METABOLIC DISORDERS

These are more general digestive system disorders characterized by long-term imbalance of body weight.

Obesity

Obesity is the carrying of excessive weight, usually in the form of fat.

The amount of weight that is considered excessive often depends upon the culture. Modern Western culture values thinness (a Vata or air type frame). Many eastern and traditional cultures have valued heaviness (a Kapha or water type frame), indicating affluence or plenty to eat.

Overweight may not be a disease, therefore, but a condition of holding more weight than the cultural standard. It should be noted that attempts to stay artificially thin may be unhealthy and may aggravate Vata, the biological air humor. Overweight truly becomes a disease when extra weight held is quite high and leads to other health problems (hypertension, diabetes or arthritis).

Still, according to Ayurveda, it is better to be too thin than too heavy.

It is easier to build up a person who is too thin than to reduce one who is too heavy. A heavy body is a good breeding ground for toxins (Ama) and may reduce the life expectancy.

Causes of overweight include overeating, eating too much heavy or cold food, too frequent meals, excessive sleeping, and lack of exercise.

Hormonal imbalances may exist. Emotional factors include attachment, sentimentality and clinging. Lack of self-esteem can be an important factor. Sometimes the extra weight becomes a security factor, put on for greater protection in dealing with the world. Generally, the digestive fire will be weak in this disease of low or slow metabolism. It is usually a Kapha (water) disease in Ayurveda.

Weight-reducing and appetite-suppressing drugs may also suppress the digestive fire and, over the long-term, further weaken the metabolism.

They will also increase Vata (air) and thereby aggravate nervous-type obesity.

General Treatment

Overweight requires a lightening (langhana) or reducing method, with light diet, fasting, spicy herbs to improve digestion, mild laxatives to keep the bowels clean. Sometimes tonic herbs provide a deeper kind of nourishment which we may be looking for in excessive eating. Guggul and myrrh are good general herbs, as also shilajit. One gram of guggul or 1/2 gram of shilajit taken two to three times a day with ginger and honey can correct most forms of obesity over a period of several months. Aloe

Digestive System Disorders 155 gel with ginger or turmeric is another good combination. Nervines are useful to calm the tendency towards excessive eating. Best is gotu kola.

The Herbal Reduction Formula (no. 13), taken with honey, is a specific formula for this condition.

Strong reducing therapies should not be started in the winter season, as they can lower heat and resistance. Usually long-term mild reducing therapies will be more successful than short-term crash methods.

Kapha (Water) Type

Overweight is more common in Kapha constitutions. Their metabo-lism is slow, and they easily put on weight. Their appetite is continuous, and they often eat as a means of relieving stress or tension. They can become attached to or addicted to the joys of cooking and eating. In addition, they may suffer from hypo-thyroid or other hormonal conditions that cause them to hold weight.

Their excessive weight consists largely of water and fat. It is usually related to weak function of the pancreas and kidneys, and the pulse and energy level may be low. The individual is generally flabby, pale in complexion with moist skin. There will be excessive phlegm or saliva.

Subcutaneous fat deposits may develop along with benign tumors.

Treatment is primarily dietary, following an anti-Kapha diet for an extended period of time. Sugar and sugar products should be avoided as much as possible. Salt intake should be reduced. Dairy, sweet fruits, breads, pastries, meats, fish and oily foods should be taken as little as possible. Sprouts, yeast and other enzymatic agents should be taken to help in the process of digestion. Food should not be taken before 10 am.

or after 6 pm. Hot spices should be taken to raise the metabolism, along with fasting, unless there is debility. Fruit juice fast should be avoided, with spice teas or vegetable juices taken instead. All cold drinks should be avoided. As the condition is a long-term metabolic imbalance which the system has become used to, these measures should be employed gradually, allowing a slow, natural speeding up of organic functions that will not shock the system.

While it is preferable to eat less in quantity, it is even better to eat a different quality of foods — more vegetables, preferably steamed without oil or salt, beans and whole grains, and less of the heavier foods. Mung beans are excellent.

Excessive sleeping, or sleeping during the day, should be avoided.

Exercise, particularly of an aerobic nature, should be undertaken. How-ever, if the patient is weak, exercise should not be taken to the point of excessive sweating, shortness of breath or fainting.

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Herbs include: hot spices to increase the metabolism — cayenne, black pepper, ginger, garlic and turmeric; bitter herbs to reduce fat — katuka, barberry, gentian, myrrh. Barberry is considered a rejuvenative for fat tissue, both eliminating excess fat and producing better quality tissue. The usual combination of turmeric and barberry is also useful here for obesity. Guggul or myrrh (preferably as a tincture) is specific and can be taken along with spices or bitters.

