Efficacy of Udvartana and Bashpa Sweda followed by Virechana Karma in Android Obesity and Gynoid Obesity wsr to Sthoulya A Comparative Clinical Study

in recent times diet pattern has been globally changing, consumption of energy dense foods consisting of high fats and sugars decrease in physical activity due to occupational demand more access to transportation and increased urbanization without preventive measures leads to manifestation of many systemic complications like obesity type 2 diabetes mellitus hypertension osteoarthritis hyperlipidemia coronary artery diseases stroke hormone dependent cancer and polycystic ovary syndrome etc

obesity is defined as a state of excess adipose tissue due to an enlargement of fat cell size (hypertrophic obesity) or an increase in fat cell number (hyperplastic obesity) or a combination of both in 2022 2.5 billion adults aged 18 years and older were overweight including over 890 million adults who were living with obesity this corresponds to 43% of adults aged 18 years and over (43% of men and 44% of women) who are overweight in 2021 the who estimated that obesity caused at least 2.8 million deaths annually on average obesity reduces life expectancy by 6 to 7 years

obesityhas diverse presentations of fat distribution in the body which can be categorized as android and gynoid obesity android obesity is characterized with excessive accumulation of fat in the abdominal region especially around waist and upper body resembling an apple shape whereas the gynoid obesity has excessive accumulation of fat in the lower body particularly in the hips thighs and buttocks resembling pear shape in asian ethnic group the bmi of 23 and above is considered to be overweight obese and morbidly obeseand this almost resembles the vagbhatas classification of hina madhyama and adhika sthula the measurement of waist to hip ratio plays an important role in determining an individuals proportions of android and gynoid obesity fat distribution

the management of obesity in contemporary system of medicines includes lifestyle advice weight loss diets drugs and bariatric surgical treatment though they are being practiced there are no encouraging results in achieving long term therapeutic effects and have the tendency to cause adverse effects hence it is the need of the hour to develop treatment protocol to have a better management in this condition.

in ayurveda obesity can be compared to sthoulya it is caused due to vitiation of these three morbid entities ie sleshma meda and mamsa wherein android obesity may present with dominance of sleshma and mamsa while gynoid obesity may present with dominance of sleshma and meda the concept of sleshma samvibhajya prayojayethighlights the factors to be considered in the management of sthoulya sthoulya is one among the santarpanajanya vyadhis sleshma nanatmaja vikaras medopradoshaja vikara and kleda pradhana vyadhi charaka mentions medomamsa ativrudhi chalatwa of sphik udara and sthana lambana as the cardinal symptoms of sthoulya acharya sushruta emphasizes rooksha udvartana vyayama and lekhana basti madhu shilajatu prayoga medohara loha etc have been explained as line of management rookshana in the form of udvartanacan be employed as vishista poorvakarma with mustadi gana choorna bashpa sweda with ushna jala which has nayati dravatva action can be considered as ushma swedamoorchita tila taila is the formulation of universal choice for both bahya snehana and abhyantara shodhanaga snehapana as it is indicated in pravridda sleshma and medasaka conditions considering sthoulya to be bahudoshaavastha and santharpanojanititha vyadhi samshodhana in the form of langana is mentioned among the pathya trivruth a sukha virechaka has been used for virechana karma in present study

thus by considering the above factors a clinical study will be undertaken to evaluate the therapeutic efficacy of sarvanga udvartana with mustadi gana choorna and bashpa sweda followed by virechana karma in android obesity and gynoid obesitywsr to sthoulya