HERBAL WAYS FOR OBESITY REMEDIES
1Rathore K. S. *, 2Nema R. K., 1P. Sunita, 1B. Meenakshi, 3Sisodia S.S.,3M.S.Ranawat
Â 1B. N.Â Girls' College of Pharmacy, Udaipur (Raj.) 313002
2Rishiraj College of Pharmacy, Indore-MP
3B. N.Â College of Pharmacy, Udaipur (Raj.) 313002
Obesity is a very common problem worldwide; more than 5% population of the world is suffering from it. Obesity is a condition of abnormal body weight resulting from an accumulation of extra adipose tissue, generally in response to a state of positive energy balance that occurs when energy intake exceeds energy expenditure. Obesity is characterized by an elevated body mass index (BMI), which s defined as the weight of an individual in kilograms divided by the square of the height in meters. The cause of obesity is complex but a combination of behavioral, genetic, hormonal and economic factors but also in terms of its distribution through waist circumference or waist-hip circumference ratio measurements. In addition, the presence of obesity needs to be regarded in the context of other risk factors and comorbidities (other medical conditions that could influence risk of complications).
Various herbs are used in curbing obesity like guggal, ephedra, nomame herba, galega, laxatives, caffeine, tobacco and fibers.
Obesity is a growing health problem in many of the richest nations of the world and should now be considered as a chronic disease that is reaching epidemic proportion. (Rang, H.P.)
Obesity is a condition of abnormal body weight resulting from an accumulation of extra adipose tissue, generally in response to a state of positive energy balance that occurs when energy intake exceeds energy expenditure. Obesity is characterized by an elevated body mass index (BMI), which s defined as the weight of an individual in kilograms divided by the square of the height in meters, or Kg/M2. When
Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â BMI is 20-25 (healthy person)
Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â BMI is 25-30 (over weight)
Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â BMI is ?35 (obese)
Obesity is growing problem in most rich nations. The incidence at present 30% in USA and 20% in Europe- is increasing. (Report of a WHO) In the United States, the disease varies significantly by age, race and gender and is more prevalent in certain socio economic groups (Mokdad, A.H., 1999). Interestingly, more people in the world are classified as overweight and obese rather than as malnourished, according to WHO. (Must A., Spadano, J., 1992)
According to recent epidemiological data, obesity increases susceptibility to a wide range of both cardiovascular and metabolic diseases (Hubert, H.B., 1983, and Kissebah, A.H., 1982) including hypertension (Dyer A.R., 1989) non-insuline-dependent diabetes mellitus or NIODM (Chan J.M., 1994 and Ford E.S., 1997) andÂ hyperlipiodemia (Tchernof, A., 1996), and is an independent risk factor for certain cancers, including breast, colorectal and endometrial cancers (Schapira D.V. 1994, and Chute C.G., 1991), that result in diminished quality of life.
A recent survey provided estimates that more than 17million Americans took over the counter (OTC) weight loss products, more than Â¼ of young obese women and 8% of normal weight women use non-prescription weight loss products, and more than 1/3 of women and 1/10 of men who use prescription wt. loss products also use OTC products (Blanck, H.M., 2001). Direct-to-consumer advertising has dramatically increased the sales of products for weight loss. By 1997, over 10 million prescriptions for â¬ÅPhen-fen had been written (Morb Mortal Wkly Rep., 1997) Americans consume 225,000 capsules of metabolite every hour (Annual retail revenues of $900 millions). (Reno, J., 1999)
CAUSES OF OBESITY
The cause of obesity is complex but a combination of behavioural, genetic, hormonal and economic factors. All play critical roles in the origin and progression of the disease (Carpino, P.A 2003). The main cause of obesity depends on two factors (Rastogi, R., 1997):-
Endogenous FactorsÂ Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Exogenous Factors
Endocrine problemsÂ Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Imbalance diet
Genetic problemsÂ Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Low energy expenditure
Emotional problemsÂ Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Side effects of certain drugs
Obesity is complex physiological process that results from:
- Disruption of endogenous systems involved in the regulation and maintenance of energy homeostasis mechanism.
