role of herbal treatment in obesity

8/21/2019 Role of Herbal Treatment in Obesity

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TERM PAPER ON THE COMPREHENSIVE AND

DETAILED STUDY OF THE

ROLE OF HERBAL MEDICINE IN OBESITY

UNDER THE GUIDANCE OF

Dr. Swati Madan

(M.Pharm , Phd.)

SUBMITTED BY

Nipurn Bajaj

B.Pharm

A4513310015

AM ITY INSTITUTE OF PHARMACY , AM ITY UNIVERSITY


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ACKNOWLEDGEMENT

At the very outset, I would like to express my deepest gratitude to my mentorDr. Swati

Madan (assistant professor), Amity Institute of Pharmacy, Amity University for the

encouragement and guidelines for this comprehensive study. I take this opportunity to

express my gratitude to the people who have been instrumental in the successful completion

of the project.

I would like to show my greatest appreciation to maam, who gave me the opportun ity to

work on such an important topic. Without her encouragement and guidelines this project

would not have materialized.

Last but not the least I am also thankful to all those who have directly or indirectly rendered

help in completion of my work.

NIPURN BAJAJ


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Declaration

I hereby declare that project entitled Role of Herbal Medicine in OBESITYsubmitted to department of amity institute of pharmacy under the affidavit of

AMITY UNIVERSITY NOIDA, NOIDA.

This term paper has not been submitted elsewhere and is authentic work of ours.

Nipurn Bajaj

Amity institute of pharmacy


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ABSTRACT

Obesity is a global epidemic and most common disorder in the developed world. Intake of fats and

carbohydrates in excess results in Obesity. Obesity means having too much body fat. To meet this definition,one must weigh approximately 20 percent or more above one's desirable body weight. Age, height, and body

frame help determine ideal body weight. Lack of exercise, physical work also helps in accumulation of fat in

the body. In Ayurveda this condition is called Medoroga. Traditional herbal medicines may have more

acceptance than prescription drugs in many cultures with emerging epidemics of obesity. Numerous

alternative therapies are advocated for weight-loss,Including dietary modifications, hypnotherapy, and

acupuncture. Many herbal medications and dietary supplements such as conjugated linoleic acids, chitosan,

Garcinia cambogia, and Citrus aurantium, are also being used. No single approaches will successful treat

obesity. Lifestyle modification and herbal medication presently remains the main pillars of any intervention

aiming at decreasing bodyweight. This review focuses on the efficacy and safety of effective herbal

medicines in the management of obesity in human.

Key-Words-: Obesity, herbal-medicines,pharmacotherapy,herbal therapy,medoroga


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INTRODUCTIONObesity is one of the leading preventable causes of death worldwide.

A sedentary lifestyle plays a

significant role in obesity. Overweight and obesity are the most common nutritional disorders in developed

countries, affecting the majority of adults in the country. Management of this condition involves a variety of

approaches from nutritional advice to lifestyle alteration, drugs and in extreme instances - gastric surgery.

The present account concentrates on pharmacological interventions of herbal drugs. The prevalence of

obesity is increasing worldwide resulting in an association with major health problems such as type 2

diabetes, ischemic heart disease, stroke, cancer, hypertension, hyperlipidaemia and osteoarthritis. It is

necessary to treat obese individuals by both lifestyle interventions and/or pharmacological therapy.

Pharmacologic treatment and surgical interventions used in some circumstances are not always appropriate.

Unfortunately, drug treatment of obesity despite short-term benefits, is often associated with rebound

weight gain after the cessation of drug use, side effects from the medication, and the potential for drug

abuse. It is necessary to treat obese individuals by both lifestyle interventions and/or pharmacological

therapy. Complementary and alternative therapies have long been used in the Eastern world but recently

these therapies are being used increasingly worldwide. When conventional medicine fails to treat chronic

diseases and conditions such as obesity efficaciously and without adverse events, many people seek

unconventional therapies including herbal medicine Worldwide there has been a large shift towards less

physically demanding work,and currently at least 60% of the world's population gets insufficient exercise.

