Sujal Torgal Patil
Every other advertisement on the internet or in newspapers promises ground-breaking inventions which can free the overburdened populace from the shackles of those extra kilos.
India is already the third most obese country in the world and is showing increasing incidence of over-weight children and adolescents in urban areas. However, experts say the prevalence is still far lower in rural India which again is self-explanatory owing to the erratic lifestyles the urban populace has embraced. In the past, many people thought that obesity was simply caused by overeating and under-exercising, resulting from a lack of will power and self-control. Although these are significant contributing factors, we now recognise obesity as a complex medical problem that involves genetic, environmental, behavioural and social factors. And its implications are much graver than cosmetic concern as an obese person is prone to many metabolic disorders like hypertension, heart disease, diabetes, hormonal imbalances and even some cancers.
Why do we gain weight?
Ayurveda has categorically classified bodily disorders in two kinds – santarpanjanya and apatarpanjanya. The former is caused due to faulty overnutrition whereas the latter is due to undernutrition. Obesity would be ranked first amongst the disorders in the group santarpanjanya vyadhi. The conventional concept of etiopathogenesis, prognosis and management of obesity is very similar to medoroga/sthaulyaroga of Ayurveda which was conceived in 1500 BC by Acharya Charaka. Meda is one of the seven body building entities known as dhatus and can be loosely correlated to adipose tissue. Obesity or medoroga is a state of excess adipose tissue or fatty mass whereas overweight refers to an excessive amount of body weight that includes muscle, bone, fat and water which can be termed as sthaulya.
In the pathology of medo-roga, medo dhatu (adipose tissue) receives unchecked nourishment (due to innate reasons), thereby depleting other dhatus and degrading them. As a result we see excessive nourishment and accumulation of meda, but the increase in bulk doesn’t correspond to an increase in the energy levels and on the contrary there is lack of energy.
When the body’s calorie intake exceeds the amount of calories burned it leads to the storage of excess calories as free fatty acids. This physiological system orchestrated through endocrine and neural pathways permits humans to survive starvation for several months. However, in the presence of nutritional abundance (santarpan) and a sedentary lifestyle which in turn is influenced by genetic endowment, the system increases adipose energy stores and produces adverse health consequences such as obesity.
Environmental and behavioural factors have a greater influence along with consuming excess calories.
Psychological factors may also foster obesity. Low self-esteem, guilt, emotional stress or trauma can lead to overeating as a coping mechanism.
Heredity is an important predisposing factor. The chances of being overweight increase by 25 per cent if one or both parents are obese.
Certain medical conditions such as binge eating disorder (BED), Cushing’s disease and polycystic ovary syndrome can also lead to weight gain and obesity. BED is an eating disorder where a person has recurrent episodes during which the individual eats a large amount of food quickly and feels a lack of control over this eating.
Eating without being hungry, overeating irrespective of appetite, erratic schedules of eating and sleeping and mindless eating invariably hinder the process of digestion and eventually disturb one’s metabolism. If you eat a diet in which a high percentage of calories come from sugary, high fat, refined foods, the chances are you’ll gain weight. As we are tuned to eat on the go these days and look for low cost options, more people reach for high-calorie, fatty foods and beverages. Couple that with a lack of regular exercise, sedentary home or work environment and it becomes very difficult for adults to maintain or lose weight. For children, activities that don’t expend energy, such as watching television or sitting at a computer contribute to obesity.
Obesity is diagnosed when the body mass index (BMI) is 30 or higher. Acharya Vagbhat has explained three kinds of sthaulya – mild, moderate and severe. These could also be interpreted as stages if early intervention is not done.
The characteristics of an obese patient are inordinately increased fat and flesh, pendulous buttocks, belly and breasts and lower energy levels. There is inconsistent appetite, increased thirst, excessive sweating, breathing difficulties, reduced sexual drive and lack of enthusiasm, lack of energy and the overall feeling of being is lost. This fact is conveniently forgotten today while prescribing irrational diets and other regimen to manage obesity.
We often associate constipation, excessive or no sweating or reduced urination in medo-rogi which are manifestations of nothing but imbalanced metabolism. It is indeed difficult to explain these complex physiological processes in layman’s language, but the idea behind this is to underline the fact that whatever external treatments and methods we apply over the body are futile unless the internal mechanism is corrected.
Crash diets, OTC medications, supplements and irrational workouts should come under a scanner as there is a higher probability of damaging the system. In the subsequent parts we will learn about the consequences of obesity and its holistic management.
To be continued…
(Writer is CMO at Traya Natural Health Centre and can be reached at firstname.lastname@example.org)