Review Article International Ayurvedic Medical Journal ISSN:2320 5091

REVIEW ARTICLE: THE CONCEPT OF MEDOROGA& ITS MANAGEMENT

THROUGH AYURVEDA
Neha Lamba
*MD (Ayu.), Ayurvedic Medical Officer, ESI Hospital, Jalandhar, Punjab, India

ABSTRACT

Obesity or medoroga is the only disease which is gaining more and more attention at global
level. This disease is prevalent in developing as well as in developed countries, in both sexes, across
all ages and socioeconomic groups. Obesity is one of the prices we have to pay for rapid urbanisation
and sedentary life style. Obesity has been described in Ayurveda texts asmedoroga or Sthaulya.
Acharya Charaka has described eight varieties of impediments known as ashta nindita Purusha. Ati
Sthaulya comprises one of them. Obesity is the risk factor for many diseases like diabetes, CVA, hy-
pertension, etc. It is difficult to prevent and treat lifestyle disease like obesity with modern system of
medicine alone. Ayurvedic science has great potential in preventing and treating life style disorders
like obesity. The presenter view deals with aetiopathogenesis, symptomatology prevention and man-
agement of Sthaulya as given in the Ayurveda classics.

Key words:-Ayurveda, Medoroga, Obesity, Sthaulya

INTRODUCTION
In todays world, sedentary lifestyle, counted as a disorder of Sleshma Dosha seated
faulty dietary habits including ready- to- eat in Medodhatu (3).
fast food have made man the victim of many Ati Sthula can be defined as a person,
diseases. Sthaulya (Obesity) is one of these "who on account of the inordinate increase of
diseases which have taken a toll on whole fat and flesh, disfigured with pendulous but-
generations health. Obesity is emerging as an tocks, belly and breasts and whose increased
important health problem in India also. bulk is not matched by a corresponding in-
Sthaulya (obesity) is a disease, which pro- crease in energy.(4) Obesity is defined as a
vides the platform for so many diseases like state of excess adipose tissue mass (5)
hypertension, ischemic heart disease, Diabe- Aetiopathogenesis-
tes, Osteoarthritis, infertility, impotency as In Ayurvedic literature, so many aetio-
well as psychological disorders like stress, logical factors of Sthaulya Roga have been
anxiety, depression etc. Thus it can be said mentioned. Acharaya Charak has described the
that obesity is a significant contributor to- heredity component (Bijadosha) along with
wards deterioration of health. In Ayurveda, Aharatmaka, Viharatmaka and Manasika fac-
Sthaulya has been described in almost all the tors in causation of this disease. (6) Ati sam-
available texts. Charaka has described Atist- purna (excessive eating), sheeta, guru snigdha
hool purusha among the "Ashta Nindit Pu- ahaar sevana (Excessive consumption of cold,
rusha" (eight despicable personalities (1) and heavy, sweet, unctuous food), avayam (Lack
Samtarpanajanita roga (2). Sthaulya is of physical exercise), avayava (Lack of sexual
 Neha Lamba: Review Article: The Concept Of Medoroga& Its Management Through Ayurveda
life), divaswapana (sleeping in day time), 7. Kshudhatimatra (Excessive hunger)
achintanat (Relaxation from tension) are some 8. Pipasatiyoya (Excessive thirst)
of the etiological factors of the disease. Thus, CLASSIFICATION-
it is clear that both the endogenous and exoge- Obese person can be classified under 3
nous factors are responsible for the disease. categories Ati, Madhyama and Hina for easy
Though, Sthaulya is a Dushya dominant disor- diagnosis and management. (10). However,
der particularly Meda, besides that all the this classification can also be understood on
other three Doshas are vitiated, especially the basis of Body mass index, where hina,
Kledaka kapha, Pachaka pitta, Samana and madhyam & ati sthaulya correspond to over-
Vyana vayu. Acharaya Charaka and Sushruta weight, obese and very obese respectively.
have different opinion regarding the patho- (1) Hina Sthaulya: (B.M.I. 25-30 kg/m2
genesis of the disease. Charaka has empha- Over Weight)
sized Ahara as most common pathogenic Mild degree of overweight, without
factor for Medovridhhi in Sthaulya. On the any complication or secondary disease, with
other hand, Sushruta has accepted the concept less than four undesirable symptoms and with
of Ama Dosha. The various kaphavardhak duration of less than 1year can be considered
etiological factors lead to formation of undi- as Hina Sthaulya.
gested Madhura ama rasa. This madhura rasa (2) Madhyam Sthaulya:- (B.M.I. 30-40 kg./m2
while circulating in body contribute to the ex- - Obese)
cessive meda formation due to atisnigha guna. Moderate degree, with least complications
This accumulation of meda results in atist- without secondary disease, withless than 8 un-
hoolta, as outlined by Sushruta. (7). The above desirable symptoms and duration of 1 to 5
prescribed aetiological factors causes Medov- years can be considered as Madhyam Sthau-
ridhi which leads to obstruction of Srotas, the lya.
Vata moving mainly into stomach, fires up the (3) Ati Sthaulya: (B.M.I. > 40 kg./m2 Very
jatharagni and absorbs the food. The obese Obese)
person digests foods speedily and craves for Excessive degree, with complication and sec-
food inordinately. Over eating produces more ondary disease with all 8undesirable symp-
Upadana Rasa which causes over growth of toms and duration of more than 5 years can be
Medo Dhatu, thus leads to Sthulata(8). considered as Adhika Sthaulya.
Symptoms of the disease:- PROGNOSIS
The obese person has decreased endur- Krichha sadhya nature of Sthaulya has
ance and less enthusiasm in physical activity been described in most of the Ayurvedic clas-
due to inordinate increase of fat and flesh, sics. Charaka has described the bad prognosis
pendulous buttocks, abdomen and breast. (9) of Sthaulya as if an obese person is not duly
Besides thesecardinal symptoms, &in abilities managed; he is prone to death due to excessive
of Sthaulya are hunger, thirst and complications. As per the
1. Ayushohrasa (Diminution of life span) description of Vagbhata (11) Medogata dis-
2. Javoparodha (Lack of enthusiasm) eases are curable only in uncomplicated pa-
3. Kriccha Vyavaya (Difficulty in sexual act) tients with more bala and less chronicity.
4. Daurbalya (General debility) Management:-
5. Daurgandhya (Foul smelling of body) Preventive aspect:-
6. Swedabadha (Distressful sweating)

