (1.523 m) 50.8 - 54.4 50.8 - 54.4
5'-1" (1.548 m) 51.7 - 55.3 51.7 - 55.3
5'-2" (1.574 m) 56.3 - 60.3 53.1 - 56.7
5'-3" (1.599 m) 57.6 - 61.7 54.4 - 58.1
5'-4" (1.624 m) 58.9 - 63.5 56.3 - 59.9
5'-5" (1.650 m) 60.8 - 65.3 57.6 - 61.2
5'-6" (1.675 m) 61.6 - 66.7 58.9 - 63.5
5'-7" (1.700 m) 64.0 - 68.5 60.8 - 65.3
5'-8" (1.726 m) 65.8 - 70.8 62.2 - 66.7
5'-9" (1.751 m) 67.6 - 72.6 64.0 - 68.5
5'-10" (1.777 m) 69.4 - 74.4 65.8 - 70.3
5'-11" (1.802 m) 71.2 - 76.2 67.1 - 71.7
6'-0" (1.827 m) 73.0 - 78.5 68.5 - 73.9
6'-1" (1.853 m) 73.3 - 80.7 73.3 - 80.7
6'-2" (1.878 m) 77.6 - 83.5 77.6 - 83.5
6'-3" (1.904 m) 79.8 - 85.9 79.8 - 85.9
Body weight, though
not an accurate
measure of excess
fat, is a widely used
index.

32. Height Measuring
Scale
(Stadiometer)
Weighing scale

33. Category Small Frame Medium Frame Large Frame
Male < 8 inches 8 - 9.25 inches > 9.25 inches
Female < 7.5 inches 7.5 - 8.75 inches > 8.75 inches
Body weight according to Body Frame
• Body Frame is of three types.
 Small Frame
 Medium Frame
 Large Frame
• It is calculated from ankle girth.
• Take the ankle girth at the smallest point above the ankle with
the tape as tight as possible.
• Weight is different according to frame with a same height.

34. Men
Height
Small
frame
Medium
frame
Large
frame
Ft. in Cm Kg Kg Kg
5’2” 157.5
50.8 –
54.4
53.8 –
58.5
57.2 –
64.0
5’3” 160.0
52.2 –
55.8
54.9 –
60.3
58.5 –
65.3
5’4” 162.6
53.5 –
57.2
56.2 –
61.7
59.9 –
67.1
5’5” 165.1
54.9 –
58.5
57.6 –
63.0
61.2 –
68.9
5’6” 167.6
56.2 –
60.3
59.0 –
64.9
62.8 –
70.8
5’7” 170.2
58.1 –
62.1
60.8 –
66.7
64.4 –
73.0
5’8” 172.7
59.9 –
64.0
62.6 –
68.9
66.7 –
75.3
5” 9” 175.3
61.7 –
65.8
64.4 –
70.8
68.5 –
77.1
5’10” 177.8
63.5 –
68.0
66.2 –
72.6
70.3 –
78.9
Women
Height
Small
frame
Medium
frame
Large
frame
Ft. in Cm Kg Kg Kg
4’10” 147.3
41.7 –
44.5
43.5 – 48.5
47.2 –
54.0
4’11” 149.9
42.6 –
45.8
44.5 – 49.9
48.1 –
55.3
5’0” 152.4
43.5 –
47.2
45.8 – 51.3
49.4 –
56.7
5’1” 154.9
44.9 –
48.5
47.2 – 52.8
50.8 –
58.1
5’2” 157.5
46.3 –
49.9
48.5 – 54.9
52.2 –
59.4
5’3” 160.0
47.6 –
51.3
49.9 – 55.3
53.5 –
60.8
5’4” 162.6
49.0 –
52.6
51.3 – 57.2
54.9 –
62.6
5”5” 160.1
50.3 –
54.0
52.6 – 59.0
56.7 –
64.0
5’6” 167.6
51.7 –
55.8
54.4 – 61.2
59.5 –
66.2
This was first developed by life insurance companies in 1980 to determine insurance rates
based on how long people were expected to live.
Body weight according to Body frame

35. BODY MASS INDEX (BMI) {Quetelet’s index}
• Body Mass Index (BMI) is a number tool for indicating nutritional
status in adults, based on both height and weight.
• It is defined as
(Weight in kilograms divided by the square of the height in meters)
• BMI UNIT - kg/m2
• For example
Height - 1.77 m , Weight - 80 kg
then BMI = 70 / (1.77)2
= 80 / 3.1329 = 25.54 kg/m2

36. Body Mass Index (B.M.I.)
(W.H.O. classification)
< 16.00 Thinness Grade – 3
16.0 – 16.99 Thinness Grade – 2
17.0 – 18.49 Thinness Grade – 1
18.5 – 24.99 NORMAL
25.0-29.99 Overweight
30.0-34.99 Obesity Grade -1
35 - 39.99 Obesity Grade -2
≥ 40.00 Obesity Grade -3 (Morbid obesity)
BMI is also not 100% perfect as some people like athletes may measure a
high BMI but more muscle than fat.

