Obesity is the one of the oldest and globally spread metabolic disorder.  According to WHO, in 2014 globally 600 million people were Obese. Obesity is associated with various diseases, particularly cardiovascular diseases, diabetes mellitus type 2 and obstructive sleep apnea, certain type of cancer, osteoarthritis and asthma. As a result, obesity has been found to reduce life expectancy.

Obesity also has its references described in the most ancient science Ayurveda and termed as Sthaulya. Sthaulya or Obesity is termed into the Asthanindit purusha means Eight Condemned Disease. Human beings in Ayurveda comprises of seven dhatus, Three Mala and Three Dosha. Out of all dhatus, Meda dhatu is the fourth in sequence after the first three viz. Rasa, Rakta, Maansa. Excessive production of this Meda dhatu leads to abnormal accumulation and deposition of abnormal fat throughout the human body.

Common Hetus (reasons) for Sthaulya or Medoroga are excessive food intake which are of Guru and Snigdha Guna, Madhur Rasa, Sheet Vipaka, lack of Vyayama, Divaswaapa (sleeping during the day), Achinta and beej dosha.⁴ Today, modern science also classifies Obesity in a manner similar to Medoraga described in Ancient Ayurveda texts wherein Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health.

Treatment options for obesity include medications that curb appetite, such as Orlistat and Lorcaserin, but the drugs can cause side effects like cramping, diarrhea, headaches, dizziness and nausea. Although surgical techniques like liposuction & bariatric surgery are available, potential complications following these procedures is still a hindering issue. Dumping Syndrome, dehydration, gall bladder stones, dysphagia, indigestion, kidney stones, hair loss, incisional hernia, malnutrition, ulcers, intolerance to certain foods, beverages & drugs and dental problems are being faced by people after bariatric surgery. 

According to Ayurveda, management of obesity includes both internal and external routes of administration of medications i.e. Shamana Chikitsa and Shodhana Chikitsa respectively.  Shamana means alleviation while Shodhana means elimination. Shamana methods mitigate the disease and its symptoms while Shodhana methods aim at elimination of the cause of the disorder. Administration of Shaman Chikitsa takes longer duration to demonstrate efficacy whereas Shodhana chikitsa, which is also termed as Panchakarma chikitsa, gives quicker and detoxifying effect that lasts for longer periods.

A previous pilot study was carried out at our centre to assess the immunological & metabolic responses to a therapeutic course of basti in obesity. We found that Ayurvedic basti (enema) treatment is safe and it modulates immune responses by regulating proinflammatory cytokines, immunoglobulins and functional properties of T-cells. These changes were associated with reduction in the body weight which was maintained even after three months. Naval Guggul & Lekhan basti both are used in the treatment regimen of Obesity. So we proposed this study to compare the efficacy of Lekhan therapy (treatment of Obesity) when administered by 2 different therapeutic modalities viz Lekhan basti and Navak Guggul & to study changes in specific biochemical markers (leptin & Ghrelin) and genetic markers between the 2 study groups at the end of treatment. 

A multidisciplinary research effort involving a combination of clinical, biochemical and omics approaches appears mandatory to increase knowledge in the complexity of biological traits and processes associated with obesity. Through probing of the transcriptional activity of peripheral blood, the techniques allowing systematic analysis of gene expression may prove useful at identifying master genes and regulatory networks involved in human obesity and related disorders.