Obesity and ayurveda
All of us are now well aware about the Covid -19, which is declared a pandemic by the WHO. It has infected 27.2 million people worldwide at the time of authoring this article.
But do you know that according to another 2016 statistics of the WHO, obesity has gripped more than 650 million of the adult world population. And the numbers are raising, not going down. If we consider overweight people too, the number is above an alarming 1.9 billion. That is about 40% of all the adults in the world! (1)
Covid 19 is a highly infectious disease which requires high alert. It has killed around 900 thousand people yet. But obesity and associated diseases are killing at least 2.8 million every single year. (2)
Obesity and being overweight can also make you more vulnerable to the Covid 19 pandemic too.
Enough of the depressing facts, there is one silver-lining. Obesity can be easily prevented, perhaps easier than the covid 19. Even if you were not able to prevent it, Ayurveda can help you to reverse obesity and its effects. The one price you have to pay is dedication.
First let us understand what obesity is. Obesity is if your body has too much fat and it causes excess increase of weight. To determine whether the weight is too much, an indicator called Body Mass Index of BMI is used. It is defined as a person’s weight in kilograms divided by the square of their height in meters (kg/m2). BMI = weight/ (height in meters)^2 . If your BMI is more than 25, you are considered as overweight and if the BMI is greater than 30, you are having obesity.
What causes obesity
Some scientists attribute socio economic conditions like affluence, urbanisation, advertisements of certain food items and unavailability of healthy food options. Others consider lifestyle and personal habits like lack of exercise and choices of food. Certain diseases and genetic conditions affecting hormonal balance and metabolism also can cause obesity.
Whatever is the reason, obesity is basically an imbalance of energy in the body. When you consume too much energy than the body spends for different tasks, the excess energy needs to be stored. This storage is mostly in the form of fat. The fat is stored in special cells called adipocytes in the adipose tissue. Adipose tissue is mostly found below the skin and around internal organs and intestines. It is this fat which increases your body weight and makes you look big.
Overeating and wrong food choices
The most common cause of obesity is over consumption of calories in forms of sugars and fat. Different kinds of sugars are the main culprit as they are loaded with high amounts of energy, but without any other beneficial nutrients or fibre. Refined flour, fast food, packed food, beverages like colas and juices amount to most of the bad sugars consumed. Fries and chips which are indispensable in fast food culture gives more calories and unhealthy fat.
By choosing refined flour breads, fries, preserved juices, desserts etc as opposed to full grain diets, vegetables and other healthier options we take the first step to unhealthy weight. When sugars and carbohydrates are supplied in excess in every meal, it triggers insulin secretion. The insulin will signal the adipocytes to hold on to the stored fat, because it tries to burn the sugar for energy.
The per capita energy intake from food across the globe has gone up drastically, compared to even the 1960s. (3) But unfortunately all that calories consumed are not used up.
The modern sedentary lifestyle reduces the expenditure of the calories put in by the above diet habits. Roads are designed for us to drive and not to walk. Conveniences like remote controls and escalators take us to destinations. Busy timelines and deadlines compel us to take faster transport than walking distances. All this has made physical exercise an additional chore which we must do to stay healthy.
Many of us are predisposed to gaining more weight and obesity, due to our genetic makeup. Our parents do not necessarily be obese, but some genes which can cause more fat storage shall be present in us. There are around 40 gene sites which are linked to weight. But for these genes to make us obese or overweight, they have to be triggered with constant supply of high calories and sedentary habits.
Also some genetic disorders like ‘Prader Willi’ syndrome can cause obesity.
Medical causes of obesity
There are some diseases which can make us obese.
Hypothyroidism is the most common. Others are growth hormone deficiency, ‘Cushing’s’ syndrome etc. All these conditions impair the body’s ability to convert sugar into energy.
Mental and Emotional factors
Eating, especially consuming sugars will activate the ‘reward system’ in the brain. This makes us feel good. So many of us tend to comfort ourselves with food when facing emotional challenges. This pattern of eating, called ‘binge eating’ is associated with stress, anxiety and depression. The food thus consumed is obviously not required by the body. It is like a drug which gives temporary emotional relief and comfort. So those extra calories adds up to the fat storage.
Use of medications
Some medications like antipsychotics, antidepressants and steroids are known to increase body weight.
Why is it not good to have excess fat in the body
Obesity can cause a number of harmful effects in the body and can lead to life threatening situations.
Metabolic syndrome: The excess fat causes insulin resistance. That is, insulin is not able to carry glucose from the blood efficiently to the cells and convert them to energy. Thus excess sugar is circulated in blood resulting in diabetes. This process also triggers retention of sodium and crease in blood volume resulting in high blood pressure.
When the body stores too much fat, there will be more ‘triglycerides’ and low density lipids in the blood. Those are the bad fat. Also the good fat or high density lipids will be less. This increases the risk of heart diseases.
This cluster of conditions is called metabolic syndrome. It increases the risk of heart disease and stroke.