37. The guidelines have been revised lately for Asians, considering the
fact that Asians (esp. South East Asians including Indians) are
more susceptible to metabolic syndrome.

38. 1. Relative Weight (RW) =
2. Ponderal Index =
3. Broca Index = Height (cm) minus 100 (Ht - 100)
4. Lorenz’s Formula =
5. Corpulence Index = Actual weight / Desirable weight.
(It should not exceeds 1.2)
3 )
(
)
(
Kg
Weight
Body
cm
Height
)
(
4
)
(
2
150
)
(
100
)
(
men
or
women
cm
Ht
cm
Ht



Weight
Desirable
Weight
Actual
RW > 120 % Obese
RW > 200 % Morbid obese

39. Skin fold thickness (S.F.T.)
• It is a rapid and ‘non invasive’ method for assessing body fat.
• Several varieties of calipers used for this (e.g. Harpender skin calipers).
• The measurement may be taken at all the four sites
 Mid-triceps
 Mid-biceps
 Sub-scapular
 Supra-iliac regions
• The sum of the measurement should be less than 40 mm in boys and 50
mm in girls.
• Unfortunately standards for subcutaneous fat do not exist for comparison. The main
drawback of skin fold measurement is their poor repeatability.

40. 40 10/2/2021
Sub-scapular Supra-iliac regions
Mid-triceps Mid-Biceps

41. • Waist – Hip Ratio (W.H.R.)
 This is the Waist circumstance divided by Hip circumstance (in cm).
 Waist circumstance is measured half way between the superior iliac
crest and the rib cage in the mid axillary line measured in the
horizontal plane, with the subject standing.
 Hip circumstance is measured one third of the distance between the
superior iliac spine and the patella.
 The average value
W.H.O. (in cm) NIDDK
MALE < 0.90 < 1.0
FEMALE < 0.85 < 0.8
National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK)

42. • Waist Circumference
Waist is measured at mid point of
lower border of rib cage and iliac crest (at the
level of umbilicus).
Co-Morbidity risk with Waist circumference
normal Increased risk Substantial risk.
Men < 90cm (≈36’’) > 94 cm (≈37”) >102 cm (≈40”)
Women <80cm (≈32’’) > 80 cm (≈32’’) > 88 cm (≈35”)
NHLBI – National heart, Lung and Blood institute (United states)

43. Arthritis – OA, RA
Cancers
Cardiovascular Disease (CVD)
Deep Vein Thrombosis (DVT)
Diabetes (Type 2)
End Stage Renal Disease (ESRD)
Hypertension
Infertility
Low Back Pain
Gout
Heat Disorders
Impaired Immune Response
Impaired Respiratory Function
Infections Following Wounds
Liver Disease
Birth Defects
Carpal Tunnel Syndrome (CTS)
Chronic Venous Insufficiency (CVI)
Daytime Sleepiness
Gallbladder Disease
Obstetric and Gynecologic
Complications
Pain
Pancreatitis
Sleep Apnea
Stroke
Surgical Complications
Urinary Stress Incontinence
And many more
Complications

45. Investigations
• Routine evaluation of co-morbidity such as diabetes, hypertension,
dyslipidaemia.
• A cardiovascular examination is needed for those older than 40
years or persons having history of heart disease.
• Various laboratory tests may be performed to assess co- morbid
conditions-
 Fasting lipid profile
 Liver function tests
 Thyroid function tests
 Fasting glucose and haemoglobin A1c(HBA1c)

46. “Most obese people
won’t enter treatment,
most who do, won’t
lose weight and most
who lose weight,
regain it” ~ Stukardz

47. OBESITY
LIFESTYLE
CHANGE
PHARMACO
THERAPY
SURGERY
• The best way to lose weight is decrease it slowly.
• The National Institutes of Health recommend a weight loss goal of
5% to 10% of the person's current weight over six months

48. LIFESTYLE CHANGE
• The safest and most effective way to lose weight is setting
goals with life style changes through
 Dietary Modifications
 Physical activity
 Behavior modification
• If lifestyle changes are not enough then only medicines and
weight loss surgery are options.

