Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Ayurveda has explained Pramana Sharira i.e. ‘normal anatomical proportions of the body and body parts’. Every part of the body has a particular quantity and it differs between the Prakritis. The body proportions should be within the range of normal proportions in accordance with one’s Prakriti.
Being overtly thin or excessively obese, both are out of body’s normal proportions. While obesity is above the line of normal body proportions, emaciation is below it. But both are not ideal.
Even among both, being thin is said to be better than being obese.
Ref – A.H.Su.14/31b-33a
Now, let us see through the reference and try to understand more about this.
Being thin is better than being obese!
कार्श्यमेव वरं स्थौल्यात् न हि स्थूलस्य भेषजम्॥३१॥
बृंहणं लङ्घनं वाऽलमतिमेदोग्निवातजित्।
मधुरस्निग्धसौहित्यैर्यत्सौख्येन च नश्यति॥३२॥
क्रशिमा स्थविमाऽत्यन्तविपरीतनिषेवणैः।
Master Vagbhata says –
‘Karshya – emaciation (being thin) is better than sthoulya – obesity (being fat). There is no treatment for obese persons. This is because brimhana – stoutening therapies or langhana – lightening or thinning therapies are incapable of destroying atimeda – excess fat accumulation, agni – digestive fire (metabolism) or vata. Emaciation gets cured by use of Madhura – sweet and snigdha – unctuous or fatty foods and saukhya – comfortable ways of living. On the other hand, obesity gets cured by use of foods and activities which are extremely opposite to those mentioned above in the context of emaciation, that too when used in maximum quantity’.
Reading in between the lines
Ati sthula – overly obese or overweight and Ati Krsha – excessively lean persons have been counted by Ayurveda amongst ‘Ashta Nindita’ i.e. eight types of despicable people and socially unfit persons. This is because of anatomical disfiguration against one’s prakriti. This is because both these conditions are difficult to treat and even among these, Acharya Vagbhata says that there is no treatment for obese individuals.
Why is treatment of obesity difficult?
Treatment of obesity is a tricky and challenging thing for the physicians. This is because the treatment of obesity involves mutually antagonizing principles. As the master says, excessive fat, increased agni and increased vata are big obstacles in the treatment of obesity. Medicines meant to reduce fat would increase agni and vata. This would increase more craving for food and further increase in calorie input, increase of fat deposition and worsening of obesity.
Example pungent, bitter and astringent tastes or medicines and foods predominant in these tastes are capable of destroying meda i.e. fat, but these tastes increase vata. This increased vata would increase agni. Increased vata and agni is a notorious combination and would be highly destructive in the long run.
On the other hand, medicines which would decrease vata and agni i.e. sweet, sour and salt tastes or medicines rich in these tastes would increase kapha and meda. To find some medicine or foods which would balance all these three components i.e. decrease fat and at the same time not worsen vata and agni are very rare to find. The options are very few and rare. This makes obesity difficult to cure.
Also, Guru Apatarpana i.e. heavy to digest foods which are also non-nourishing in nature should be administered for obesity, which is ideal but planning such a diet is also difficult.
Obesity requires a comprehensive planning of therapies, medicines, lifestyle changes, exercise, behavioral training which needs a dedicated practice and active involvement of the patient into the process. Many times, either the planning fails or execution.
Obesity gets cured with opposite foods and activities as those prescribed for emaciation i.e. use of katu – pungent and ruksha – dry foods and asaukhya – i.e. strenuous way of living with vigorous exercise and workouts. All these should be used in maximum quantity which is very difficult.
Treatment of obesity involves depleting unwanted things from the body, which is difficult and painful.
Why is emaciation better than obesity?
Emaciation involves addition of things which the body has lost. Addition is easy, nurturing the body is easy in comparison to depletion and subtraction needed for treatment of emaciation.
Emaciation can be easily handled with administration of sweet and unctuous foods which are usually likable by all persons and easy to consume. Treatment of emaciation demands a comfortable life. Patient can afford a resting, relaxing and sedentary life, against an obese person who should constantly workout to trim down his body and bring it down. The options of treating emaciation are many.
The treatment principle of emaciation is laghu santarpana i.e. foods which are light to digest but nourishing in nature. This is easy to administer.
To sum up
Due to the above said reasons, we can conclude that, in spite of both emaciation and obesity being ‘not good body dimensions’, karshya – emaciation is far better than sthoulya – obesity. But medically, both conditions should not be neglected due to the extensive systemic harm they can cause. It is also important to find out the etiological factors and keep them away and have healthy food and lifestyle choices and effective stress management. There may be some long-standing diseases in the backdrop of obesity and emaciation. Treating them promptly will be a gamechanger in the management of these conditions.