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 Neha Lamba: Review Article: The Concept Of Medoroga& Its Management Through Ayurveda
Obesity is going to take the form of Management of Sthaulya is quite diffi-
epidemic across the world, if proper preven- cult because both Agni and Vayu are in aggra-
tive measures are not taken. Ayurveda princi- vated state. If Apatarpana is done Vayu gets
ples give more importance to prevention rather Vriddha and Agnistarts burning other Dhatus
than curing the disease. General measures of and if Santarpana is done the disease will be
prevention are the adoption of swasthvritta in aggravated. The treatment principle of the dis-
ones life. For the prevention of disease one ease is well explained in Charaka Samhita.
should follow Dincharya, Ritucharya and Administration of Guru and Apatarpaka arti-
Sadvritta. Prevention in terms of ahaar can be cles which possess additional Vata, Shleshman
achieved by adopting pathya ahaar in diet. and Medonashaka properties is considered as
Pathya consist of ahaar dravya like Yava an ideal shamana therapy for Sthaulya.(17)
(Hodium vulgare), Kodravya (Paspalum scro- Chakrapani has explained that guru guna is
bulatum), Patola (Trichosanthuscucumerine), sufficient to alleviate vitiated Agni and Atik-
Mudga (Phaseolus radiates), shyamaka (Echi- shudha. Apatarpana property provides less
nochloa frumentacea), etc. (12) nourishment and thus leads to depletion of
In Ayurveda, general principles of manage- meda.Among Shad Upakrama, Langhana and
ment are divided into 3 parts Rukshana can be performed for Samshaman
1) Nidana Parivarjana purpose in Sthaulya. Shamana Chikitsa can
2) Samshodhana beimplemented through seven different ways
3) Samshamana in patients of sthaulya-
Nidana Parivarjana 1. Deepana-. Deepana dravyas are domi-
The first line of treatment for Sthaulya nated by Agni and Vayu Mahabhutas
is to avoid those factors which are responsible which are antagonistto the constitution of
for the causation of Sthaulya. To stop the pro- Meda and Kaphai.e. Jala and Prithvi Ma-
gress of the disease, all the Aharatmak, Vi- habhuta
haratmak, Mansika & other described nidana 2. Kshudha and Trishanigraha-Fastingis
must be avoided. also beneficial because the food is the
Samshodhan therapy- main source of Nutrition for Meda
Being a syndromic condition (Bahu- dhatu.Fasting controls the over production
Doshasya Laksanama) Samsodhana therapy is of medadhatu. So kshudha nigrahan has
highly recommended for patients possessing been advised to obese patients.Person who
stamina & strength (13). Ruksha Udavartan experience difficulty in complete fasting
(bahya shodhana) is advised for sthool pu- can practise alpa ahaar sevan.Lukewarm
rusha.(14). It is Kaphaharaand MedasaPra- water in small quantities is beneficial for
vilayana in action. Abhyantara shodhana em- obese person. From the word control of
ployed for the patient are Vamana, vire- thirst it can be said that obese person
chana,rakatmokshana, (15). Ruksha, Tikshna should avoid sweet and soft drinks, nutri-
and Ushna basti (16).It helps in scraping out tious fruit juice and cold water.
the excessive accumulated meda and kapha 3. Vyayama-Avyayam is one of the causes of
from the body and also pacifies the other two obesity and thus, in the management of
doshas. Sthaulya importance has been given to
Samshamna therapy:- Vyayam. It works as Nidana Parivarjan as