This is primarily due to increasing use of mechanized transportation and a greater prevalence of labor-

saving technology in the home. In children, there appear to be declines in levels of physical activity due to

less walking and physical education. The World Health Organization indicates people worldwide are

taking up less active recreational pursuits, while a study from Finlandfound an increase and a study from

the United States found leisure-time physical activity has not changed significantly. In both children and

adults, there is an association between television viewing time and the risk of obesity.A 2008 meta-

analysis found 63 of 73 studies (86%) showed anincreased rate of childhood obesity with increasedmedia

exposure, with rates increasing proportionally to time spent watching television.Large-scale American

and European studies have found that mortality risk is lowest at a BMI of 2025 kg/m2 in non-smokers

and at 2427 kg/m2

in current smokers, with risk increasing along with changes in either direction.Inthe

United States obesity is estimated to cause an excess 111,909 to 365,000 deaths per year,while 1

million(7.7%) of deaths in the European Union are attributed to excess weight. On average, obesity reduces

life expectancy by six to seven yearsa BMI of 3035 reduces life expectancy bytwo to four years, while

severe obesity (BMI > 40) reduces lifeexpectancy by 10 years.Obesity is from the Latin obesitas, which

means "stout, fat, or plump." sus is the past participle of edere (to eat), with ob (over) added to it.


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November 26th (every year) is dedicated as Anti-Obesity Day in India. Obesity is a medical condition in

which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading

to reduced life expectancy and/or increased health problems. It is defined by body mass index (BMI).

BMI is calculated by dividing the subject's mass by the square of his or her height, typically expressed

either in metric or US customaryunitsMetric:BMI = ki lograms / meters2. (singh.Netal2010)

Types of OBESITY (WHO: Obesity and overweight, 2009)

Simple Obesity

This type of obesity describes the majority of cases. In most situations, obese people will consume more

calories than the body can burn. The number of calories that the body is able to burn varies between

individuals, depending on factors that include the body's metabolic activity and lifestyle. Some people are

able to burn more calories and can consequently eat more, while other people burn significantly fewer

calories. This population variance occurs as a result of a number of factors that include genetics, activity

levels, age, gender, and overall health.

Medical professionals can help you gain control of your body weight by providing guidelines that suggest

how much a person of your height, age, and gender should consume. A dietician can help you plan meals so

that you do not accidentally over-eat.

Many people with simple obesity are able to lose weight by monitoring their caloric intake, dieting, and

exercising. Talk to your doctor about safe ways to diet, especially if you have other medical conditions such

as hypertension, diabetes, anemia, and heart problems.

Secondary Obesity

Some medical conditions can cause your body to experience a hormone imbalance. As a result, you may

gain weight, even if you diet and exercise. Certain thyroid conditions can cause you to gain weight as a side

effect. Other medical problems include Cushing's syndrome, polycystic ovary syndrome, and insulin tumors.

A simple blood test may be available to determine whether you have any of these underlying conditions.

Many health problems are identifiable through a routine physical exam.


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Childhood Obesity

A rising number of children and adolescents fall outside of the healthy weight range for their height and

weight. Children and adolescents who are obese are at risk for developing complications as they age

including diabetes, hypertension, thyroid problems, and high cholesterol - conditions that normally affect

older adults. As a result, obese children may experience complications in their growth and development.

Mood Disorders

Certain mood disorders such as depression can cause you to over-eat and gain weight. While some people

stop eating when they are depressed, others will eat more - sometimes to an unhealthy extent. Usually,treating the mood disorder is the first step to helping you treat your obesity. If you think that you have a

mood disorder and you are gaining weight, you should talk to a doctor immediately. Treating your mood

disorder will help you stop gaining weight, but you will still need to determine a course of action to

effectively lose the weight that you have gained.

Medications

Certain medications can cause you to gain weight. One drug that can cause your body weight to fluctuate is

the birth control pill. Steroids can also cause people to gain weight by increasing appetite.


