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Table of Contents
CASE REPORT
Year : 2022  |  Volume : 10  |  Issue : 4  |  Page : 271-275

Effect of Yogic management with Ayurveda regimen in underweight: a case report


Swasthavritta and Yoga, Government Ayurveda College, Nagpur, Maharashtra, India

Date of Submission18-May-2022
Date of Decision21-Sep-2022
Date of Acceptance16-Oct-2022
Date of Web Publication31-Dec-2022

Correspondence Address:
Dr. Rohini M Kendre
Swasthavritta and Yoga, Government Ayurveda College, Nagpur, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jism.jism_44_22

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  Abstract 

Nowadays, everyone is conscious of body fitness and bodybuilding. People experiment with their body by exercising in the gym with heavy workout and with different diet plans. These experiments result in an adverse effect. In this case study, a 27-year-old male patient, lean built since childhood, with low body mass index (BMI), wanted to increase his weight. We took a detailed history to find out the exact cause. The patient was taking an extra amount of food for weight gaining, but because of the slow digestive fire, there was no positive effect of food seen; rather, the patient suffered adverse effects such as sour belching, anorexia, and indigestion. The cause of slow digestion cured with the help of Vaman Dhauti (Yogic therapeutic self-induced emesis) that helped in body detoxification. Drug therapy with do’s and don’ts were advised for 30 days, which subsided Pitta vitiation and increased appetite by increasing digestive fire. After that, the patient needs to take more quantity of food but should be balanced, so a diet plan, Yoga, and Pranayama were explained for the next 60 days. The result was a remarkable improvement in subjective symptoms as well as the weight of the patient increased from 50 kg to 58 kg and the BMI increased from 17.7 (underweight) to 20.5 (normal). With the help of traditional knowledge, we can achieve our targets to live happily and confidently. The combination of Yogic procedures (an easier method for the cleansing body) with Ayurveda principles results in remarkable improvement without adverse effects. This study has a unique intervention; lean patients also need to detoxify their body first for a better relief, then the medication will work out, which needs to be studied on a large scale.

Keywords: Ayurveda regimen, BMI, digestive fire, Karshya (underweight), Pranayama, Vaman Dhauti


How to cite this article:
Kendre RM, Jain SS. Effect of Yogic management with Ayurveda regimen in underweight: a case report. J Indian Sys Medicine 2022;10:271-5

How to cite this URL:
Kendre RM, Jain SS. Effect of Yogic management with Ayurveda regimen in underweight: a case report. J Indian Sys Medicine [serial online] 2022 [cited 2023 Feb 5];10:271-5. Available from: https://www.joinsysmed.com/text.asp?2022/10/4/271/366511


  Introduction Top


In the Ayurveda literature, Acharya Charak included Karshya (underweight) in Ashtaunindit Purusha. As described by Charak, Krusha patients due to various diseases fall victim to spleen enlargement, cough, tuberculosis, asthma, abdominal tumors, hemorrhoids, ascites, and diseases of the duodenum. They do not tolerate physical exercises, food cravings, hunger, thirst, very hot and cold environment, and coitus.[1]

According to modern science, Karshya can be co-related with undernutrition, i.e., underweight. According to WHO, body mass index (BMI) < 18.5 kg/m2 is considered underweight.[2],[3]

In today’s era, being underweight is like social stigma; people spend lots of money buying different mass gainers containing steroids and have heavy exercises such as gymnasium to get rid of leanness, which causes tiredness and many side effects. To reduce side effects while gaining weight, there should be a proper diagnosis and an accurate line of treatment given. This study discusses how to achieve the compactness of the body by using Shatkarma (six karmas), daily routine, do’s and don’ts, etc., as described in Ayurveda.

Objective

The objective of the study was as follows:

  1. To study the effect of Vaman Dhauti (Yogic therapeutic self-induced emesis) to rule out the causes of Karshya


  2. To study the effect of Asanas, Pranayama, and Ayurveda regimen in Karshya (underweight).


Patient Information

A 27-year-old male patient working as a computer engineer in Pune, Maharashtra, having a lean body structure since childhood, tried to gain weight through different therapies but has no significant effect. He came to us on September 2, 2021, having height of 168 cm, weight of 50 kg, and low BMI and willing for weight gain. The patient has no systemic disease such as diabetes, hypertension, or any family history. We examined and recorded all his complaints as shown in [Table 1] and [Table 2]; after calculating his BMI, we planned a 3-month treatment module.
Table 1: Chief complaints

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Table 2: Ashtavidhapariksha

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All vitals were stable as per general and systemic examination [Table 3].
Table 3: The general examination

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Samprapti

Hetu (the patient habituated to cleaning throat forcefully every morning) causes the vitiation of Vat Dosha. Apana moves upward and contaminates the Samana in the stomach; simultaneously, it disturbs Pachak Pitta and Kledak Kapha. As a result, the appetite decreases; because of a lack of appetite, nutrition compromised that tends to Karshya.

