Sthoulya is a condition described under Shleshma nanatmajavyadhi ⁽¹⁾, Santarpana nimittaja vyadhi⁽²⁾ and Atibrimhana nimittajavyadhi⁽³⁾. It is described as Upachita shareeratvam⁽⁴⁾ and is characterized by excess accumulation of Medas. There are many lakshana of Sthoulya⁽⁵⁾ as mentioned in Ayurveda , of which a few symptoms that are commonly found in children are Atinidra, Alasya, Ayase Shwasa and Atikshudha.

The clinical symptomatology of Sthoulya is similar to that of Overweight and Obesity in contemporary science, which has been defined as, a body mass index of 23kg/m² and 27kg/m² respectively. (Indian cutoffs after 2 years of age, which is between 85^th to 95^thpercentile) ⁽⁶⁾ Enlargement of fat cell in its size; or an increase in number of fat cells; or both, leads to abnormal growth of adipose tissue which is known as obesity. In such condition, body fat is extensively accumulated under the skin and around certain organs such as belly, breasts, thighs ⁽⁷⁾

According to a study in 2021, the prevalence of overweight and obesity among school children in Mysuru, Karnataka showed that there was 3.86% of obesity and 12.27% of overweight ⁽⁸⁾. A recent study conducted 2021, in school children of Mysuru, Karnataka revealed significant differences in variables such as body weight and BMI, before and after lockdown. Post lockdown the BMI increased among all the participants from 17.32 to 17.80 kg/m² (p<0.001). The study also depicted that obesity has a proportional impact on the children’s quality of life (QOL)⁽⁹⁾ In a recent study done in Rishikesh ,Uttarakhand, in the year 2021,it was found that 6.8% of adolescents were obese and that about 17.1% were overweight.⁽¹⁰⁾ These studies give enough proof for the prevalence of overweight and obesity among children even in adolescent age group.

Some of the common complications of childhood obesity, if left unattended are Obstructive sleep apnea, Asthma, Acanthosis nigricans and Polycystic ovarian syndrome and Psychological problems like Anxiety, Low self esteem and Worsening school performance ^(11,12). Contemporary science has a multi disciplinary approach in the management of obesity, like lifestyle modification, regular meal timings and at least 7-8 hours of sleep at night ^(12).

Ayurveda also describes multi model therapy including diet, medicine and life style modifications for Sthoulya. Some of the Shamanoushadhi indicated for Sthoulya are Triphala churna, Vidanga Churna, Vidangadhya louham and Navakaguggulu. ⁽¹³⁾ Usage of Triphala and Madhu have been specifically mentioned in Sthoulya chikitsa in Charaka Samhita and Ashtanga Samgraha ⁽¹⁴⁾. According to the Kerala based text dealing with Kaumarabhritya viz; Arogya Raksha Kalpa Druma

,Triphala triturated in the Kwatha of Khadira and Asana, consumed for 1 month reduces Sthoulya. It has been specifically mentioned for children ⁽¹⁵⁾. A previous clinical study conducted in the year of 2011 have shown significant results of Khadira and Asana Kwatha Bhavitha Triphala in children