Obesity -view of Dr Nitin Urmaliya
12 min read
INTRODUCTION:Take things seriously but yourself lightly being the right kind of an attitude has unfortunately become take things lightly but yourself seriously. This has led to many problems in the society and health too is no exception. Man in the true sense is one who has the ability to discriminate and so, is a gifted creation. In the present era, We have complicated our living. In short, we are alien to or away from Nature. Since recent times, we have been talking about lifestyle disorders. Among these lifestyle disorders, a major share is attributed to Obesity, similar to its bulky nature.
OBESITY DEFINITION :
Obesity is a condition in which there is an excessive amount of body fat.
-Medicine by Price
According to Dorland, “Obesity is an increase in body weight beyond the limitation of skeletal and physical requirements as the result of excessive accumulation of body fat”.
Ayurveda : Obesity means Staulya.STHAULYA word is derived from dhatu Sthoola Brihaie with an addition of Ach pratyaya which means thick on solid or strong.
ASSESSMENT OF OBESITY
If a person looks fat, the person is fat. ( API text book of medicine 7th Ed.)
Obesity can be assessed in several ways.
Most commonly used parameters are:-
Body mass Index (BMI or Quetelets Index)
Weight (Kg) Weight (lb) x 703.1
BMI = or BMI =
Height (M)2 Height (Inches) 2
Body Mass Index Associated Disease Risk
Obesity class
BMI (Kg /m 2)
Risk
Under weight
< 18.5
Increased
Normal
18.5 24.9
Normal
Overweight
25.0 29.9
Increased
Obesity – Grade 1
30.0 34.9
High
Obesity – Grade 2
35.0 39.9
Very high
Extreme obesity
> 40.0
Extremely high
HOW DOES AYURVEDA DEFINE OBESITY?
Ayurveda describes obesity in a simple and yet a powerful way, based on both subjective and objective modes. As already stated, obesity is one among the eight undesirable constitutions. Obese people have eight inherent defects Astau doshah, which are as follows,
Decrease in lifespan
Slow or sluggish body movements
Difficulty in sexual intercourse
Weakness
Emit foul smell from the body
Excessive perspiration
Excessive hunger
Excessive thirst
(Ref: Caraka Samhita, sootrasthana, 21st chapter)
PATHOGENESIS OF STHAULYA:-
Obese humans having an increase in number and / or size of adipose cells suggests hyperplasia and/or hypertrophy of adipocytes either due to functional demand in particular age or sex or due to increase in energy intake or decrease in energy expenditure influenced by hypothalamic, genetic, endocrine, behavioural, psychological or iatrogenic component.
Treatment
Ayurveda provides effective remedies for both obesity and skin problems. In the condition where kapha is more aggravated and medo dhatu is impure the first line of treatment includes rukshana or shoshan karma. Shodhana can be done in eligible patients but physician should be careful because in obese patients vata is also vitiated, so due to excess shodhana, vata can worsen the condition. In such conditions only shamana therapy should be used.
SADHYA ASADHYATA:
If patient is having less number of etiological factors, then sadhya otherwise asadhya.
LATEST TREATMENTS FOR OBESITY:
The following are some of the latest treatments for Obesity:
Cognitive behavior therapy
Office counseling
Diet restriction & Exercise regime
Medicines Sibutramine, Orlistat, Diethylpropion, Phentermine, Mazindol, Phendimetrazine, Benzphetamine
Lap banding, Gastric bypass & Gastroplasty
STHAULYA CHIKITSA:
Three step of treatment priciples – 1.Nidana Parivarjana 2.Sanshodhana 3.Sanshamana
REFERENCES
Vanaspatyam-6/535
Amarkosh Nanarth Varga-20
Hemchandra
Bhav-Prakash 39
Charaka Sutrasthana Chapter 21/9
Charaka Sutrasthana Chapter 21/4
Charaka Sutrasthana Chapter 1/89
Charaka.su. 27/272
Charaka .su. 21/4
Ashtang Hariday. Su. 14/31
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