49. Dietary Modification
• Food weight (Calorie):
 A kilocalorie deficit of 500/day, in order to facilitate sustained
weight loss of 5 to 10 % of body weight at a rate of 0.5 to 1
kg/week.
 Eat foods that are lower in calories, contain high fiber and
low fat.
 Whole-grain foods (whole-wheat bread and chapati, oatmeal and brown
rice)
 Legumes and nuts
 Fat-free and low-fat dairy products, such as low-fat yogurt, cheese
and milk
 Avoiding whole milk, whole-milk cheese, cream, butter, and ice
cream, solid fats (vanaspati ghee, lard, coconut, and palm oils), fried
fast foods
 Limiting use of ground beef, sausage and processed meats

50. • Food portion size
 Use a smaller plate, bowl etc.
 Avoid oversized portions is a good way to eat fewer calories.
• Low calorie diet (LCD)
 Diets consisting of between 800 and 1200 kcal/d are classified as
LCDs.
 LCD is a low fat diet
• Very low calorie diet (VLCD)
 VLCDs provide 200 to 800 kcal per day, with a substantial number
of calories coming from protein in order to preserve lean body
mass.
 Though these diets can lead to rapid weight loss, but Cutting
calories drastically may lead to serious health problems. So they
Normally the recommended daily calories are 2,500 for men and 2,000 for women.

53.  Regular physical exercise is essential to increase energy
expenditure.
 Exercise is very effective in preventing long term weight regain.
 At least, doing exercise 3 times / week for 45 minute Or doing
20 minute exercise each day.
 Start physical activity slowly and increase intensity and duration
gradually with time.
 Start activity with doing more everyday activities, such as taking
the stairs instead of elevators and doing house hold chores.
Physical Activity

54.  Changing behaviors or habits related to food and physical
activity is important for losing weight such as:
 Change the habits promoting weight gain such as
watching television for long hours.
 Keep a record of weight loss.
 Ask for help or encouragement from friends, family and
health care provider.
 Reward the success for meeting weight-loss goals.
Behavioral changes

55. PHARMACOTHERAPY: (DRUGS)
• Anti-obesity drugs can be useful adjuncts to diet and exercise
for obese adults who have failed to achieve weight loss with
diet and exercise.
• Drugs are only prescribed when BMI is ≥ 28 kg/m 2 with other
weight related conditions or BMI ≥ 30 kg/m 2 .
• Anti-obesity drugs work by
• Inhibiting intestinal fat absorption (Orlistat)
• Suppressing food intake by act on CNS to suppress
appetite (Phentermine)
• Increasing energy consumption and thermogenesis

56. Medication Dose How It Works
• Orlistat
60 - 120
mg/day TID
• Works in gut to reduce fat absorbtion from
the food
• Phentermine-
Topiramate
3.75 mg/23
mg to 7.5
mg/46 mg
OD
• Phentermine lessens appetite
• Topiramate (seizures or migraine),
• Make less hungry or feel full sooner.
• Naltrexone -
Bupropion
8 mg / 90 mg
OD
• Naltrexone (alcohol and drug
dependence)
• Bupropion (depression or to quit
smoking)
• Make feel less hungry or full sooner
• Liraglutide
0.6 mg SC
Inj, OD
• Mimics like glucagon-like peptide-1 (GLP-
1) that targets areas of the brain that
regulate appetite and food intake

57. Medication Dose How It Works
• Semaglutide
(Weekly by injection)
0.25 mg SC
weekly
Mimics a hormone called glucagon-
like peptide-1 (GLP-1) that targets
areas of the brain that regulate
appetite and food intake
• Setmelanotide • 2 mg SC, OD
Reduce appetite and increase feeling
of fullness, increase resting
metabolism
• Sibutramine
(Banned)
• 5 – 15 mg OD • Appetite suppressant
• Other medications
that curb desire to eat
 Phentermine
 Benzphetamin
e
Increases chemicals in brain to
increase feeling of fullness,

58. WEIGHT - LOSS SURGERY (Bariatric Surgery)
• Used to treat people who are severely obese
(For BMI of 35 kg/m2 with co-morbidity or BMI over 40
kg/m 2).
• Common weight-loss surgeries include:
 Laparoscopic adjustable gastric banding (LAGB)
 Gastric bypass surgery
 Gastric sleeve
 Biliopancreatic diversion with duodenal switch
(BPD/DS)

59. An inflatable silicone device placed around the top portion of the stomach,
intended to slow consumption of food and thus the amount of food consumed
reduced.
Bariatric Surgery

60. Roux- en- Y Gastric Bypass Procedure -
First divides the stomach into a small
upper pouch and a much larger lower
"remnant" pouch and then re-arranges
the small intestine to connect to both.
Sleeve Gastrectomy -
Removal of a portion of
the stomach.

61. BPD/DS is a complex procedure
1. First, a sleeve gastrectomy is
performed.
2. The small intestine (first part or
duodenum) is then divided. A
very short length of the last part
of the small intestine is brought
up and attached to it
(duodenum). This is the duodenal
switch.
3. The part of the small intestine
that has been separated is
reconnected to the last part of
the small intestine. This is the
biliopancreatic diversion.