Ayurvedic formulas include Trikatu or the Digestive Stimulant (no.

1). Mild laxatives such as the Ayurvedic Triphala, aloe gel or cascara sagrada are good. Strong purgatives may not be good; they tend to lower the metabolism further. Trikatu and Triphala together with honey are excellent. A similar effect can be gained combining the Digestive Stimulant (no.l) with the Colon Tonic (no. 5). A specific formula is the Weight Reduction formula (no. IS).

Mild diuretics — plantain, corn silk or gokshura can be helpful, as well as herbs or formulas for improving kidney function such as shilajit.

Nervine herbs such as gotu kola and calamus combined or skullcap counter the habit side of the disease.

Chinese formulas include Citrus and Craetagus, which is, generally, good for overeating and food stagnation (Arna) conditions. Additional Western herbs are alfalfa, dandelion and chicory roots.

Vata (Air) Type

Vata caused obesity is characterized by irregularity in weight. Periods of overweight fluctuating with periods of normal weight, or even under-weight, may occur. Weight gain or weight loss may be sudden or unpre-dictable. Appetite will also be variable. Excessive amounts of sugar or carbohydrates taken to help calm the nerves will contribute to obesity.

Psychological factors are fear, anxiety, worry and nervousness. Extra weight will give greater feelings of security or stability.

The most difficult form of obesity is a combined Vata-Kapha type with a nervous mind (Vata) and a slow metabolism (Kapha). Mental habit and physical weakness combine in ways that are difficult to counteract.

Under such conditions it is better to aim at reducing Vata (calming the nerves) than reducing Kapha (applying restrictive diet).

Treatment involves anti-Vata diet but with emphasis on complex carbohydrates. Foods to be taken include whole grains and starchy vegetables. Pure sugars should be avoided. Spices should be used with discretion; fewer of the hot spices (pepper and cayenne) and more of the spicy-sweet ones (fennel, cardamom, coriander).

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Digestive System Disorders 157 Ayurvedic formulas include Asafoetida 8. Herbs to calm the mind and allay nervous habits are good, including gotu kola, calamus, jatamansi, nutmeg and valerian, or formulas like Sarasvat powder. Guggul or myrrh are helpful here also.

Pitta (Fire) type

Pitta obesity is usually caused by overeating. The appetite is high and the digestion is usually good, so there will be a tendency to eat more. As fire types can best digest sugar, they can also become addicted to it. They will also tend to eat more red meat. Weight will involve a good develop-ment of muscle and not just flab.

Treatment involves anti-Pitta diet. Meat, fish, oily or greasy food should be avoided, as well as sugars and pastries. One should take raw salads along with green herbs and chlorophyll. Digestive bitters are specific, as well as bitter laxatives.

Ayurvedic herbs include aloe, katuka, barberry, turmeric. Formulas include Sudarshan powder, the Liver Tonic (no. 8) and other liver-regulat-ing formulas. Chinese formulas include Major Bupleurum combination.

Helpful Western herbs are barberry, gentian, dandelion, cascara sagrada and Swedish Bitters formula.

Gems for Saturn, such as blue sapphire or amethyst, are helpful for obesity along with gems for Mercury like emerald, peridot and jade. Ruby or garnet for the Sun can be helpful when the condition is due to chronically low digestive fire.

Underweight

Underweight can also be a disease, though in our culture it is not always recognized as such. Lack of body weight can cause poor resis-tance, low vitality, nervousness and insomnia. There will be lack of appetite, depression, malaise, and psychological instability.

There may be wasting away of the tissues including loss of hair, falling of teeth, weakness of the bones and lack of sexual vitality, as well as other signs of premature aging.

Causes are frequently constitutional. Undue suppression of the diges-tive fire — too much fasting, dieting, or too much eating of light, cold or raw food, irregular eating habits, etc. — can contribute. Other factors include overwork, too much exercise and excessive sexual activity.

Psychological factors are worry and grief (often following loss of a loved one), excessive study or too much mental activity.

Low weight may also be involved in convalescence from a severe disease that has depleted the body tissues. It may occur more commonly

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in the elderly or in children. Treatment involves an increasing or tonifica-tion therapy. Heavy, rich nutritive diet is taken along with tonic, building herbs.