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 Neha Lamba: Review Article: The Concept Of Medoroga& Its Management Through Ayurveda
well as it melts the excessive fat, deposited Single and Compound drugs-Various single
in the fat depots of obese persons. and compound drugs are mentioned in the text
4. Atapa and Marutasevan- It enhances for the treatment of obesity.
Ushma in the body. This raised body heat Common herbs that can be used are
reduces Meda by Vibhajana and Vilayan. Haridra, vidang, Agni-
It potentiates Kleda Vilayana and helps in manth,Chitraka,Chakramada,Guggulu,Vacha,
weight reduction. Vata sevana is also Haritaki, Rasanjana. Some Samsamana yoga
beneficial as the Ruksha Guna of Vata re- like Guduchi, Bhadramusta, Triphala, Tak-
duces Kleda and Kapha by Shoshana and rarista, Makshika,Vidangadi Lauha, Bilvadi-
Stimulation Jatharagni. panchmula and Shilajatu with Agnimantha
Svarasa are advised for prolonged period (18)

Table-1 Some drugs mentioned in sthaulya roga(19,20)

Single drugs Compound drugs
Madhuka Triphala
Vidanga Takrarista
Agnimanth Vidangadi Lauha
Chitraka, Bilvadipanchmula
Chakramada Triphaladya Churna
Guggulu Dasanga Guggulu
Vacha Trayusnadi Guggulu
Haritaki Lauharishta
Rasanjana Arkadi gana
Guduchi Trayushnadi gana
Bhadramusta Gomutrapaki Haritaki
Makshika Rodhrasava
Shilajatu Navaka Guggulu, Amruta Guggulu
Various group of drugs like, Varunadi gana, chological factors along with genetic predis-
Salasaradi gana, Rodhradi gana, Mustadi position also play a major role in its aetiopa-
gana, etc. are described as Medanashaka (21) thogenesis. There is an involvement of all the
Bhavaprakash has mentioned the remedies for three Doshas in Sthaulya but the vitiation of
Medohara purpose Chavyadi Saktu, Erand- Kapha-Vata and Meda is of prime importance.
patra Kshara, Badaripatra Peya, Amritadi By adopting Ayurvedic principles of healthy
Guggulu, Lauha Rasayana (22) etc. So, for the lifestyle and effective treatment modalities
treatment of Sthaulyamedicine should be ad- given by physicians of ancient time one can
ministered before meal and ideally in the stay healthy to prevent oneself from obesity
morning and empty stomach. (23). and also from the problems associated with it.