62. • It involves implanting a device under the skin of the abdomen
that sends intermittent electrical pulses to the abdominal vagus
nerve, which tells the brain when the stomach feels empty or
full.
Vagal nerve blockade

63. Intragastric Balloon (Gastric Balloon)
• Placing a deflated balloon into the stomach, and then filling it to
decrease the amount of gastric space.

64. Treatment principle
Nidana parivarjanam
A
a
• Guru-Apatarpana = Madhu
• Vataghna-Slesma-Medohara Annapana
• Ruksha-Tikshna–Usna Basti = Lekhana Basti with Gomutra
• Ruksha Udwartana = Triphala Churna, Kolakulathadi Churna
(C.SU. 21/20-21)
तत्र मेदोनिलश्लेष्मिाशिं सर्ााममष्यते। (A.H.Su. 14/21)

65. Shamana ausadhies
• Kashaya kalpana (60ml BD before 1/2hr of food)
 Ashanadi Kashaym, Vatsakadi Kashayam, Varashanadi
Kashayam, Triphaladi Kashayam, Punarnavadi Kashayam, Patya
Punarnavadi Kashayam, Agnimantha Kvatha
• Churna Kalpana (5gm BD after food)
 Guggulu Panchapala Churnam, Yogaraja Churnam, Vidaga Yava
Lohadi Churnam, Navayasa Churnam, Madhusnuhi Churnam,
Vidangadi Churna, Vyoshadi Saktu, Chavyadi saktu, Trikatu
Churnam,Triphala Churna
• Guggulu / Vati kalpana (2 BD after food) (125-250mg)
 Medohara Guggulu (Vyosadi Guggulu / Navaka Guggulu -
Triphala, Trikatu, Trimada, Guggulu), Punarnavadi guggulu, Amrita

66. • Lauha kalpana (125-250 mg after food)
 Saptamrita Lauha (2 BD), Lauha Bhasma (500mg BD), Tapyadi
Lauham, Vidangadi Lauha (Medohara), Traushanadi Lauha,
Vaadabagni Lauha
• Lehya Kalpana (10gm BD after food)
 Dasamoola Haritaki Lehyam
• Asavarista kalpana (25ml BD after food with equal water)
 Lohasavam, Madhyasavam, Ayaskriti, Lauharista
• Single drugs
 All drugs mentioned in Sneha ativyapat are effective
 Silajeet, Haritaki, Gomutra, Gomutra Arka, Shyamaka, Sila
Mandoor, Brikshamla, Vijayasara

67. SINGLE
DRUGS

69. Shodhana therapy
• UDVARTANAM
 Triphala Churna, Kulattha Churna, Kolakulatthadi Churna,
Aragvadhadi Churna
• TAILA KALPANA (for abhyanga)
 Sarshapa Taila, Murchita Tila Taila, Aasadya Tailam, Pachabija
Tailam, Chadrasura Tailam
• MRUDU VIRECHANA (25 gm morning empty stomach)
 Kalyanaka Gulam, Trivrit Lehyam, Hridya Virechanam
• VASTI
 Lekhana Vasti

70. Sample Prescription slip
1. Navaka Guggulu - 500 mg BD after food with Gomutra arka
2. Lauhasavam - 25ml BD after food with equal water
3. Vidangadi Lauha (Medohara) – 250 mg BD after food with water
4. Triphala Churna – 5 gm OD at night with lukewarm water
5. Cap Vrikshamla – 1 Cap BD after food with water
6. Panchakarma therapy
• Ruksha udvartan with Kolakulatthadi Churna
• Lekhana Vasti
Advice for
• Nidana
Parivarjanam
• Pathyapathya

71. Pathya – Apathya for Obesity
Pathya Apathya
Ahara Varga
Suka Dhanya
Yava, Venuyava, Kodrava, Nivar,
Jurna
Godhuma, Navanna,
Shali
Sami Dhanya
Mudga, Rajmasha, Kulattha,
Chanak, Masur, Adhaki
Masha, Tila
Mamsa Rohit Matsya
Anupa, Audaka,
Gramya
Saka Varga Vruntak, Patrasaka, Patola Madhura saka, Kanda
Phala Kapitha, Jamun, Amalaki Madhuraphala
Dravya
Takra, Madhu, Ushnodaka, Tila
Taila, Sarshapa Taila, Asavarista,
Jirnamadya
Dugdha, Ikshu, Navnit,
Ghrita Dadhi
Vihara Varga
Divaswapna

72. THANK U
• Medications don’t replace physical activity or
healthy eating habits as a way to lose weight.
• Studies show that weight management
medications work best when combined with a
lifestyle program.