Efficacy of Abhyantar Snehapan and Anuvasan Basti in The Management of Sthaulya

Obesity (Sthaulya) is a chronic disorder characterized by excessive body fat accumulation, predisposing individuals to cardiovascular disease, diabetes, and other comorbidities. In Ayurveda, Sthaulya is described as a Santarpanajanya (overnutrition) condition involving excess Meda (fat) and is managed with Apatarpana (de-nourishment) therapies and Panchakarma detoxification. This study evaluates the efficacy of Abhyantar Snehapan (internal oleation with medicated ghee) versus Anuvasan Basti (medicated oil enema used as Sneha Pravicharana, an alternative oleation method) in the management of obesity, in patients who all subsequently underwent Virechana (therapeutic purgation). A total of 10 obese patients were divided into two groups of 5 each. Group A received internal Snehapan with Go Ghrita (cow ghee) for 7 days, while Group B received Sneha Pravicharana by daily Anuvasana Basti with Bruhat Saindhavadi Taila for 7 days. All patients then underwent a classical Virechana procedure to eliminate vitiated Doshas. Outcomes, including body weight and body mass index (BMI) were measured before treatment and after completion of the therapy. Results: Both groups showed reductions in weight and BMI, but Group A (internal Snehapan) demonstrated a significantly greater mean weight loss (≈3.66 kg, ~4.5%) compared to Group B (≈1.88 kg, ~2.3%) (p<0.01). Group A’s BMI decreased from 31.7 to 30.3 (mean), whereas Group B’s BMI decreased from 32.1 to 31.4. No severe adverse effects were observed in either group. Discussion: Internal oleation was found to enhance the efficacy of Virechana by achieving better systemic lipid mobilization and elimination, resulting in more pronounced weight reduction, while Anuvasana Basti provided moderate improvements. These findings align with classical Ayurvedic principles that emphasize the importance of adequate Snehana for successful Shodhana outcomes. Anuvasana Basti, though less potent in short-term weight loss, offers a viable alternative for patients unable to tolerate oral intake of ghee, and it may be safer or more practical in certain clinical situations. Conclusion: Abhyantar Snehapan combined with Virechana therapy was more effective than Anuvasan Basti (Sneha Pravicharana) combined with Virechana in reducing weight and BMI in obese patients under the conditions of this study. Proper internal oleation appears to facilitate a more thorough detoxification in the management of Sthaulya. Nevertheless, Anuvasana Basti still conferred meaningful benefits and can serve as an alternative Sneha therapy in obesity management, especially for individuals contraindicated or intolerant to oral ghee intake. Further large-scale studies are recommended to confirm these results and to explore long-term outcomes, including metabolic parameters.