Presenting Complaints with severity and episode duration

  • Over weight

Brief Relevant Medical History:

Patient, was apparently healthy before 5-6 years. Then he started gaining weight gradually. He was overweight. He underwent an accident 1 yr back and injured his ligament in Lt Knee. Later he was unable to do physical exercises and gained weight. Patient gained around 10kgs in one year andwants to reduce weight.

Current medication: Nil

Clinical Status
Vital Parameters

  1. BP - 120/70 mm of Hg.
  2. Pulse - 70 beats /min
  3. RR – 20/min
  4. Weight - 97kg
  5. BMI - 31.6/Obese
  6. WHR – 1.23
  7. Height - 5ft9inch
Asta Sthana Pariksha

  1. Nadi - Kaphaja
  2. Malam - Samyak
  3. Mutra - Samyak
  4. Jihva - Alipta
  5. Shabda - Samyak
  6. Sparsha - Sheeta
  7. Drik - Samyak
  8. Akruti - Uttama

  1. GC - Fair, Afebrile.
  2. CVS - S1, S2 heard
  3. CNS - NAD
  4. RS - NVBSheard
  5. PA - Soft, No Organomegaly

O/E - Mild pain in Lt knee joint while flexion.

Dasa Vidha Pariksha

  1. Prakriti - Kaphavata
  2. Vikriti - Kaphavatadosha
  3. Sara - Mamsa, Meda
  4. Samhanana - Uttama
  5. Pramana - Uttama
  6. Satmya - Ushna, Katu
  7. Satva - Madhyama
  8. Aharashakti - Madhyana
  9. Vyayam Shakti-Avara
  10. Vaya-Madhya
  11. Desha-sadharana
  12. Kala- Adana
Rogi Bala - Madhyama
Roga Bala - Pravara
DSQ findingsRating
1. ADRS Med
2. ADSS High
  1. Nidana - Excessive intake of guru, madhura, sheeta, snigdha food along with absence of physical activities, not having Chinta or not being bothered about anything, genetic factors.
  2. Roopa - flaccidity in buttocks, Abdomen, breasts due to increased Medas and Mamsa, no interest in any activities.
  3. Updrava - Decreased ayu, loss of interest, difficulty in sexual activity, loss of strength, bad body odour, excessive sweating, excess hunger and thirst.
  4. Arishta Lakshana - Nil
  5. Samprapti
    1. Dosha - Vata, Kapha
    2. Dushya - meda, mamsa
    3. Agni - Jataragni, Dhatwagni
    4. Ama - Jataragni
    5. Srotas - Meda, Mamsavaha srotas
    6. Sroto Dushti Prakara - Sangha

Lab Tests- Not done

RogaSamprapti Flow Chart
Due to Nidanasevana, increase of Medodhatu

Increased medodhatu does Avarana of srotas

Vatadosha gets aggravated

Enhances agni and digests food quickly

Intake of more and more food


Differential Diagnosis with reasoning

Obesity - a BMI greater than or equal to 30 is obesity.

Differential Diagnosis with reasoning

Sphikstanaudaralambana, ayathopachaya
Utsaha = Atishoola (Ch Su 21)

Evidence Based Diagnosis with References
Evidence Based Diagnosis with References

  • Follow timely meal. Have freshly prepared warm homemade food.

  • Boiled- Warm jeera/ Coriander seed/ginger for Drinking water.

  • Ginger, hing , Jeera, Turmeric in cooking

  • Cooked vegetables

  • Refrigerated, deep oily fried, spicy, canned food items.

  • Fast foods
  • .
  • Avoid fermented food preparations
  • .
  • Curd, Pickles

  • Uncooked Salads.

  • Avoid exposure to cold.

  • Keep yourself warm and covered.

  • Exercise

  • Varanadikashaya 3tsp + Triphala choorna 1tsp + with 8tsp warm water morning on empty stomach.

  • Ardhavilwadhikashayam(3tsp)+T Chandrapraprabha(1 tab)+10 tspwarm water evening on empty stomach.

  • T. Kanchanaragugulu (1 tab) + T Hyponid (1 tab) thrice daily after food.

  • Chinchadhi Tailamwarm it and apply ½ hour before bathing.

