A person who due to excessive accumulation of muscles and fat in the body presents with sagging butts, abdomen and breasts, the muscles and fat tissue are nourished and formed normally (they are abnormally deposited) and the energy levels also are not normal (below normal) is called atisthula or obese.

CAUSES

Avyayama (lack of exercise),

Divasvapna (sleeping at day time),

ShleshmalaAharaSevana – intake of foods which increase KaphaDosha

Due to above factors the annarasa (the end product of digestion) becomes sweet by not getting properly digested and there by results in accumulation of sneha (oiliness) and fat.

PATHOLOGY

Due to the blocking of tissue channels by the fat tissue, the successive Dhatus (bone, marrow and Shukra) do not get nourishment and they fail to develop properly.

It leads to more accumulation of Medas – fat, resulting in the person facing difficulty in executing his daily tasks.

CLINICAL FEATURES

Kshudrashwasa (gasping for air),

Trusha – excessive thirst,

Moha – delusion, inprecisive work,

SvapnaKrathana – snoring

Saada – exhaustion.

Kshut – excess hunger,

Sveda – excess perspiration,

Durgandha – foul body odor,

Alpapran – short breaths

Alpamaithuna- less sexual strength occur due to depletion of Shukradhatu.

In human beings, fat gets accumulated in abdominal region.

The root for medovahasrotas – fat channels are – Vrukka (kidney) and Vapvahana (greater omentum) as per the statement of Charaka –

That probably is the cause for the pendulant abdomen in sthoulya people.

ASHTA DOSHA ACCORDING TO CHARAK

1. Short life span

2. Inability to work

3. Loss of libido

4. Weakness

5. Foul odour of the body

6. Excessive sweating

7. Exacessive appetite

8. Excessive thirst

COMPLICATIONS-

1. Visarpa

2. Bhagandar

3. Jwar

4. Diarrhoea

5. Diabetes

6. Piles

7. Filariasis

8. Apache

9. Kamala

EFFECT ON AGNI

Due to blocking of fat tissues, VataDosha is increase within Koshta – (alimentary canal). Vata influences the Agni and leads to increase of Agni (digestive fire). This leads to parching of food.

This leads to quicker digestion of food, forcing the person to long for food and indulge in binge eating.

This binge eating habit leads to severe health complications in due course of time.

AMA RELATED COMPLICATIONS

prameha  pidaka (carbuncles),

jvara (fever),

bhagandara (fistula in ano),

vidradhi (abscess),

Vataroga

According to VijayaRakshita, Madhukoshavyakhya,

The complications in sthula is caused by the aggravated vayu and agni, the accumulation of fat is directly proportional to the increase of vata which results in difficult to cure complications which affects the quality of life.

The excessive vrddhi of the medas and mamsa with in the regions of the spik (gluteals – hip region), udara (abdomen) and stana (breast tissues) is so humongous that it causes pendulance of those structures. The unrestrained (ayatha) accumulation of medas in human being is known by the name sthula or sthoulya.

Sthoulya means obese or looking obese (bulky / busty). This is an anatomical description of the disease. This also is another term which reflects MedoVriddhi. Symptoms to differentiate MedoVriddhi and Sthoulya have not been given. But these different terms have been used in different contexts. By description, it looks like Medovriddhi is the physiological part of disturbance (imbalance) which takes place on the backdrop of sthoulya. Sthoulya is the anatomical presentation of Medo Vriddhi.

CHIKITSA SIDDHANT-

1.       Nidana parivarjana

2.       Karshan, guru aptarpana chikitsa

3.       Sanshodhan chikitsa

4.       Vyayama

5.       Vata kapha nasak ahar vihar

6.       Mutra –purisha virechaniya aushadhi prayoga

ADARSHA CHIKITSA PATRA

1.       Vidangadi curna 2gm + trikatu curna 1 gm + trimurti rasa 125mg (twice with madhu)

2.       Arogyavardhani 250mg + triushnadhya loha 250mg + navak gugglu 500mg (twice with madhu)

3.       Loharista 20ml (twice with 20ml water)

4.       Triphala curna (3gm at bed time)

SANSAMANA CHIKITSA PATRA

1.  A. Panchmula kvatha(fresh) 30ml + madhu 20ml (twice empty stomach use 1-3 month)

B. Triphala curna + vidanga (curna) (5gm twice with hot water)

C. Takrarista 20ml + madhu 10ml (twice)

2.  A. Medohar guggul

B. Triphala

C. Gokshuradi

D. arogyavardhani

3.  Shilajatyadi loha 250mg + Suddha shilajatu 500mg + Sothari Loha 250mg (twice with madhu)

PATHYA- 

purana Sali, munga, kulatha, yava, chana, sava, bajra, makka, masoor, parval, amla, sarsapa taila, priyangu, tikta, kasaya rasa dravya, gugglu, drinking water before meal.

Chiunta, shrama, ratri jagran, stri sevan, ubtan, langhan, dhup sevan, aptarpan, vyayam, ushnodaka snana

APATHYA-

Navin Sali, gehu, udad, aalu, dugdha, fish, mamsa, egg, ghrita, dadhi, bhojan paschat jala sevan

Sheetan jala snana, diva svapna. 

LEKHAN BASTI-

1.       Giloy 50gm + Triphala 50gm + Nagarmotha 50gm (make 200 kvatha add 30ml eranda taila + 10gm saindhav) à basti

2.       Triphala 50gm + Vayavidanga 50gm + Sunthi 50gm + Giloy 50gm + Nagarmotha 50gm (make 200ml kvatha add 50ml gomutra + 10gm yavakshar + 5gm saindhav)(add usher mitti 1gm + Shilajatu 500mg + Tuttha 2gm + Suddha kasisa 2gm + Saindhvadi taila 30ml + madhu 30ml ) à basti

3.       Dashmoola kvatha 100gm + agnimatha 50gm (make 200ml kvatha add saindhav 5gm + Saindhvadi taila 50ml + gomutra 50ml + yavakshar 10gm)à basti

(anuvasan basti saindhavadi taila if require(In case of abdominal pain or irritation on anus) or 1st & last basti)