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CAUSES

1) High glycemic diet.

2) Genetic disorder

3) Eating disorder

4) Stressful mentality

5) Insufficient sleep

Herbal medicine is the oldest form of healthcare known tomankind. The World Health Organization

(WHO) estimates that 4 billion people, 80 percent of the world population, presently use herbalmedicine fo r some aspect of p rimary health care. Various allopathic ar e present in market for the

treatment of obesity. Some anti-obesity drugs have severe and often life- threatening side effects. The

allopathic drugs carry risk of high blood pressure, faster heart rate, palpitations, closed-angle glaucoma,

drug addiction, r e s t l e s s n e s s , agitation, and insomnia. Some drugs, b loc ks absorption of dietary

fats, and as a result may cause oily spotting bowel movements, oilystools, stomach pain, and flatulence.

Because of the various side effects are often associated with their mechanism of action, people are

moving towards herbal drugs. ( "WHO | Physical Inactivity: A Global Public HealthProblem,2009)


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PLANTS HAVING ANTI-OBESITY ACTION(, Apovian CM etal (February 2006).)

THE FOLLOWING TABLE CONSISTS OF VARIOUS PLANT SHOWING ANTI-

OBESITY ACTION AS FOLLOWS :-

S.No Plant Name Common Name Biological Source M.O.A

1 Trifala Trifala Terminalia chebula Help in proper

distribution of fat

2 Cabbage Cabbage Brassica oleracea Inhibit the

conversion of sugarother carbohydrates

into fat

3 Tomato Tobacco

hornworm

Manduca sexta It is a reverse leptin

resistance

4 Guggal Guggal Commiphora mukul Increase

triglycerides level

5 Guar gum Guar flour Cyamopsis

tetragonolobus

Inhibit digestion

6 Caffeine Theobroma

cacao

Coffea Arabica Has anorectic and

thermogenic actions

7 Garcinia Vilayati imli Garcini a cambogia Inhibit fat production

8 Cascara Bitter bark Rhamnus purshianus Works as a laxative

9 Aloe vera Curacoa aloe Aleo barbadensis Increases the bowel

movement

10 Onion Onion thrips Al ium cepa Lowers blood

cholesterol level


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Mechanisms of action (lamxi etal feb 2009)

Anti-obesity drugs operate through one or more of the following mechanisms:

Suppression of theappetite.Catecholamines and their derivatives (such asphentermine and

otheramphetamine-based drugs) are the main tools used for this, although other classes of drugs such as

anti-depressants and mood stabilizers have been anecdotally used for appetite suppression

(bupropion andtopiramate). Drugs blocking thecannabinoid receptors may be a future strategy for

appetite suppression

Increase of the body'smetabolism

Interference with the body's ability to absorb specific nutrients in food. For example, Orlistat (also

known as Xenical and Alli) blocks fat breakdown and thereby prevents fat absorption. The OTC fiber

supplementsglucomannan andguar gum have been used for the purpose of inhibiting digestion and

lowering caloric absorption

Anorectics are primarily intended to suppress the appetite, but most of the drugs in this class also act

asstimulants (dexedrine,e.g.), and patients have abused drugs "off label" to suppress appetite (e.g.digoxin).

HOME REMEDIES FOR OBESITY

1) Obesity treatment using Lime Juice-HoneyFasting on lime juice-honey water is highly beneficial in the treatment of obesity. In this mode of

treatment, one teaspoon of fresh honey should be mixed with the juice of half a lime in a glass of

lukewarm water and taken at regular intervals.

2) Obesity treatment using JujubeThe leaves of jujube or Indian plum are another valuable remedy for obesity. A handful of leaves should be

soakedovernight in water and this water should be taken in the morning, preferably on an empty stomach.

