A Randomised Standard Controlled Clinical trail on Bhavitha Triphala Churna in Sthoulya vis-a-vis childhood Overweight and Obesity

Sthoulya isa condition described under Shleshmananatmajavyadhi (1), Santarpana nimittaja vyadhi(2) and Atibrimhananimittajavyadhi(3). It is described as Upachita shareeratvam(4) and is characterized by excess accumulation of Medas. There are many lakshana of Sthoulya(5) as mentionedin Ayurveda , of which a few symptomsthat are commonly found in children are Atinidra, Alasya, Ayase Shwasa and Atikshudha.

The clinical symptomatology of Sthoulya is similarto that of Overweight and Obesity in contemporary science, which has beendefined as, a body mass index of 23kg/m2 and 27kg/m2 respectively. (Indian cutoffs after 2years of age, which is between 85th to 95thpercentile) (6) Enlargement of fat cell in its size; or anincrease in number of fat cells; or both, leads to abnormal growth of adipose tissue which is known asobesity. In such condition, body fat is extensively accumulated under the skin and around certain organs such as belly,breasts, thighs (7)

  According to a study in 2021, the prevalence ofoverweight and obesity among school children in Mysuru, Karnataka showedthat there was 3.86% of obesity and 12.27% of overweight(8). A recentstudy conducted 2021, in school children of Mysuru, Karnataka revealedsignificant differences in variablessuch as body weight and BMI, before and after lockdown. Post lockdown the BMI increasedamong all the participants from 17.32 to 17.80 kg/m2(p<0.001). The study also depicted thatobesity has a proportional impact on the children’s quality of life (QOL)(9)In a recent study done in Rishikesh ,Uttarakhand, in the year 2021,itwas found that 6.8% of adolescents were obese and that about 17.1% were overweight.(10)These studies give enough proof for the prevalence of overweight andobesity among children even in adolescent age group.

  Some of the common complications of childhood obesity,if left unattended are Obstructive sleep apnea, Asthma,Acanthosis nigricans and Polycystic ovariansyndrome and Psychological problems like Anxiety,Low self esteemand Worsening school performance (11,12). Contemporary science has a multi disciplinary approach in the management of obesity, like lifestyle modification, regular meal timingsand at least 7-8 hours of sleep at night (12).

Ayurveda alsodescribes multi model therapy including diet, medicine and life stylemodifications for Sthoulya. Some of the Shamanoushadhi indicated for Sthoulya are Triphala churna, Vidanga Churna,Vidangadhya louham and Navakaguggulu.(13) Usage of Triphala andMadhu have been specifically mentioned in Sthoulya chikitsa in Charaka Samhita and Ashtanga Samgraha (14). Accordingto the Kerala based text dealing with Kaumarabhritya viz; Arogya Raksha Kalpa Druma

,Triphala trituratedin the Kwatha of Khadira and Asana, consumedfor 1 month reduces Sthoulya. It has been specifically mentionedfor children (15). A previous clinical study conducted in the year of 2011 have shown significant resultsof Khadira and Asana KwathaBhavitha Triphala in children

of 5-15 yearswith Sthoulya in comparison to thecontrol group -Pathya.

 Based on the above references, the present study hasbeen planned to evaluate the efficacy of Bhavita Triphala churna in Sthoulya viz a viz childhood overweightand obesity in adolescent children.