Acharya Sushruta in Sushruta Samhita clearly points out towards the etiological factors and the etiopathogenesis of sthoulya (Obesity), which is strikingly similar to that of Prameha (Diabetes Mellitus). The process by which obesity or Atisthoulya leads to the development of Prameha has also been mentioned in Ayurved.

Sthoulya (Obesity) and Karshya (Emaciation/wasting) are the results of disturbance in Rasa Dhatu (lymph). Food which increases Kapha dosha (see Basic Principles of Ayurveda), eating food even before the previously consumed food is digested properly (Adhayasana), not performing exercise, day time sleep, and all those causative factors that lead to the development of Aama (undigested food) are the factors for causing Obesity.This Aama is excessive sweet in taste (madhur-tara), it flows in the body. Due to atisnigdhata (unctuousness) Vikrut Meda dhatu (abnormal adipose tissue) is generated leading to atisthoulya.

The above pathology occurs as a result of obstruction to the path of Vata (see Basic Principles) due to Kapha and Meda. Due to this Margavarodha (Obstruction in the nutrient flow in cells & tissues) the other Dhatus are not nourished well and may undergo Kshaya (emaciation). If the pathology proceeds in the same way it may lead to the development of diseases like Prameha (Diabetes mellitus), Prameha pidaka (carbuncles & skin infections), Jwara (many types of fever), Bhagandar (Fistula in ano), Vidradi (abscesses) and other Vata disorders (Neuromuscular) due to Margavarodha (obstructive pathology). The management of this condition is Nidan Parivarjan (to get rid of the causative factors). The drugs to be used in this condition include the drugs that cause virukshan (dryness) and chedan (pungent & penetrating).

Shilajattu (Rock extract), Yava, Guggul preparations, Mudga (Moong bean), Gomutra (Cow’s urine), Kordushak, Trifala, Shyama, Loha raja (Natural iron preparations), Koddalak, Rasanjan (extract of Aloe vera), Madhu (Honey) are used for the management of this condition. Even the use of Lekhan basti (Medicated enemas) has been advocated in obesity. From the above description it is clear that it points towards the Margavarodhajanya samprapti Obstruction in channels). It has been clearly described in the Ayurvedic texts that Madhumeha(Diabetes Mellitus) too develops as a result of either Margavarodha (Obstruction in channels) or due to Dhatukshaya (Tissue emaciation & wasting)