An Ayurvedic and Historical Review of Sthaulya (Obesity): Concept, Nidana, Samprapti and Management

Abstract

Background: Sthaulya (obesity) is a well-recognized condition in the Ayurvedic corpus, discussed across Vedic, Saṃhita, and later compendia. Classical authors treat it as a Santarpanajanya and Medovṛddhi disorder with multifactorial causation and important social-clinical consequences. Aims and Objectives: To synthesize classical and historical descriptions of Sthaulya – its terminology, Nidana (causes), Lakṣaṇa (clinical features), Samprapti (pathogenesis), complications, and classical management by reviewing primary Ayurvedic sources and traditional commentaries. Materials and Methods: Narrative review and thematic synthesis of classical descriptions and commentarial interpretations as compiled in the historical and Ayurvedic review manuscripts. Primary texts surveyed include Charaka Saṃhita, Susruta Saṃhita, Aṣṭaṅga Hridaya/Saṃgraha, Madhava Nidana, and later compendia. Discussion: The term Sthaulya and its synonyms (e.g., Medoroga, Sthula, and Medovṛddhi) appear in Vedic, Puranic, and classical Ayurvedic literature. Classical authors emphasize dietary (Aharatmak), behavioral (Viharaatmak), and mental (Manasika) Nidanas, notably Atisampurṇa, Guru, Madhura Ahara, Avyayama, Diwasvapa, and Harṣanitya/ Achinta, and locate pathology in Meda Dhatu and Medovaha Srotas with Kapha predominance. Samprapti integrates Srotodushti, Agni-Vikara, and Dhatuparinama concepts; clinical features include Udaraparsva-vr̥dhi, Daurbalya, Kricchavyavaya, Srama, and Daurgandhya. Classical management emphasizes Nidana-pariṣkara, Saḍ-upakrama (Langhana, Rukṣa, and Sodhana measures), external therapies (e.g., Udvartana), and internal regimens (Virechana, Vamana in indicated cases), supported by Pathya-Apathya and lifestyle (Dinacarya/ṛitucarya) measures. Conclusion: Classical Ayurveda provides a systematic, multifactorial model of Sthaulya encompassing cause, pathogenesis, and multi-modal treatment. Re-examination of these concepts, particularly Nidana emphasis, Agni–Meda interplay, and preventive lifestyle prescriptions, has relevance for integrative public-health strategies addressing modern obesity.