Therapeutic Intervention

The intervention was done in three phases. First, Vaman Dhauti was given to the patient [Table 4]; then medicinal treatment was given for the next 30 days; during this, all do’s and don’ts were explained to him [Table 5] and [Table 6]. When parameters got stable, after achieving a state of normal digestive fire, a plan for the next 60 days of the diet, Yoga, and Pranayama were given to the patient [Table 7] and [Table 8].
Table 4: Details of Vaman Dhauti (Yogic therapeutic self-induced emesis)

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Table 5: Internal medication advised for the patient

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Table 6: Do’s and don’ts advised to the patient

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Table 7: Diet advised to the patient

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Table 8: Yoga and Pranayama advised to the patient

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Assessment Criteria

The assessment done on the basis of subjective and objective parameters was shown in [Table 9]; the gradation of subjective parameters was given in [Table 10][Table 11][Table 12][Table 13].
Table 9: Changes in subjective and objective parameters of the patient

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Table 10: Gradation of sour belching

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Table 11: Gradation of anorexia

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Table 12: Gradation of indigestion

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Table 13: Gradation of exertion without work

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  Results Top


Subjective as well as objective parameters of the patient are as shown in [Table 9].


  Discussion Top


According to Ayurveda, Karshya is Vata Dosha’s dominant condition. If Krusha patient takes a full stomach diet, the patient has to face adverse effects as they are having a slow digestive fire.[4] To ignite digestive fire, body detoxification regarding case presentation is important. After cause-eradicating treatment, for the next 60 days, diet was advised with proper timing of hunger.

Probable Mode of Action

Vaman Dhauti

It is one of the procedures from Shatkarmas explained by Yoga Shastra, which removes toxins and promotes proper digestion. It should be done in the early morning, after the evacuation of the bowel, and should be done on an empty stomach.[5]

In the present case study, the patient was having Pitta, Kapha-vitiated symptoms, including a chronic history of sour belching and a habit of forceful vomiting in the morning.[6]Vaman Dhauti advised, which inhibited all Pitta and Kapha Dosha vitiated symptoms, cleansed the gastrointestinal tract, and helped to increase appetite.[7]

Internal Medication

Avipattikar Churna and Sutshekhar Ras have ingredients with Tikta, Kashaya, and Madhur Ras, which cause smoothening effect, promote strength, and pacify Vata, Pitta Doshas.[8]Aampachak properties balance the PH of the stomach and normalize the acid–base balance in the gut, and improve constipation and slow digestive fire.[9]

Do’s and don’ts were explained to the patient.[10]

Diet

Bruhana is the line of treatment for gaining weight as explained in Ayurveda.[11] Foods having sweet in taste (Ras), sweet in ripening (Vipaka), sweet in potency (Virya) were given to the patient as explained in [Table 4]. Generally, sweet is composed of solid and water; both are heavy elements. Hence, they brought stability to the body, which increased the actual weight of the patient.[12]

Yoga

Yoga was advised for healthy growth, muscular strength, good blood circulation to all parts of the body, and a peaceful mindset.

Sun Salutation

Sun salutation is a combination of 12 steps of yoga poses with coordination of respiration. One should follow it while the stomach is empty. It brings flexibility to all joints, imparts a sense of pleasure, and provides benefits all over the body. Alternate stretching and compression of the abdominal organs improve digestion by igniting a digestive fire.[13] It helps in burning excessive fat and maintaining the compactness of muscles. The patient was advised to take more quantity of food, which was majorly sweet in taste, ripening, and potency. As mentioned above, the Sun salutation helped to digest it properly, inhibited deposition of excessive fat, and promoted healthy growth.

Asanas

Vajrasana improves circulation to the limbs and hence prevents constipation and flatulence. This is the only asana that one can do after taking a meal.[14]

Dhanurasana provides a massaging effect and stimulates the liver, pancreas, small intestine, and large intestine, which helps in the proper production of enzymes. It prevents anorexia and loss of appetite.[15]

Shalabhasana improves circulation to the back, which improves the flexibility and strength of the back and neck muscles, and improves the activities of the renal system and prevents lower back ailments such as central obesity.[16]

Paschimottanasan strengthens the abdominal muscles, provides a massaging effect on the abdominal organ that initiates enzymatic secretion, improves circulation, and kindles the digestive fire.[17]

Shavasana is the relaxing posture one should perform after the above Asanas. It relieves strain and stress occurred by Asanas and calm down the mind and thought waves that help conserve energy.[18]

Pranayama

Pranayama is the procedure, which helps control breathing and thought waves of the mind. Regular practice of Anulom Vilom leads to kindle digestive fire and increases glow.[19] Humming sound produced in Bhramari provides a soothing effect to the brain, imparts sleep, and removes stress.[20]

Yognidra

For gaining weight besides all treatments, deep sleep is very important as explained in Ayurveda; here, the patient was working in a technical field that produced continuous stress that was ruled out by advising Yognidra, a meditative practice that balances the mind and body. Research showed that work-generated stress, strain, and anxiety are reduced by Yognidra that one can achieve deep sleep.[21]

It was a single-case report; objective parameters also showed improvement as the weight of the patient increased from 50 to 58 kg. BMI increased from 17.7 (underweight) to 20.5 (normal) as well as all subjective parameters showed improvement within 90 days of treatment. This case study promotes unique intervention and provides solutions to people with current busy lifestyles, which needs to be studied on a large scale.