CONCLUSION REFERENCES
Thus, it can be concluded that Obesity 1. Shastri Kashinath & Gorakhnath
is the worlds oldest metabolic disorder. Sed- Chaturvedi, Charaka Samhita of Agnive-
entary life, lack of exercise, faulty food habits, sha elaborated Vidyotini Hindi commen-
and urbanization precipitate the disease. Psy- tary, Sutra sthana 21stchapter Ashtanindi-

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 Neha Lamba: Review Article: The Concept Of Medoroga& Its Management Through Ayurveda
tiya, Chaukhambha Bharati Sansthan, Va- 9. Shastri Kashinath & Gorakhnath
ranasi, reprint edition; 2005. p. 408 Chaturvedi, Charaka Samhita of Agnive-
2. Shastri Kashinath & Gorakhnath sha elaborated Vidyotini Hindi commen-
Chaturvedi, Charaka Samhita of Agnive- tary, Sutra sthana 21st chapter Ashtanindi-
sha elaborated Vidyotini Hindi commen- tiya, Chaukhambha Bharati Sansthan, Va-
tary, Sutra sthana 23rd chapter Santarpa- ranasi, reprint edition; 2005. p. 409
nadhyaya, Chaukhambha Bharati 10. Tripathi Ravidutt, Ashtanga Sangraha of
Sansthan, Varanasi, reprint edition; 2005. Vagbhata, saroj hindi commentary, Sutra
p. 436 Sthana 24th chapter, dwividhupkram-
3. Brahmasankara Misra, Bhavprakash of niya,Chaukhambha Bharati Sansthan, Va-
Bhavmisra, edited with vidyotini hindi ranasi, reprint edition; 2003. p. 436.
commentary, 39th chapter, Medoro- 11. Atrideva Gupta, Ashtanga hridya of
gadhyay, Chaukhambha Sanskrit Sansthan, vagbhata, vidyotini hindi commentary, su-
Varanasi, 8th edition; 2003. p. 405 tra sthana 14th chapter dwividhupkram-
4. Shastri Kashinath & Gorakhnath niya, Chaukhambha Bharati Sansthan, Va-
Chaturvedi, Charaka Samhita of Agnive- ranasi, reprint edition; 2007. p. 80.
sha elaborated Vidyotini Hindi commen- 12. Shastri Kashinath & Gorakhnath
tary, Sutra sthana 21st chapter Ashtanindi- Chaturvedi, Charaka Samhita of Agnive-
tiya, Chaukhambha Bharati Sansthan, Va- sha elaborated Vidyotini Hindi commen-
ranasi, reprint edition; 2005. p. 411 tary, Sutra sthana 21st chapter Ashtanindi-
5. HarrisonsPrinciples of Internal Medicine, tiya, Chaukhambha Bharati Sansthan, Va-
Vol 1, chapter 64, Obesity, Mc-Graw ranasi, reprint edition; 2005. p. 415
Hills; 16th Edition;2005. p.422 13. Shastri Kashinath & Gorakhnath
6. Shastri Kashinath & Gorakhnath Chaturvedi, Charaka Samhita of Agnive-
Chaturvedi, Charaka Samhita of Agnive- sha elaborated Vidyotini Hindi commen-
sha elaborated Vidyotini Hindi commen- tary, Sutra sthana 16thchapter
tary, Sutra sthana 21st chapter Ashtanindi- Chikitsaprabhritiya, Chaukhambha Bharati
tiya, Chaukhambha Bharati Sansthan, Va- Sansthan, Varanasi, reprint edition; 2005.
ranasi, reprint edition; 2005. p. 409 p. 321.
7. Shastri Ambikadutt, Susruta Samhita ed- 14. Shastri Kashinath & Gorakhnath
ited with Ayurveda tatva sandipika Hindi Chaturvedi, Charaka Samhita of Agnive-
Commentary, Sutra Sthana 15th chapter, sha elaborated Vidyotini Hindi commen-
Dosha-dhatu-mala-kshaya-vriddhi- tary, Sutra sthana 21st chapter Ashtanindi-
vigyaniya, Chaukhambha Sanskrit tiya, Chaukhambha Bharati Sansthan, Va-
Sansthan, Varanasi, reprint edition; 2007. ranasi, reprint edition; 2005. p. 414
p. 62 15. Shastri Kashinath & Gorakhnath
8. Shastri Kashinath & Gorakhnath Chaturvedi, Charaka Samhita of Agnive-
Chaturvedi, Charaka Samhita of Agnive- sha elaborated Vidyotini Hindi commen-
sha elaborated Vidyotini Hindi commen- tary, Sutra sthana 23rd chapter Santarpa-
tary, Sutra sthana 21st chapter Ashtanindi- nadhyaya, Chaukhambha Bharati
tiya, Chaukhambha Bharati Sansthan, Va- Sansthan, Varanasi, reprint edition; 2005.
ranasi, reprint edition; 2005. p. 411 p. 437