Inflammation and arthritis: The high fat and insulin levels also triggers inflammation response and cause chronic inflammation in the body. Chronic inflammation along with the weight burden can lead to arthritis and other degenerative diseases.
Cancer risk: Obesity is also associated with increased risk for cancers of digestive system, thyroid, kidney etc.
Liver issues: Non alcoholic fatty liver and gall bladder stones are more found in obese people than others.
Hormonal imbalance: Obesity cause imbalances of sex hormones in both males and females.
Why is it so difficult to lose weight
Once we become obese, the stored fat alters the energy management mechanism of our body. Usually hormones called leptin, adiponectin, ghrelin etc balances our energy intake by triggering hunger, satiety etc. Those hormones are also responsible for energy expenditure by diverting the fats and sugars to muscles for burning, or to liver and tissues for storage. The effects of these hormones are dulled once we get obese.
Diets are often difficult to sustain because loss of fat from storage results in triggering of hormones responsible for appetite and reducing energy expenditure.
In simple terms, the fattier version becomes the ‘new normal’ for the body and the innate homeostasis mechanism tries to maintain that.
The body constantly produces a feeling of hunger and even if you eat less, insulin levels in the blood remain high. High insulin in turn prevents stored fat from being released.
Ayurveda view of obesity: (4)
It’s notable that obesity is explained in detail in Ayurvedic classics. This makes it clear that the issue was prevalent centuries ago too. Interestingly, they had identified it as a health issue and understood the implications of excess fat on all organ systems and lifespan itself.
Not only the process behind obesity but also the associated problems and complications were categorically identified and explained.
The sanskrit terms for pathological overweight and obesity are ‘Medovikara’ and ‘Sthoulya’.
The causes explained are mostly the obvious ones. Over eating, especially heavy greasy and fatty food food, sedentary lifestyle, day sleep and excessive sleep are pointed out. Hereditary susceptibility of obesity was also noted and documented.
Detailing the pathology, Ayurveda says that the accumulated fat will block physiological channels and result in the vitiation of vata in the digestive system. The vata in turn causes imbalance of digestive fire and bouts of hunger. At the same time inability to convert the nutrients to energy (dhatu agni mandya) increases fat accumulation. This observation is in line with the modern findings.
The complications of obesity are also numbered down as shorter life span, breathing difficulty, excess thirst, perspiration, diabetes, abscess, renal diseases, skin diseases etc.
The science of weight loss
Researches have proved that while limiting calories will mobilise stored fat initially, extreme diet restriction may induce the breakdown of muscle. Also, the imbalance in hormones associated with metabolism will prevent the fat from being used up easily. So a careful balance between supply and restriction of calories is required.
Exercise can add to calorie expenditure, but exercise alone without diet is found to be ineffective. In fact exercise can increase only 10% to your normal calorie spending. Also obese people will find it difficult to exercise at first. They are also more susceptible to injuries from exercise because the joints are weaker to support all the weight. Mobility restrictions also add to injuries and difficulty in performing exercises.
How ayurveda can help
Ayurveda helps to reduce or prevent the common hurdles and problems people face with the standard approach to weight management. As in all health diseases, ayurveda addresses obesity multi dimensionally. Ayurvedic weight loss treatment includes planned diet, yoga and other exercises, medications to balance the metabolism (agni) and hormones etc. If necessary, massages and other external treatments or panchakarma cleaning are also incorporated.
Indian herbs for weight loss will help to mobilise stored fat easier than with diet and exercise alone.
If the excess weight is a result of hormonal imbalance or other diseases, your ayurvedic doctor will identify the cause and give medications to correct the condition. It is also important to address other diseases or conditions which arose as the result of obesity. For example, Kerala Ayurvedic medicines for obesity include combinations to reduce insulin resistance and over production of insulin. Assessment of basic ‘prakriti’ or dosha combinations will help to select specific medications and exercises which will act faster than general ones.
Herbal medicines for obesity will help to correct and normalise the agni. So when medicines are combined with diet, people will not feel the hunger bouts or cravings to eat sweets or fried food. Thus the diet would be more sustainable. Also these medicines will help to prevent complications and development of metabolic syndrome affecting all systems of the body. It is also observed in our regular practice that fat burn from exercise also is enhanced while taking ayurvedic medicines, than doing workouts alone.
Common herbal combinations for weight management include ‘Varadi Kashayam’ , ‘chandraprabha’ tablets, ‘ayaskriti’, ‘glycohar plus’ tablets etc.
Other than medicines, treatments like ‘udwartanam’ (dry massages) are done to speed up the mobilisation of subcutaneous fat.
Panchakarma cleaning therapies which combine ‘vasti’ (medicated enema), virechana (purgation) etc are also found to be very beneficial in managing excess weight and obesity.
As obesity is a metabolic issue, correcting metabolism is a key step in its management along with diet and exercise. So combining ayurvedic treatments will provide sustainable results.
(4. Caraka Samhita, Sootra Stana Chapter 21)