Effect of Virechana on weight in managing Obesity

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Previous research:

Effect of Virechana Karma on reduction of weight in management of obesity

Dr.Yogesh Deole, Assistant Professor, Department of Kayachikitsa

GJ Patel Institute of Ayurvedic Studies and Research, New VV Nagar.

 Introduction

The incidence of Obesity is high on rise in India. A report states that almost 65% of adult urban Indians are-either overweight or obese or have abdominal obesity. [1] Atisthaulya is enlisted among the eight dosha in Ayurveda. All the classical texts have given due importance to this disorder in reference to the Apataropana / Langhan Upkrama. Moreover Obesity is the leading cause for co-morbid diseases like dyslipidemia, Diabetes, Cardio-vascular disorders including Hypertension, PCOD, Infertility, Osteoarthritis, etc. Many patients are being advised to reduce weight to get freed from their sufferings.

Ayurvedic texts like Charaka Samhita,[2], [3], [4] Ashtanga Hridaya have prescribed Samshodhana Chikitsa for the treatment of Santarpanajanya diseases like Sthaulya. Vamana, Virechana, Lekhaniya Basti are the most common procedures to be advised in Obesity. Considering the co-morbidity of cardio-vascular diseases like Hypertension; convenience to the busy patients, Virechana can be the safest procedure for elimination of Doshas in Atisthaulya. A research is being conducted to study the effect of Virechana Procedure on overweight and obese patients.

 Aims and Objectives

The present research is aimed to study the effect of Virechana on reducing weight and BMI of the obese patients.

Material and Methods

Patients from the OPD and IPD of SG Patel Ayurveda Hospital are being studied under the present research trial.

Inclusion criteria:

1.      Overweight and Obese patients with BMI above 25 are included for the study irrespective of their sex, religion, occupation.

2.      Patients between the age of 16 years to 70 years are included.

Exclusion criteria:

1.      Patients not fulfilling the inclusion criteria, with any other serious systemic illness and who are not suitable for Virechana as per the classics are excluded.

Methods: 

Classical Virechana Procedure including Deepana-Pachana, followed by Abhyanatara Snehapana ( Mahatiktaka Ghrita, Panchatikta Ghrita, Phala Ghrita, Dadimadi Ghrita as per the co-morbid disease) until (Samyak Snigdha Lakhana are observed), VIrechana and Samsarjana Krama is followed. The patients were advised to follow a stipulated diet and lifestyle during Virechana schedule of average 15 days.

Assessment criteria:

Weight in Kg., Body Mass Index ( kg/m²), and subjective feeling of well being are assesses before and after the Virechana Procedure.

       Observation and Results

Table 1: Data of 25 patients of Obesity

Sr.No.	Criteria	Maximum	Minimum	Average
1.	Age ( in years)	63	17	40.29
2.	Weight ( kg) Before Treatment	114	53	82.45
3.	Weight( kg) After Treatment	111	50	77.37
4.	Snehapana Dose (ml)	1350	90	416.25
5.	Virechana Vega	24	5	9.79
6.	Weight Loss after deepana- pachana	4	2	1.22
7.	Weight Loss after Snehapana	7	-1	1.52
8.	Weight Loss after Virechana	5	0	1.91
9.	Weight Loss after Samsarjana	5	0	0.41
10.	Total weight loss	11	1	5.08
11.	BMI Before Treatment	41.37	25.08	32.57
12.	BMI After Treatment	40.28	22.99	30.58
13.	% improvement in BMI	13.41	1.17	6.14

Table 2: Statistical Analysis

Sr.No.	Criteria	Mean ± SD		T value	P
		BT	AT
1	Weight	82.45 ± 195.83	77.37 ± 175.81	1.29	P<0.05
2	BMI	32.57 ±19.16	30.57± 19.08	1.65	P<0.01

Graph 1 : Weight loss pattern during Virechana

Total 24 patients are enrolled in the present study, out of which 15 were female and 09 were male. The observations and results of the treatment are shown in the tables 1 and 2.  The pattern of weight loss during the procedure is shown in graph 1.

The observations show that    there is a steady weight loss pattern after deepna-pachana ( average 3 days, 1.22 kg), the weight further reduces after Snehapana ( after avg.5 days,1.52 kg) and it further continues to decrease after virechana( after 4 days including vishrama of 3 days, 1.91 kg). It decreases minimally after sansarjana krama. Thus after the treatment of Nearly 15 days of Virechana schedule, average 5.08 kg weight loss is observed. Some patients reported pain in abdomen, burning sensation in abdomen after taking Virechana yoga, which was reduced after Virechana was over and needful treatment of Anulomana.     

Discussion

The mode of action of Virechana in reducing the weight needs to be discussed. Sthaulya is predominantly a Rasaja Vikara as per Sushruta. Charaka states it as a Medoja vikara. Agnimandya at the level of Rasa and Meda dhatu is the important  factor which needs to be corrected. Virechana is the Shodhana procedure which corrects the Agni at gross level as well as Dhatu level. As observed the Deepana Pachana drugs can remove the obstruction at the Dhatu, followed by Snehapana which can dissolve the Meda dhatu dosha ( mainly circulating fats). These wastes can further be eliminated by Virechana procedure. The dissolving of fat into fat is a topic of further study. Moreover Virechana can give additional benefits of feeling of well being in sense organs, elimination of doshas from body, Good sleep,  correction of appetite and digestion.

Conclusion

From the study, it can be stated that Virechana procedure is helpful in reducing he weight of the obese patients.

Acknowledgement

The authors are highly thankful the management of CVM and SG Patel Ayurveda Hospital, staff of Department of Panchakarma including Head Prof.MK Vyas and Dr.Kundan Chaudhury for their support in the procedure. The authors are also thankful to Dr.Somraj Kharche,Lecturer,Department of Kayachikitsa for help. The authors admire the help of Dr.Pradnya Chauhan in recording the data of patients.   

References

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[1] http://www.diabetes2bfree.com/blog/rising-prevalence-of-overweight-and-obesity-in-india/ downloaded on 03/07/2012

[2] Agnivesha Charaka Samhita. Sutra sthna 22/19, pg. 121

 

[3] Agnivesha Charaka Samhita. Sutra sthana 23/8, pg. 122

[4] Vagbhata, Ashtanga Hridaya, Sutra sthana 14/12, pg. 101