This treatment should be continued for at least one month to achieve beneficial results.
http://en.wikipedia.org/wiki/Appetitehttp://en.wikipedia.org/wiki/Catecholamineshttp://en.wikipedia.org/wiki/Phenterminehttp://en.wikipedia.org/wiki/Amphetaminehttp://en.wikipedia.org/wiki/Bupropionhttp://en.wikipedia.org/wiki/Topiramatehttp://en.wikipedia.org/wiki/Cannabinoid_receptorhttp://en.wikipedia.org/wiki/Metabolismhttp://en.wikipedia.org/wiki/Orlistathttp://en.wikipedia.org/wiki/Glucomannanhttp://en.wikipedia.org/wiki/Guar_gumhttp://en.wikipedia.org/wiki/Anorectichttp://en.wikipedia.org/wiki/Stimulanthttp://en.wikipedia.org/wiki/Dexedrinehttp://en.wikipedia.org/wiki/Digoxinhttp://en.wikipedia.org/wiki/Digoxinhttp://en.wikipedia.org/wiki/Dexedrinehttp://en.wikipedia.org/wiki/Stimulanthttp://en.wikipedia.org/wiki/Anorectichttp://en.wikipedia.org/wiki/Guar_gumhttp://en.wikipedia.org/wiki/Glucomannanhttp://en.wikipedia.org/wiki/Orlistathttp://en.wikipedia.org/wiki/Metabolismhttp://en.wikipedia.org/wiki/Cannabinoid_receptorhttp://en.wikipedia.org/wiki/Topiramatehttp://en.wikipedia.org/wiki/Bupropionhttp://en.wikipedia.org/wiki/Amphetaminehttp://en.wikipedia.org/wiki/Phenterminehttp://en.wikipedia.org/wiki/Catecholamineshttp://en.wikipedia.org/wiki/Appetite


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3) Obesity treatment using Cabbage

Cabbage is considered to be an excellent home remedy for obesity.Recent research has revealed that a

valuable chemical called tartaric acid is present in this vegetable which inhibits the conversion of sugar and

other carbohydrates intofat. Hence, it is of great value in weight reduction. Substituting a meal with cabbage

salad would be the simplest way to stay slim.

4) Obesity treatment using Tomato

One or two ripe tomatoes taken early morning as a substitute for breakfast, for a couple of months, are

considered a safe method of weight reduction. They also supply the food elements essential to preserve

health.

5) Obesity treatment using Finger MilletFinger millet is an ideal food for the obese, because its digestionisslow and due to this, the carbohydrates

take a longertimeto get absorbed. By eating preparations made of finger millet, the constant desire to eat

is curbed, thus reducing the daily calorie intake. At the same time, finger millet supplies an abundant

quantity of calcium, phosphorus, iron, Vitamin B1 and B2 and prevents malnutrition in spite of restricted

food.

6) Obesity treatment using Ephedra and caffeine.The combination of ephedrine and caffeine has both anorectic and thermogenic actions ,thereby

assisting weight loss and weight maintenance by affecting both aspects of energy balance. The modes of

actions of ephedrine and caffeine and their interactions, particularly in relation to their stimulatory effects

on thermogenesis, have been described with ephedrine promoting the release of noradrenalin and

caffeine potentiating or prolonging noradrenalin-mediated thermogenesis by reducing negative feedback

mechanisms that inhibit noradrenaline release and actionsthemetabolism slows down.

7) Obesity treatment using Cascara

Cascara, works as a laxative and is a common ingredient in most herbal slimmer

8) Obesity treatment using Dandelion

It is an excellent diuretic leads to weight loss by reducing the water content of the body


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9) Obesity treatment using Aloe Vera

Aloe Vera consumed orally works to increasing bowel movements, if consumed wrongly or on excess

it can lead to abdominal cramping, diarrhea and decrease in potassium level in the body.

10) Obesity treatment using Garcinia

Garcinia fruit is a rich source of hydroxycitric acid (HCA), the active agent that aids in weight loss by

inhibiting fat production and suppressing appetite. Garcinia contains citrine, an extract that is 50-60%

HCA, which inhibits an enzyme that helps the body synthesize fat for storage in adipose tissue.