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 Neha Lamba: Review Article: The Concept Of Medoroga& Its Management Through Ayurveda
16. Shastri Kashinath & Gorakhnath Sansthan, Varanasi, reprint edition; 2007.
Chaturvedi, Charaka Samhita of Agnive- p. 62-3
sha elaborated Vidyotini Hindi commen- 21. Shastri Ambikadutt, Susruta Samhita ed-
tary, Sutra sthana 21st chapter Ashtanindi- ited with Ayurveda tatva sandipika Hindi
tiya, Chaukhambha Bharati Sansthan, Va- Commentary, Sutra Sthana 38thchapter,
ranasi, reprint edition; 2005. p. 414 Dravya-sangrahaniya, Chaukhambha San-
17. Shastri Kashinath & Gorakhnath skrit Sansthan, Varanasi, reprint edition;
Chaturvedi, Charaka Samhita of Agnive- 2007. p. 142.
sha elaborated Vidyotini Hindi commen- 22. Brahmasankara Misra, Bhavprakash of
tary, Sutra sthana 21st chapter Ashtanindi- Bhavmisra, edited with vidyotini hindi
tiya, Chaukhambha Bharati Sansthan, Va- commentary, 39th chapter, Medoro-
ranasi, reprint edition; 2005. p. 414 gadhyay, Chaukhambha Sanskrit Sansthan,
18. Shastri Kashinath & Gorakhnath Varanasi, 8th edition; 2003. p. 406-7
Chaturvedi, Charaka Samhita of Agnive- 23. Brahmanand Tripathi, Sharangdhara Sam-
sha elaborated Vidyotini Hindi commen- hita elaborated dipika hindi commentary,
tary, Sutra sthana 21st chapter Ashtanindi- purvakhand 2nd chapter, Chaukhambha
tiya, Chaukhambha Bharati Sansthan, Va- Subharti Prakashan, Varanasi, reprint edi-
ranasi, reprint edition; 2005. p. 415 tion; 2011. p. 25.
19. Shastri Kashinath & Gorakhnath
Chaturvedi, Charaka Samhita of Agnive- CORRESPONDING AUTHOR
sha elaborated Vidyotini Hindi commen- Dr. Neha Lamba
tary, Sutra sthana 21st chapter Ashtanindi- MD (Ayu.), Ayurvedic Medical Officer, ESI
tiya, Chaukhambha Bharati Sansthan, Va- Hospital, Jalandhar, Punjab, India
ranasi, reprint edition; 2005. p. 414-5 Email: nehafamilyfriends@gmail.com
20. Shastri Ambikadutt, Susruta Samhita ed-
ited with Ayurveda tatva sandipika Hindi
Commentary, Sutra Sthana 15th chapter, Source of Support: Nil
Dosha-dhatu-mala-kshaya-vriddhi- Conflict of Interest: None Declared
vigyaniya, Chaukhambha Sanskrit

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