  Conclusions Top


This case study concluded that the Yogic management (Vaman Dhauti, Asanas, Pranayama) and Ayurveda regimen help gain enough weight; that is, normal BMI without adverse effects simultaneously enhances a peaceful mindset.

Vaman Dhauti is contraindicated to Sukumar patients; one should perform it always under the expert’s observation. Karshya can be associated with other chronic diseases such as tuberculosis, cancer, and Acquired Immune Deficiency Syndrome; in such cases, this line of treatment will not be beneficial.

Treatment given in this study was cheaper, containing minimum medications, need to promote it on a large scale.

Patient Perspective

The patient was very happy with his body transformation without any side effects; it increases his confidence and productivity at work.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

 
  References Top

1.
Agnivesha . Sutrasthana: 21/13. In: Tripathi B, editor. Charak Samhita. Vol. 1. Reprint ed. Varanasi: Chaukhambha Surbharti Prakashan; 2020. p. 402.  Back to cited text no. 1
    
2.
Garrow JS, Webster J Quetelet’s index (W/H2) as a measure of fatness. Int J Obes 1985; 9:147-53.  Back to cited text no. 2
    
3.
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4.
Agnivesha . Sutrasthana: 21/13. In: Shukla V, Tripathi R, editors. Charak Samhita. Vol. 1. Reprint ed. Varanasi: Chaukhambha Surbharti Prakashan; 2011. p. 302.  Back to cited text no. 4
    
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6.
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7.
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8.
Sen G 4/26–27. In: Vaidya L, editor. Bhaishyajyaratnavali. Vol. 1. Delhi: Motilal Banarasidas Publication; 2012. p. 605.  Back to cited text no. 8
    
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Sharma R Ayurved Sarsangrah. 1st ed. Nagpur: Baidyanath Ayurved Bhavan Pvt Limited; 2004. p. 416.  Back to cited text no. 9
    
10.
Agnivesha . Sutrasthana: 21/34. In: Shukla V, Tripathi R, editors. Charak Samhita. Vol. 1. Reprint ed. Varanasi: Chaukhambha Surbharti Prakashan; 2011. p. 304.  Back to cited text no. 10
    
11.
Sen G 4/150–155. In: Vaidya L, editor. Bhaishyajyaratnavali. Vol. 1. Delhi: Motilal Banarasidas Publication; 2012. p. 612.  Back to cited text no. 11
    
12.
Agnivesha . Sutrasthana: 21/16. In: Tripathi B, editor. Charak Samhita. Vol. 1. Reprint ed. Varanasi: Chaukhambha Surbharti Prakashan; 2020. p. 402.  Back to cited text no. 12
    
13.
Yadav SK, Bhati KR, Bhati LS Assessment of the efficacy of Suryanamaskar in management of Sthaulya. World J Pharm Pharm Sci 2017; 6:1035-44.  Back to cited text no. 13
    
14.
Samgandi K Swasthavrittam. 1st ed. Part 1:5. Jaipur: Ayurved Sanskrit Hindi Pustak Bhandar; 2019. p. 339.  Back to cited text no. 14
    
15.
Swatmaram . 1/25. In: Agrawal S, editor. Hathayogpradipika. Reprint ed. Varanasi: Chaukhambha Orientalia; 2018. p. 15.  Back to cited text no. 15
    
16.
Swatmaram . 1/29. In: Agrawal S, editor. Hathayogpradipika. Reprint ed. Varanasi: Chaukhambha Orientalia; 2018. p. 17.  Back to cited text no. 16
    
17.
Swatmaram . 1/32. In: Agrawal S, editor. Hathayogpradipika. Reprint ed. Varanasi: Chaukhambha Orientalia; 2018. p. 19.  Back to cited text no. 17
    
18.
Samgandi K Swasthavrittam. 1st ed. Part 1:5, Jaipur: Ayurved Sanskrit Hindi Pustak Bhandar; 2019. p. 371.  Back to cited text no. 18
    
19.
Swatmaram . 2/19–20. In: Muktibodhananda S, editor. Hathayogpradipika. Reprint. 3rd ed. Mungar: Yoga Publication Trust; 1998. p. 29.  Back to cited text no. 19
    
20.
Swatmaram . 2/65. In: Muktibodhananda S, editor. Hathayogpradipika. Reprint. 3rd ed. Mungar: Yoga Publication Trust; 1998. p. 42.  Back to cited text no. 20
    
21.
Ferreira-Vorkapic C, Borba-Pinheiro CJ, Marchioro M, Santana D The impact of yoga nidra and seated meditation on the mental health of college professors. Int J Yoga 2018;11:215-23.  Back to cited text no. 21
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11], [Table 12], [Table 13]



 

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