Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Obesity and leanness or emaciation are two points of concern for those who stand wearing those bodies. Both are not ideal body frames and need to be addressed from the perspective of restoring and reestablishing the ‘body size and numbers’ to the state of normalcy in accordance with the person’s prakriti. They are definitely problems of medical concern, then, now and also in future.
Both these conditions need to be managed skillfully and sensitively, mainly obesity.
At some point of time, both obese and lean individuals would hit that point of awareness and would love to hit back to normal. They had, at that point, hit the highest point of intolerance and frustration. These people are also the victims of bullying. Ayurveda has included them under the despicable category of people, with a view that they are medically challenging conditions and difficult to treat.
Approach towards treating both these conditions should be comprehensive and from 365 degrees. Involvement of the patient into the therapy is mandatory. Treatment includes dietetic and lifestyle changes, therapies, medicines, stress management, behavioral management, exercise and much more.
People are obsessed with losing or gaining weight quickly. Both are wrong from a medical point of view. Adding or depleting anything from the body quickly and aggressively may harm the person. So, weight loss in obese individuals and weight gain in emaciated individuals should be gradual and methodical. Among both, treatment of obesity and overweight conditions is very difficult because it involves removal of fat from the body without damaging the other structures and tissues.
Guru Apatarpana and Laghu Santarpana – the treatment principles advised for obese and emaciated individuals respectively are the best principles on one side and on the other hand depict how tricky and difficult it is to treat these two conditions since they have opposite and contrasting strategies of management. This is difficult mainly in the management of obesity.
Now, we will get to the reference.
Guru Apatarpana and Laghu Santarpana for management of sthoulya – obesity and karshya – emaciation respectively
गुरु चातर्पणं स्थूले विपरीतं हितं कृशे।
यवगोधूममुभयोस्तद्योग्याहितकल्पनम्॥३६॥
Guru Apatarpanam
Guru Apatarpanam – For a person who is suffering from sthoulya – Guru Apatarpana is the treatment principle.
Guru = heavy
Apatarpana = non-nutritious therapy
The foods given to obese or overweight individuals should be both heavy and non-nutritious in nature. Obese persons will have Tikshna agni i.e. severely high digestive fire. They want more and more food frequently. It is not easy to manage agni in these people. Laghu ahara – light foods, logically should decrease fat and weight but they will increase agni and create more craving. So, heavy to digest foods should be given i.e. guru ahara. This is because these foods stay for a long time in the stomach and are digested slowly. Therefore, the person will not feel hunger frequently. On the other hand, the foods, in spite of being heavy, should not be nutritious and should not add calories. In this direction, care should be taken to provide foods which are not nourishing or non-nutritious in nature in spite of being heavy.
In case of obesity – medoroga, foods which are given to decrease fat and kapha would increase agni and vata which will lead to craving of food. Foods which are given to decrease agni will increase kapha and meda because they are generally nutritious. So, the treatment of obesity becomes tricky and challenging.
Laghu Santarpanam
The treatment for emaciated individuals should be opposite of that of the treatment principle given for obese individuals.
So, it will be Laghu Santarpanam for lean individuals.
Laghu Santarpanam – For a person who is suffering from emaciation due to loss of tissues or other reasons and is looking abnormally thin, Laghu Santarpanam is the treatment principle.
Laghu = light
Santarpana = nutritious therapy
The foods given to thin or underweight individuals should be both light to digest and nutritious in nature, exactly opposite to the principle of guru-apatarpana as given for obese individuals.
Emaciated persons will not have good ‘agni bala’ i.e. digestive strength so as to digest heavy foods. Guru ahara i.e. heavy to digest food will further deplete the agni. Due to this, the person will not be able to digest the food properly. With this, the rasa i.e. nutritious juices will not be formed in the stomach properly and as a result the tissues will be deprived of nutrition. But the emaciated individuals need more and more nutrition tapped from the food they eat. So, heavy to digest foods should not be given to these people.
On the other hand, these people need nourishment and tissue build-up. So, nutritious foods should be administered to these people.
In comparison to obese individuals, it is easier to manage emaciated individuals. This is also because things are added to the body and addition is easy in comparison to depletion as done in obese individuals, which is a painful process.
Guru ahara – heavy foods should logically increase fat and weight, but they will decrease the agni and create mandagni. This will lead to ajirna – indigestion and inadequate or improper formation of ahara rasa, and more formation of ama. The channels would get blocked and the nutrition does not reach the tissues. The person would become a victim of ama, ajirna and related disorders rather than putting weight healthily. So, light to digest foods should be given i.e. laghu ahara. This is because these foods increase agni to healthy levels, do not stay for a long time in the stomach, get digested quickly with formation of less wastes, quickly put into circulation and causes nourishment of tissues.
On the other hand, the foods, in spite of being light to digest, should also be nutritious in nature. In this direction, care should be taken to provide foods which are nourishing in spite of being light in nature.
Laghu ahara in emaciated individuals may increase agni and vata also but the food is Santarpana in nature i.e. nourishing and nutritious, which is antagonistic to vata and will not allow vata to increase. At the same time, being laghu, it does not allow decrease of agni also and counteracts the santarpana part of food which might deplete agni.
Note – Care should be taken to consider the matra i.e. quantity of food while giving the mentioned kinds of foods to obese and emaciated individuals.
Ideal guru-apatarpana and laghu-santarpana foods
While it is difficult to find many foods which are guru-apatarpana or laghu-santarpana, Acharya Vagbhata gives one best food inclusion for each category.
Yava – barley – is heavy and non-nutritious i.e. guru-apatarpana and should ideally be prescribed for obese individuals. One should plan to prepare many recipes including yava.
Godhuma – wheat – is light and nutritious i.e. laghu santarpana and should ideally be given to emaciated / thin individuals. One should plan to prepare many recipes including godhuma.