11) Obesity treatment using Guggul

Also known as Commiphora Mukul and Indian Bedellium, is a very effective It has been shown thatGuggul can lower blood cholesterol by 14-27% and can lower triglycerides by 22-30%. The effects that

Guggul has on the blood cholesterol levels is comparable to prescription medications but, being a

natural plant extract, it is a far superior and much safer product. Guggul works on the liver by

increasing the metabolism (or break down) of the bad cholesterol known as LDL Cholesterol. After

taking the product for 4 to 12 weeks, total cholesterol levels can drop triglyceride levels can drop and an

increase in HDL (the good cholesterol) of approximately 16% can occur. Its benefits as a weight- loss and

fat burning agent have been well researched and documented in several studies... It is a well

established fat burning agent.

12) Obesity treatment using Green Tea

This tea is a natural stimulant that behaves much like coffee but with the added benefit of vitamin C

and flavoniods (compounds that are antioxidants). You can regulate the strength of the stimulant by

steeping the tea quickly or for a long time. It can be purchased in a tea bag, or loose. It also is available

in capsules, but is said to be better assimilated as a liquid.


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13) Weight loss by natural Vitamins

Weight loss vitamins naturally occur in various forms like natural weight loss thermogenic formulas,

natural weight loss fat burners, natural weight loss diuretics, and natural weight loss fat blockers.The

best vitamins can be the ones that help in accelerating fat loss support like reducing hunger, enhancing

metabolism, utilizing fat and enhancing energy levels. Any vitamins that can naturally help to achieve

increasedperformance of fat loss support are the most effective weight loss natural vitamins. Most of

these natural weight loss vitamins contain Citrin, CLA, and Garcinia, lipase, theobromine and guggul

lipids. All these nutrients together help support healthy digestion. Citrin is a proven formula to suppress

appetite and maintain body fluid balance. Lipase works to break down fats and make it available for

utilization. CLA or Conjugated Linoleic Acid helps in reduction of body fat and is a valuable element

of weight management program. Theobromine also plays a key role in weight loss supplements as it aids

in maintaining healthystress levels, suppressingappetite and promoting mental health. Some of the naturalweight loss vitamins also contain a special kind of fiber that expands in the stomach and aids in

reducing hunger. Some of the other micronutrients that play a vital role in weight reduction are vitamin A,

vitamin C, vitamin B and zinc and some patented form of chromium. All these nutrients are clubbed

together to keep lean body mass and speed up fat loss.

AYURVEDA AND OBESITY (laxmi etal feb 2009)Ayurvedic treatments for obesity consist of panchakarma treatments, rasayana treatments and other diet

regulations. Panchakarma treatments are needed to remove theaccumulated toxins from the body and to

bring him back to normal self. Ayurveda cautions us that attempts to stay artificially thin may be

unhealthy and may aggravate vata dosha. Efforts at reducing body weight must take into consideration a

persons constitution also. According to Ayurveda a mild, long-term reducing plan is more natural than

crash diets. Management ofObesity includes reducing or lightening therapy with a light diet, fasting, and

digestive (spicy) herbs.

1) Panchakarma

The body purification treatments (Panchakarma) consist of five actions: Vamanam, Virechanam, Nasyam,

Vasti & Raktamoksham-. Vamanam is emesis, Virechanam is purging, Nasyam is instillation of

medicines through nose, Vasti is enema & Raktamoksham is bloodletting.


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Panchakarma Treatment (in three stages)

The panchakarma treatments used as a method of body purification comes in three stages; Purva Karma

(Pre- Purification phase), Pradhana Karma (Main Purification phase) and Paschat Karma (The Post

Purification phase). The patient who opts for any one of the five therapies must invariably undergo all

three stages. Pre-purification phase is done to prepare the body for the main treatment and consists of

massaging the body with herbal oils. The post purification phase consists of rehabilitative measures which

include guidelines on diet & lifestyle etc. Oral medicines including lehyams and kashayams are also

recommended in post purification treatments.

