Introduction

Introduction:

Obesity is disease of all age group within the people of high socioeconomic status, specifically in urban Communities. WHO declared obesity as globa lepidemic. According to WHO about 13% of the world adult population [650 million adult & 41 million children] were obese. Obesity is one of the most serious public health problem of the 21st century. It is complex, multifunction and largely Preventable disease[2]affecting, along one third of the world’s population today[3,4]. If this trends continue, by 2030 an estimated 38% of the world’s population will be overweight and another 20% will be obese [5] . It is ana abnormal growth of adipose tissue due to enlargement of fat cell size or an increase in fat cell number or combination of both. Obesity is state of excess adipose tissue mass [6] . Overweight refers to an excessive amount of body weight. Obesity i.e. Sthaulya Roga in Ayurveda comes under the heading of Medoroga which result due to dysfunction of Medadhatvagni {factor responsiblke for nourishment /metabolism of Meda dhatu} and is considerd as metabolic disorder. In Ayurveda Sthaulya is considered as Santarpanjanya Vyadhi due to excessive accumulation of Meda in the body and included under most unwanted distinctive feature under eight most undesirable constitutions of the body [7]. Qualities of Ahar like Guru, Snighdha, Madhura, Sheeta, Manda etc. Increase the kapha excessively and improperly formed Medho Dhatu which leads to further complication like Sthaulya. Sthaulya is a Santarpanajanya Vyadhi, it can be treated with Apatarpana Chikitsa, so keeping this in mind this study has been planned. The current most widely used criteria for classifying obesity is the body mass index [BMI; body weight in Kilogram, divided by height in meters squared] In both clinical a d research setting, waist circumference, a measure of abdominal adiposity has become an important measure of obesity[8].

Classification BMI[KG/M2]

Aetology

Mainly causes are meda [fat] potentiating diet and regimens,Sheeta,[cold],Snighdha [unctuous], Madhuradi kaphvardhaka [sweet and kapha increassibg] drugs along with lack of exercise and sedentary lifestyle result in excessive nourishment of medas while other bodily elements[Dhatus] are deprived of nourishment [9] .

Pathogenesis of Obesity

According to ayurveda In the pathogenesis of Sthaulya, all the three doshas are vitiated, especially KledakaKapha, PachakaPitta, Samanand Vyan vayu are dosha factors responsible for the samprap ti of Sthaulya. Aama annarasa traveling in the body channels get obstructed in the Medovaha Strotas and combined with Kapha and Meda, decreasing yje Medo dhatvaaagni which in turns get rise to augmentation of Meda.Vitiated Vyan Vayu propels this augmented Meda dhatu to its sites viz. Udara [Abdomen], Spika [Hipregion], Sthana [Breast], Gala [Neck] etc, resulting in Sthaulya [10].

Symptoms of Sthaulya[11]

1. Atisweda [Excessive sweating].
2. Alpaayu [Short lifes pan].
3. Karyadaurbalya [Difficulty to perform heavywork].
4. Atinidra[Excessive sleep].
5. Sharirdaurgandhya [Foul odour of the body].
6. Jadyatta[Stuggishness].
7. Alpabala[Decresed bony strength].
8. Atitrishna[Excessivet hirst].
9. ShramjanyaSwasa[Breathlessness on mild exertion].

Udvartana

Panchakarma therapies are becoming popular in Indiaand throughout the World. Udvartana is one of the Panchakarma therapies which differed from Abhyanga in its direction of application and pressure during the procedure. It is simple and affordable procedure with no harmful effects. The procedure of massaging the whole body below the neck in a adirection opposite to the orientation of hair with some pressure is called udvartana [12]. According to Acharya Charak there are two type of Udvartana

 SNIGHDHA UDVARTANA [13] :

Used in treatment of karshya, in which oil is used in procedure

RUKSHA UDVARTANA

Used in treatment of Sthaulya in which dry powder of herbs [Churna]with no addition of oil are used.The Udvartanakarma,which has kaphahar and Medohara properties. It is simple, low cost with no side effects and effective in Sthaulya.

Aim:-

To study efficacy of Sarvang Snehan ,Swedan, Udvartan in management of Sthaulya.

Materials and Methods

A male patient of age 26 yr old In OPD Panchakarma diagnosed as sthaulya with complaints of Bharvrudhi Ayasenshwas Angagauravta All abovecomplaints since more than 1yrs.

Pasthistory

No history of diabetes mellitus, Hypertension or any major illness. No history of any major surgery.

Treatment

Treatment was given for 7 days.

• • Sarvang Snehan was done with Tila Taila for seven days.
  • Sarvang swedan was done for Sevendays.
  • Udvartana wasd one with Kolkulathadi churna for Seven days.

Ahara

Laghu, Supachya ahara was advised

Observation:-

Herearesomeclinicalfindingsofthepatient.OthDay7thDay

Discussion

The disease Sthaulya originates due to consumtion of Kapha Vrudhhikara Ahar, Vihara. These factors derange jatharagni causing Ama-Annarasa which results in Medo dhatvagni mandya. This condition leads to excessive growth and accumulation of Meda Dhatu causing the disease the disease Sthaulya.Udvartana is mensioned under Shodhana Chikitsa of Sthaulya by defferent Acharyas in Ayurvedic texts. The word Udvaratana literally means rubbing of the body. According to Vagabhatta Udvartana normalise Kapha and liquefies Meda. It gives firmness to body, smoothness to skin and increase its complexion. By doing Udvartana it liquefies the Medas it means normalize kaphas and liquefies Meda. Giving friction to body by churna is known Udvartana. Sushruta describe Udvaratana helps to restore the deranged Vayu of the body to its normal condition. It liquefiesKapha and Meda, gives smoothness and cleanness to skin and imparts firmness to the limb. In present study, Ruksha Udvartana with Kolkulathadi churna was carried out. It consist of kola churna - 1 part, Kulattha churna - 1 part, and Devdaru churna - 1 part,Yava churna - 1part Shatpushapa 1part mashah powder 1part Atasi churna -1part Vacha churna -1part Kushta churna -1part its ingredients mainly have Katu, Tikta, Kashaya Rasa and Dravyahaving Laghu, Tikshna, Ruksha Gunaand UshnaVirya. The drug possessing Katu, Tikta, Kashaya Rasa acts as Kaphahara, Krumighna, Kandughna. Ushna Virya prossesing Srotoshudhhi, Ruksh Guna predominace of Agni and Vayu Mahabhuta pacifies Snighdha and Pichila Guna of Kapha and subsequently decreses Kledatwa. Hence Udvartana using Kolkulathadi churna is most effective in Sthaulya.

Conclusion

Sthaulya is Dushya dominant Vyadhi [Medadhatu]. There is an involvement of all the three Doshash in Sthaulya but the dominancy of Kapha - Vata and meda of prime importance. Based on the observation of the present study Kapha- Meda were the main etiological factors. This vitiated Meda obstruct the path of Vata and causes its Avarana which results in provocation of Vata. Thus remaining in the Koshta Vata causes Atikshudha, this increase gravity of the disease and make the Sthaulya Krutchhsadhya Vyadhi By doing Udvartana the increased Twakgata Agni increase uttarouttar. Dhatwaagni functions, by increase Medodhatvaagni. The Dhatupaka process increase and excessive accumulated Vikruta Medo dhatu decreasesd, thus effective in Obesity or Sthaulya. Based on the observation of presentstudy , it can be concluded that Udvartana can be considers as an effective supportive therapy in management of Sthaulya.

Conflict Of Interst

The authors declare that they have no known competing financial interest or personal relationships that could have appeared to influence the work reported in this paper.