It describes about Obesity and Its Dietary management that includes Fasting, Formula Prepared diets and Some Kitchen Remedies as per Ayurveda

1. “DIETARY MANAGEMENT OF
OBESITY”
Dr. Nagendra Prasad,
MD (Ayu.), PhD,
Professor and H.O.D,
Dept. of Kaya Chikitsa,
Dr. Anar Singh
Ayurvedic College
and Hospital,
Farrukhabad, U.P.

2. It includes
» What is Obesity
» Relation between Obesity and Covid -19
» Treatment modalities in Obesity
» Principles of Diet Therapy
» Some Kitchen remedies for Obesity
» Conclusion

3. What is Obesity
• obesity is defined as an abnormal growth of the
adipose tissue due to an enlargement of fat cell
size or fat cell number (Hyper trophic or hyper
plastic respectively) or a combination of both.

4. • increased weight as compare to the ideal
weight for particular sex and height. Wt. >
• 10% of ideal weight – Over Weight
• Wt > 20% of ideal weight – Obesity

5. Relative Weight (RW):
•The RW is “actual weight” divided by “desirables
weight” (derived from acceptable weight table) X
100
•RW > 120% Obese
•RW > 200% Morbid Obese

6. Class 1: BMI of 30 to < 35
Class 2: BMI of 35 to < 40
Class 3: BMI of 40 or higher.
Class 3 obesity is sometimes categorized as “extreme” or “severe”
obesity.
If your BMI is less than 18.5, it falls within the underweight range.
If your BMI is 18.5 to <25, it falls within the normal.
If your BMI is 25.0 to <30, it falls within the overweight range.
If your BMI is 30.0 or higher, it falls within the obese range.
Body Mass Index (BMI) /
Quetlet’s Index:

7. Cont...
Weight(kg) / Height2 (m)
BMI TERMINOLOGY
•Below 20kg/m2 Under Weight
•20 - 25kg/m2 Normal
•25 - 30kg/m2 Over Weight
•30 - 40kg/m2 Obese
•Above 40kg/m2 Very Obese.

8. Relation between Obesity and
Covid-19
Obesity-related conditions seem to worsen the
effect of COVID-19.
(World Obesity Federation)

9. New York study
A study of 3,615 COVID-19 patients who visited
an academic hospital in New York shows that
obesity increased the risk of severity even
among relatively younger patients. For instance,
patients who were highly obese (BMI >34 kg/m2)
and were aged less than 60 years were 3.6
times more likely to be admitted to ICU
compared to patients in the same age group
who had a BMI lesser than 30

10. Cont...
BMI
(patients
<60 years)
Likelihood of
admission to:
Acute care ICU
30-34 2 times 1.8 times
>34 2.2 times 3.6 times

11. French Study
• In a single centre in France, 124 consecutive patients
admitted in intensive care for COVID-19 were studied for
the link between Body Mass Index (BMI) and
requirement for invasive mechanical ventilation (IMV).
Graph 1 shows that the share of overweight
(represented in blue) (25-30 kg/m2), obese (represented
in orange) (30-34) & severely obese (represented in red)
(>34) people are more among COVID-19 patients than
among non-COVID-19 severe acute respiratory infection
patients (both categories were admitted to intensive care
in 2019.) Also, there is a relatively low share of lean
(represented in green) (BMI <25) people among COVID-
19 patients.

12. Cont..

13. Cont...

14. Treatment Modalities in Obesity
• 1.Patient Counseling.
• 2.Diet Therapy
• 3.Behavioral Modification
• 4.Exercise Therapy
• 5.Drug Therapy
• 6.Surgical

15. PRINCIPLES OF DIET THERAPY: -
Ayurvedic view: -
“Gurum capatarpanam sthulanam karshanam
prati”
(Ch. Su. –21/20)

16. Modern view
When planning diet for an obese person, a weekly weight
loss at 0.5 to 1 kg. should be aimed. In general, a deficit of 32
thousand kJ. (7,700K.cal.) leads to loss of 1k.g. By estimating
the patient’s daily caloric needs [approximately 125 to 150 kJ.
(30 to 50 Kcal.) per kilogram of body weight.]
An obese middle aged house wife lose weight satisfactorily
on a diet providing 800K.cal. to 1000K.cal. per day, where as
an obese man engaged in active physical work, the diet
containing 15,000K.cal. per day is required. The diet should
contain – protein 50gm, carbohydrate 100 gm, fat 40gm,
vitamin A and C, minerals like iron and calcium, fluids and
salts.

17. TREATMENT MODALITIES
IN DIET THERAPY: -
FASTING: -
STARVATION :-
RAW DIETS :-
FORMULA PREPARED DIETS :-
(a) Very low density calorie diet (VLCD):
(b) Low Calorie Diets (LCD):

18. Way to fast-
Fasting can be done once in a week or once in 10 days
on such day
when energy need not be spent on talking, shouting at
youngsters and
servants.
v Morning should be started with a glass of plain water
v One can have only fruit juice or just plain water whole
day.