Underweight is usually a Vata condition, as air types tend towards lightness. Vata individuals often forget to eat or their irregular eating habits cause long term suppression of the digestive fire. Use of stimulant drugs such as amphetamines can bring this condition about also.

Treatment

An ami-Vata diet is usually best. Meat and fish are helpful or other heavy foods like root vegetables, whole grains, nuts, dairy, oils and sugar.

Meat or bone marrow soup may be necessary in the beginning or a mild starchy grain gruel (rice, mung beans or oats).

" Spices are indicated but not necessarily in the beginning treatment.

The hotter-spices in particular, may cause further depletion of vital fluids by their drying nature, and overstimulate what is usually already a hypermetabolism.

Tonic herbs are essential: ashwagandha, shatavari, bala, licorice prepared in milk. Ayurvedic formulas are Ashwagandha compound, Shatavari compound, Dhatupaushtic compound, Chyavan prash. These can be taken with milk or draksha.

Additional Western herbs include comfrey root, slippery elm, marshmallow, and saw palmetto. Chinese herbs are ginseng, astragalus, dang gui, and rehmannia; formulas include Ten Major Tonic and Woman's Precious Pill.

Pitta (Fire) Type

Underweight can also occur as a high Pitta condition in which persons literally burn themselves up. Often there is high fire in the mind with excessive thinking and an overly critical nature. The condition may follow a severe febrile disease, blood loss or hepatitis. Anemia and poor liver function are usually involved.

Treatment is similar to that for Vata with an anti-Pitta diet that emphasizes building-type foods. All spices are to be avoided. Salads and raw vegetables should not be taken in excess, as they are not strengthening enough but cooked vegetables are good. A milk fast may be advisable in the beginning. Ghee is excellent. Whole grains such as wheat and rice are good and mung beans in specific. Raw sugars can be used in moderation.

Ayurvedic herbs include aloe gel, gotu kola, and shatavari. Guduchi is excellent. Formulas include Chyavan prash, Brahma rasayan, and Shatavari compound.

Digestive System Disorders 159 Chinese herbs include ho shou wu (fo ti) and formulas include Women's Precious Pill (can be used by men also). Additional Western herbs are comfrey root, marshmallow, slippery elm, American ginseng, and licorice.

When underweight, gems for Jupiter such as yellow sapphire, yellow topaz or citrine are best, along with gems for Mercury such as emerald, peridot and jade. Green color, that of Mercury, is good for regulating metabolism: for increasing weight in those too thin; for decreasing it in those too fat.

Anorexia

Anorexia can become a severe condition connected to over-dieting and underweight. The digestive fire may be suppressed to the point where no food can be taken in or held in the stomach. There can be repeated vomiting to the point of dehydration. Causes are usually emotional traumas or chronic undereating.

While nausea, vomiting and mild anorexia are usually symptoms of a Kapha (water) disorder, severe anorexia with pronounced weight loss is mainly a high Vata (air) condition involved with fear, nervousness, insomnia, pain in the chest and abdomen and palpitations. There may be a feeling of constriction in the throat, along with difficulty swallowing, possibly with a feeling of choking.

Even Vata people can become anorexic or lose their appetite if they eat too many sweet or Kaphogenic foods, particularly at the beginning of meals, like sugars, ice cream, milk, cheese or yogurt. Vata types like the calm they feel by excess eating of sugars and carbohydrates, but it can derange them further. Periods of overeating of carbohydrates may alter-nate with periods of lack of appetite and undereating, thus deranging the whole digestive process and leading ultimately to severe anorexia.

Treatment

Spices to regulate digestion and stop vomiting — cardamom, fennel and fresh ginger — are required. Ayurvedic formulas include Cardamom compound or Asafoetida 8, but remember that the taste of asafoetida may be hard to take.

A mild bland diet is best such as Kicharee (equal parts rice and mung) or meat soup (preferably chicken). Coffee, tea and all drugs and stimulants must be avoided. The rest of the treatment is like that for underweight, , with tonics like Chyavan prash and Ashwagandha compound.

In addition, calming and grounding nervine herbs should be taken including valerian, nutmeg, ashwagandha or sandalwood. Rest and a

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calming and supportive environment are required. Two parts ash-wagandha and one part gotu kola are excellent taken with 1/2 part of cardamom and fennel. One to two teaspoons of the powder is infused in a cup of water with a little honey and sipped every 2-3 hours until the system is calmed.

Sesame oil massage is very helpful, particularly to the head and feet (but not to the abdomen). Sandalwood oil to the head often restores balance and calm.

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