Details of Allopathy medicine if continued:b>


Type – OPT
Duration – 19 days
Primary Treatments - NIL
Main Treatments -
  • Udwartana
  • Virechana (Therapeutic Purgation)

Medications for Virechana-
  • Snehapana- Varanadighrita
  • Sarvangaabhyanga with Brihatsaindhava+Chinchaditaila
  • Virechana – Tab Icchabhediras

Post Treatments-NIL

Chikitsa Paddhati

Chikitsa and medicines selected, cures Medodushti, main cause for Sthoulya, which may also lead to Prameha, kushta etc rogas if not treated.

1. Udwartana - with Kolakulatthadi + Triphala + Kottamchukkadi churna

  1. Ruksha Udwartana is one of the treatments mentioned for sthaulya. It is kaphahara and liquefies excessive medodosha (Ch Su 21).
  2. Triphala churna is ruksha, kaphamedohara and lekhana (AH).
  3. Kolakulatthadi churna is indicated in sthaulya, since it is ruksha and ushna, medohara.
  4. Kottamchukkadi churna is indicated in Vatavyadhi, so controls Vata and also it is Ruksha and Teekshna.

2. Virechana -

  1. Virechana is done to remove the mobilised medodosha from the body.
  2. Sneha selected is Varanadighrita which is indicated in conditions with Kapha and vata involvement.
  3. Abhyanga with Brihatsaindhava, Chinchaditaila reduces kapha and prevents aggravation of Vata and to reduce pain in Lt knee joint.
  4. Virechana with Icchabhediras which contain Jayapala- Crtontiglium, a teekshnavirechaka, which does Lekhana and is Ruksha.

Internal mdeicines-

Varanadikashaya- kaphavata association, lekhana.

Triphalachoorna- indicated in meda, kaphavikara, prameha (AH)

Ardhabilwakashaya- indicated in mutravahasrotovikara, shopha- removes water retention in body, and is ruksha and teekshna.

Chandraprabhavati- Indicated in Prameha, a Kaphamedodushtijanyaroga.

Kanchanaraguggulu- indicated in Kaphamedojanyarogas, lekhana.

Hyponid- indicated in prameha, PCOS- kaphamedojanyarogas.

Referral Opinion Sought if any - No

    • Samyak Lakshanas achieved (Control Charts Summary Attached)
    • Sneha samyak lakshana achieved. Control Chart attached- No.1.
    • Snehana and swedana samyak lakshana achieved. Control Chart attached- No.2.
    • Virechana - 7 vegas – Avarashuddhi - No.3.
  1. Standardised Outcome Scales Used (Summary Table Attached) Attached - No.4
  2. Other outcomes as per following table -
  3. #Outcome ParametersRTSDTTED
    1Sleep (Nidra)GoodGoodGoodGood
    2Appetite (Agni)GoodGoodGoodGood
    3Bowels (Mala)RegularRegularRegularRegular
    4Urination (Mutra)RegularRegularRegularRegular
    5Stress (Manas)MediumMediumMediumMedium
    6Vitality (Ojus)MediumMediumMediumMedium
    7Wellbeing (0-10)5677
    10Weight, Kg103979593
    11Diet (Ahara)PoorFairFairFair
    12Exercise (Vyayama)NilNilNilNil
    13Lifestyle (Vihara)PoorPoorPoorPoor
    14Lt mid arm circumference in cm-1514.514.2
    15Rt mid arm circumference in cm-15.514.514
    16Waist circumference in cm-454545
    17Hip circumference in cm-4342.442
    18Lt mid thigh circumference in cm-24.523.522
    19Rt mid thigh circumference in cm-282323

    Patient’s Outcome Scale

    #Presenting ComplaintWeightageStatus_TSDStatus_TEDStatus_1WeekStatus_1 Month
    1 Obesity 80% Fair Good V good V good
    2Lt knee joint pain 20% V good V good V good V good
    WEIGHTED AVERAGE SCORE-----> - - - - -
    IMPROVEMENT %-----> --0%100%100%

    Adverse Incident Report (Drug or Treatment): NIL


At the end of treatments, patient felt better. Weight is decreased from 97 kgs to 90 kgs- Measurements also showed reduction in circumference of various parts. He is advised to continue all his internal and external medicines for 15 days and review thereafter.

Disclaimer: * Outcomes may vary from person to person