19. v At first one should be advised to break fast with
vegetable or fruit juices
v There after semi fluids for the next meal
v T hen solid food items, either fruits or raw or
boiled vegetables.
Way to break the fast:

20. The major problem in the management of obesity is not
weight reduction but to maintain the reduced weight.
Obesity is an eating disorder, But only by limiting food intake
can not reverse the underlying mechanisms.
Further patients should be advised as follows
• No over eating
• Regular daily exercise
• Avoid saturated, refined sugar and confectionery
products
• No eating between meals
• No alcohol

21. As a general guidelines, caloric intake below 800K.cal. / day has
been taken as the definition of very low caloric diet (VLCD). The
newer very low calorie diets involve formula preparations
containing 500 to 800 K.cal. / day, with 50 to 80gm of high
quality protein. The remaining calories consist of carbohydrate
and fat. Vitamin and micro nutrient supplements are incorporated
in the formula or added as a supplement. Such high quality low
caloric diet formula lead to relatively rapid weight loss. But
should not be taken continuously as the sole calorie source for
more than 6weeks. In the absence of co existing diseases like
gout, renal in sufficiency, cardinal arrhythmias etc. such diets are
safe when taken under medical supervision.
Very low density caloric diet (VLCD):

22. Diets providing adequate high quality protein and
greater than 800K.cal./day are referred as low calorie
diets (LCDs) and are safe in otherwise healthy obese
individuals.
Low Calorie Diets (LCD):

23. Morning Drink
1. Two to three glasses of plain water
Or
2. Juice of one lemon and one spoon honey in a glass of warm
water
Or
3. A glass of buttermilk without salt.
Or
4. Two spoons of fresh Indian gooseberry juice in a glass of
warm water. If fresh berries are not available, dried ones
can be soaked overnight and crushed to extract the next
morning.

24. Breakfast
☺ Any single fruit like papaya, unpeeled apple, orange, grape, guava,
pineapple, plum, etc.
Or
☺ Porridge made of ragi, a small plate of soaked and sprouted whole
bengal gram [chana] or whole green moong . Any one at a time.
Or
☺ juice of any vegetable like tomatoes, spinach, beetroot or all three
mixed, or of carrot, ginger, lemon, beetroot and coriander leaves or
cucumber or better gourd juice.
Or
☺ Orange juice, pineapple juice, grape juice, apple juice.
[Any one]
Or
☺ Wheat barn in either skimmed milk [diluted] or butter milk.

25. Lunch :-
V One bowl raw vegetable, one bowl boiled vegetables,
a little unpolished or boiled rice or one small whole
wheat bread.

26. Evening and Night:-
► Any fruit or vegetable juice, or buttermilk in the evening.
Dinner:-
Same as lunch, but in smaller quantity.
or
A plateful of any of the above mentioned fruits.
Drink at bedtime should be nothing other than warm water with
lemon juice and honey

27. Food items tobe avoided
Fried Items
Sugar
Sweets, Chocolates and Pastries
Pudding
Dryfruits
Ghee, Butter and Cheese
Mayonnaise
Icecream

28. Eat in moderate quantities
• Bread, Chapatti, Noodles, Fish, Chicken
not more than twice a week.
• Lean meat not more than once a week
• Boiled potatoes
• Eggs twice a week
• Cold drinks

29. Unresticted Food items
• Green leafy vegetables
• Fruits and Salads
• Khakra
• Clear soups
• Roasted Chana
Take a glass of water every hour per day

30. SOME KITCHEN REMEDIES FOR OBESITY: -
1. Extract juice of one lemon in a glass of lukewarm water. Add a
teaspoonful of honey, mix well and take in the morning
immediately after waking up and before taking anything else. In
the same type of drink, in place of honey, add first a pinch of black
or rock salt, mix well and take in the afternoon.
2. Roast barley seeds and powder it. Mix it with little milk and
honey. Make a small ball take it in breakfast. A pinch of salt can
be added with a little water and a small ball can be taken at noon.
3. Sieve wheat flour and remove the bran. Mix two table spoon of
this bran in a glass of skimmed milk, add honey and take it at
least once a day.
Don't add sugar.
Bran can also be taken with buttermilk.

31. TO CONCLUDE: -
v Excessive accumulation of fat tissues beyond the limitation of skeletal
requirement is termed as obesity.
vObesity is a nutritional error, basically caused due to intake of wrong foods,
wrong types of calories per meal and eating meals in the wrong patterns
each day.
V 90% of obesity occurs due to over eating.
V It is the diet, which gets pre-eminent position for management of obesity.
v Food is more powerful than any weight reducing pills.
v Diet therapy can range from starvation to different formula prepared diets
like LCD, VLCD etc.
vWhen planning diet for an obese person, a weekly weights loss at 0.5 to 1
kg. should be aimed. In general Medically crash diets are not ecommended
because they carry risk and it is an unpleasant fact, that those losing weight
thus, usually regain the lost weight, once they go off it.
vIt is important to drink plenty of water, include raw diet, reduce salt intake,
regular exercise to maintain reduced weight as the major problem in the
treatment of obesity is not weight reduction but maintenance of
reduced weight.

32. https://youtu.be/Gmh_xMMJ2Pw
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