Panchakarma- Enhancing the Potential in Every Human

BeingPanchakarma is more than a cleansing procedure. It comes with several unheard of benefits including

slowing down the ageing process and strengthening the immune system.It enhances digestive processes,

improves sleep pattern and energizes the body. It brings in a sense of peace, contentment andtranquility

and helps us lead healthy lives.

2 ) Nutritional Therapy for Obesity.

Treatment involves eating differently, not eating less. More than half of the calories eaten each day

should come from carbohydrates, and less than a quarter should be derived from fats. The remainder of

calories should come from proteins. Carbohydrates and proteins supply four calories per gram, while fat

provides nine.

Some of the foods that should be emphasized include:

High-fiber and unrefined complex carbohydrates, such as whole grains, because the body is less

successful digesting these and feels full sooner than with refined carbohydrates, such as sugar

and white flour

Raw or lightly cooked vegetables

Protein with low amounts of saturated fat, including dry peas and beans

Nutritional therapy's treatment program for obesity also calls for drinking plenty of purified water each

day, altering eating habits, and exercising daily. Certain nutritional supplements may also be prescribed.

Supplementsofzinc, B vitamins, and chromium may prove useful


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3) Detoxification, Fasting, and Colon Therapy forObesity.

Detoxification therapy holds that certain toxins (from chemicals to pesticides) can build up in the body,

particularly in fat cells. These toxins need to be cleansed away as part of a dietaryand exercise treatment

program for obesity. In addition, various detoxification regimens can help prevent obesity from returning.

Treatments may include fasting, colonic irrigations, and several other measures.

Several herbs, such as dandelion root or burdock, can be used in conjunction with a detoxification and

fasting regimen to boost the function of the liver, which cleanses toxins from the body. A juice fast for

detoxification might consist of carrot and green vegetable juices diluted with an equal amount of water.

Consume one quart daily, plus additional water if thirsty. Any fast should be supervised by a health care

professional.

4) Hypnotherapy for Obesity.Hypnotic trances dealing with eating habits and recognizing true hunger, coupled with a diet and exercise

program, are particularly effective for obesity treatment Possible herbal treatments include dandelion

root, plantain, and garcinia. Aroma means scent, and therapy means treatment. Aromatherapy, then is

the use of the fragrant parts of aromatic plants to improve your health and general well being.

5) Aromatherapy

Have many other benefits, too. Inhaling the appropriate fragrance can reduce stress, lift a depression,

hasten a good night's sleep, soothe your soul, or give you more energy. Aromatherapy is already helping

office workers stay alert while doing repetitive mental tasksandhospitals are experimenting with using

aromatherapy to help patients relax. Massaging aromatic oils into your skin is another way to benefit from

aromatherapy. That'sbecause essential oils, the compounds responsible for a plant's fragrance, offer a

multitude of healing benefits in addition to their individual scents. A pungent liniment such as Chinese

Tiger Balm, for instance, eases aches and pains and the latest fragrant shampoos and body oils will

improve the health of your complexion and hair while at the same time inducing a particular mood.

Aromatherapy, then, is very versatile and can be used in many different ways to treat a wide range of

physical and emotional problems. Common plants like rosemary, lavender, oranges, and lemon all

produce essential oils that can be used therapeutically.


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CONCLUSION

Obesity has been the problem in effluent societies of developing and developed world. Hence the diseases,

which are common manifestation of obesity, are prevalent in obese persons. To get rid of those diseases it is

necessary to avert obesity. In light of above discussion it is proposed that the herbal drugs may be a vital tool

tofight against obesity and prevent such diseases likehypertension, MI, diabetes mellitus before their

occurrence. The widespread use of herbal compounds for management of obesity should be of concern to

clinicians and policy makers. Clearly, patients will continue to access traditional healing systems as it is

important to local cultural values and beliefs. Therefore, efforts should be made by mainstream health

professionals to provide validated information to traditional healers and patients on the judicious use of

herbal remedies. This may reduce harm through failed expectations, pharmacologic adverse events and

unnecessary added therapeutic costs. Efforts should also be directed at evaluating the possible benefits

natural products in obesity treatment nature.


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