Background: Obesity is similar to Sthaulya or Medoroga described in Ayurvedic classical texts. Results from case studies/series and small clinical trials concluded that Ayurveda interventions have been effective in the management of obesity. This protocol aimed to do a systematic review of clinical studies related to Ayurvedic interventions in the management of obesity and further meta-analysis of eligible studies to generate the evidence regarding effectiveness and safety of Ayurvedic treatment modalities for obesity.
Materials and methods: Clinical studies related to Ayurvedic interventions in the management of Sthaulya/Medoroga or overweight/obesity published in English/Hindi will be screened as per the inclusion criteria without restriction on publication date and type. Primary outcomes to be assessed will be improvement in clinical features of Sthaulya/Medoroga and change in body weight, body mass index (BMI), waist circumference, waist–hip ratio, and skin-fold thickness. Data will be extracted independently by two review authors on study characteristics (authorship, publication-related information, methodology, participants, interventions, comparators, outcomes, and results) in a prestructured format for assessment of study quality and data analysis. Two authors will independently assess the risk of bias in included studies. We will conduct meta-analyses only when the included studies will be sufficiently homogeneous in terms of design, study population characteristics, interventions, and outcome measures. If meta-analyses will not be conducive, we will summarize the results of included studies as systematic qualitative synthesis.
Conclusion: The results generated from this review will be helpful in identifying the status of evidence for Ayurvedic interventions in management of obesity. It will also provide way for future research to generate stronger evidence regarding efficacy of Ayurvedic interventions in the treatment of obesity.
Clinical significance: The study will be able to generate evidence for effective implementation of Ayurvedic interventions in treatment and prevention strategies for obesity.
Study registration: PROSPERO 2019—CRD42019130104.
World Health Organization. Obesity: preventing and managing the global epidemic. WHO; 2000.
Yao R, Ananth CV, Park BY, et al. Obesity and the risk of stillbirth: a population-based cohort study. Am J Obstet Gynecol 2014;210(5):457. e1–457. e9. DOI: 10.1016/j.ajog.2014.01.044.
Hackethal V, Obese women may have 25% increased risk for stillbirth. Medscape Medical News. March 27, 2014. Available from: https://www.medscape.com/viewarticle/822711.
Jiao L, Berrington de Gonzalez A, Hartge P, et al. Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts. Cancer Causes Control 2010;21(8):1305–1314. DOI: 10.1007/s10552-010-9558-x.
Kyrgiou M, Kalliala I, Markozannes G, et al. Adiposity and cancer at major anatomical sites: umbrella review of the literature. BMJ 2017;356:j477. DOI: 10.1136/bmj.j477.
Mulcahy N. “Strong evidence”: obesity tied to 11 cancers. Medscape Medical News. 2017 Feb 28. Available from: https://www.medscape.com/viewarticle/876410.
World Health Organization. Available: http://www.searo.who.int/entity/non communicable_diseases/media/non_communicable_diseases_obesity_fs.pdf, last accessed 05 August 2019.
World Health Organization. Available: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight, 2018, February 16, last accessed 05 August 2019.
Shannawaz M, Arokiasamy P. Overweight/obesity: an emerging epidemic in India. J Clin Diagn Res 2018;12(11):LC01–LC05. DOI: 10.7860/JCDR/2018/37014.12201.
Misra A, Chowbey P, Makkar B, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 2009;57: 163–170.
Rucker D, Padwal R, Li SK, et al. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ 2007;335(7631): 1194–1199. DOI: 10.1136/bmj.39385.413113.25.
Abdollahi M, Afshar-Imani B. A review on obesity andweight loss measures. Middle East Pharmacy 2003;11:6–10.
Selvendran SS, Penney NC, Aggarwal N, et al. Treatment of obesity in young people-a systematic review and meta-analysis. Obes Surg 2018;28(8):2537–2549. DOI: 10.1007/s11695-018-3285-x.
Haywood C, Sumithran P. Treatment of obesity in older persons- a systematic review. Obes Rev 2019;20(4):588–598. DOI: 10.1111/obr.12815.
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004;292(14):1724–1737. DOI: 10.1001/jama.292.14.1724.
Valizadeh E, Ghalichi F, Ostadrahimi A. Traditional herbal medicine for weight management: a review. Int J Med Res Health Sci 2016;5(11):393–399.
Vijayakumar TM, Sravanthi A, Vinodhini VM, et al. A randomized double-blind placebo controlled trial of OBERAY (Ayurvedic Proprietary Medicine) in overweight and obese adult population. Obes Med 2017;8:6–12. DOI: 10.1016/j.obmed.2017.09.005.
Prasad SVLN, Rao PV, Punitha V, et al. Efficacy and safety of an ayurvedic regimen in Medoroga. Indian J Tradit Know 2009;8(3):379–386.
Paranjpe P, Patki P, Patwardhan B. Ayurvedic treatment of obesity: a randomised double-blind, placebo-controlled clinical trial. J Ethnopharmacol 1990;29(1):1–11. DOI: 10.1016/0378-8741(90)90092-8.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6(7):e1000097. DOI: 10.1371/journal.pmed.1000097.
Higgins JPT, Green S, ed. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0: updated March 2011. The Cochrane Collaboration; 2011. Available: https://handbook-5-1.cochrane.org/, last accessed on 20 August 2019.
Institute of Medicine. Finding What Works in Health Care: Standards for Systematic Reviews. Washington DC: The National Academies Press; 2011.