An Ayurvedic Perspective on Sthaulya: Lifestyle and Dietary Interventions with Special Emphasis on Aptarpana (Langhana) and Autophagy

Abstract

Obesity is the accumulation of fat that adversely affects health, contributing to diabetes, cardiovascular disease, hypertension, and dyslipidaemia. In Ayurveda, Sthaulya is viewed as a Santarpanottha disorder related to disrupted Meda metabolism. Modern research suggests that fasting-induced autophagy modulates lipid metabolism and adipokine balance. Objective: To synthesize Ayurvedic classical and contemporary biomedical perspectives on Sthaulya and explore how interventions such as Langhana (Aptarpana) may mechanistically engage autophagy to mitigate obesity and its complications. Methods: This narrative review examines classical Ayurvedic texts (e.g. Charaka, Shushruta, Aṣṭanga Hridaya) for concepts of Sthaulya, Nidana, Samprapti, and therapies (diet, fasting, lifestyle, local therapies). Contemporary literature (PubMed, Google Scholar) on obesity, fasting, autophagy, adipokines, and lipid metabolism was surveyed. Results: Ayurvedic treatments emphasize moderation in Ahara and Vihara, use of Langhana or light diet, localized therapies (e.g. Udvartana), and when suitable, shodhana (Vamana, Virechana). Fasting may activate autophagy, possibly reducing ApoB100, modulating TNF-α, IL-6, leptin/adiponectin, improving lipid profile, and insulin sensitivity. A theoretical integration supports a translational framework. Conclusion: Structured Langhana may potentially harness autophagy to restore homeostasis in Meda Dhtau in Sthaulya. Clinical trials with biomarker endpoints are needed to validate safety, dosing, and efficacy.