- Mechanism that signal the level of fat store e.g. leptin (has ob-R receptor present on ARC neuron) act as a depot sensor of energy stores in body, relaying information to controlling sites in hypothalamus.
- When leptin increased it causes release of alpha-melanocyte stimulating hormone (anorectic hormone) which activate systems that results in decreased food intake and increase energy expenditure, but when leptin decreased it causes release of neuro-peptide Y and agouti related protein (or exogenic hormones) which have opposite effect.
- Insulin also act as depot sensor of energy stores, it stimulates leptin release from fat cells and it enters the CNS where it can decrease food intake by affecting the action of NPY.
- Other factors that control energy balances are; endocrine, autonomic mediators, GI peptides, CNS transmitters etc.
- Fat cells, both white cells (as lipolytic agent) and brown cells (as thermogenic agent) has major role in control of energy balance.
- Decreased thermogenesis in adipocytes owing to reduction of beta 3 adrenoceptor mediated action on lipid metabolism.
- Dysfunction of the proteins UCP1 and UCP2 (Mitochondrial uncoupling proteins) that uncouple oxidative phosphorylation.
- By disruption in genetic factors (Rang, H.P.)
Mechanism for a drug or herb to reduce body weight or body fat:-
a)Â Â Â Â Â Decrease appetite
b)Â Â Â Â Â Decrease absorption
c)Â Â Â Â Â Increase metabolism
Herbs used for weight loss:
In Ayurveda the most famous medicine for curing obesity is a Resiti guggulu. This gum should be purified by boiling it in the decoction of the triphala or cow's milk. Guggulu is present in many preparations like - Triphala guggulu, Navaka guggulu and can be given in the dose of three tablets twice daily (Bhatt, N., 2003).
Ephedra (Ephedra sinica) contains the amphetamine like substance ephedrine and is the natural form of phenyl propanolamine (PPA). Ephedrine in combination with caffeine and aspirin results in a small but significant weight loss (Daly, P.A., 1993).
(3) Nomame Herba:
It inhibit lipase activity, reduced weight gain and elevation in triglycerides when fed a high fat diet (Yamamoto, M., 2000).
(4) French Lilac (Goat's Rue,Galega officinalisÂ ):
Galega is well known for its hypoglycaemic action. Galega has a novel weight reducing action in mice, is largely independent of a reduction in food intake. The mechanism of wt. reducing action is unclear but involves loss of body fat (Palit, P., 1999)
(5) Fibers (Psylium, Plantago, Guar fibers):
Several studies support the use of fiber to promote weight loss. Fiber remains in the gut and thus may increase subjective feelings of fullness and decrease food intake. Large amounts of fiber can cause gastrointestinal distress (Rytting, K.R., 1989).
(6) Laxatives (Cassia Senna, Cascara) and Diuretics:
Laxatives limit absorption, diuretics cause loss of fluid. Diuretics cause temporary weight loss as fluid with no loss in body fat. Serious risks of electrolyte imbalance with reported human cases of seizures and permanent heart damage products are not recommended for weight loss.
Caffeine obtained from guaranÃÂ¡ (P. cupana), kola nut (Cola nÃÂtida), or yerba mateit stimulates fat breakdown via sympathetic receptors and is often added to weight loss products for its thermogenic effect (Bray, G.A., 2000). Most clinical studies include caffeine as a co-ingredient with agents such as ephedra. This makes it hard to separate the independent effect of caffeine. In 1991, the FDA banned caffeine as an additive to non-prescription weight loss products because it had not been proven effective.
(8) Banana (Lagerstroemia speciosa Linn. Leaves):
Extracts from banana leaves have been reported to reduce diabetic symptoms in genetically diabetic mice. Banana had a beneficial antiobesity effect on obese female KK-AY mice. This effect was due to a reduction in the accumulation of triglyceride (Yuko Suzuki Tomonori, U., 1999).
Nicotine isolated from tobacco leaves (Nicotiana tobacum) increases metabolism, decreases food intake (Schechter, M. D., 1976). It increases fat oxidation and energy expenditure, an effect limited to time of exposure and more prominent in normal than overweight subjects (Audrain, J.E., 1995).
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