Fatty Liver and Obesity

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Fatty Liver and Obesity: What It Means 

Fatty liver occurs when more than 10% fat starts accumulating in the liver cells; on the other hand, diabetes is a condition when body stops reacting to insulin. And these two conditions are interlinked with each other. 

How are fatty liver and obesity connected?

According to Ayurveda, both Yakrit Roga (liver dysfunction) and Medoroga (obesity) are interlinked with each other as they share a common root, concerned with disrupted lipid metabolism and digestive fire (Agni). If Agni (digestive fire) slows down due to an unhealthy lifestyle or overeating, food is not digested properly, creating Ama (toxins), which further mixes with Kapha dosha and disrupts the Medo dhatu (fat tissue). 

Blood channels (Rakta-vaha srotas) and fat channels (Medovaha) have their origin in the liver (Yakrit). Due to unhealthy eating, excess oil and heavy fats get clogged in these channels, which can cause fatty liver and obesity.  

Ayurveda views Medoroga (obesity) as Nidanarthakara Roga (a disease that triggers another disease), which directly affects Yakrit Roga.  

Who Is Affected And Risk Factors

Nearly one in three people suffer from metabolic dysfunction- associated fatty liver worldwide, mostly caused by obesity. Ayurveda says people with different doshic imbalances are affected most. Some of the common doshas are:

• Kapha-dominant Prakriti: Individuals with kapha dosha are prone to heavy builds, slow metabolism, and fluid retention.
• People having constant Mandagni: Individuals with tissue-level Mandagni (weak digestion) have a high risk of obesity and fatty liver.
• People with a sedentary lifestyle: Individuals with a poor lifestyle, no movement, and working in high-stress environments have a high risk of doshic imbalance.
• Adults in their middle ages: Adults between the ages of 40-65 years naturally have Kapha or doshic imbalances due to slowing physiological rhythms.

Risk factors include

Ayurveda says the root causes of these diseases are linked with an unhealthy lifestyle and Apathya (dietary choices) that disrupt Kapha dosha, which can further lead to Yakrit Roga.

Some common risk factors are:

• Abhisandhi foods: Eating unbalanced food such as dairy products, junk food, oily, refined, and processed foods can increase the risk of doshic imbalance.
• Over- nutrition: Consuming heavy or over-nutritious foods can lead to obesity, and in the long run it can cause fatty liver.
• Day sleep (diva- swapna): Reduction in night sleep or increase in day sleep can spike Kapha dosha.
• Avyayama: Lack of physical activity can create doshic imbalance and hormonal malfunction, which directly increases the risk of fatigue in the body.
• Ajirna (Indigestion): Individuals having ajirna for a long time are in a case of weak agni (digestive fire) are at high risk of obesity.
• Ati- Chinta: Mental fatigue can disrupt the Vata dosha and Agni (digestive fire).
• Poor lifestyle behaviors: Ayurveda says poor lifestyle behaviors such as eating processed foods, added sugar, and lack of physical activity disrupt the balance of doshas (vital energies) in the body, which further leads to physical and mental issues.

Symptoms Or Presentation

These conditions are related to obesity, which can increase the risk of fatty liver. If you have any of these conditions, contact Jiva Ayurveda for better treatment:

• Fatigue (feeling tired)
• Constant weight gain (Medo-vridhi)
• Slow digestion (Agnimadya) OR Indigestion (Ajirna)
• Sugar craving (Madhur-asya)
• Malaise (feeling unwell without any specific reason)
• Abdominal swelling or pain
• Jaundice (yellowing of eyes and skin)
• Body swelling (fluid retention)

How It Is Diagnosed

Fatty liver and obesity can be diagnosed using a mix of physical assessments and blood testing: 

Obesity can be diagnosed with the combination of BMI and circumference of the waist:

• BMI (Body mass index): A BMI of 30 or more indicates obesity. BMI can be measured using height and weight. You can calculate your BMI simply by dividing weight in kilograms by height in meters.
• Circumference of the waist: Generally, 35 inches for males and 31 inches for females are considered obese. Waist measurement can help in tracking fat stored around the abdomen.

Fatty liver can be diagnosed with:

• Abdominal ultrasound
• Blood tests like ALT and ASTs
• Fibroscan
• Liver biopsy
• MRI or CT scan

Ayurvedic Management

Ayurveda focuses on Sroto-shodhana, which aims to clear root blockages. These methods help in balancing Agni (digestive fire) and scraping the excess fat. It includes:

• Deepana and Pachana: Using hot, pungent, and bitter herbs (such as ginger, cumin, and Katuki) to stimulate the internal fire (agni) and break down metabolic waste.
• Shodhana:  This process aims at purification. Practitioners use methods like virechana to remove accumulated fat toxins (Ama) and pitta.
• Pathya: It includes dietary changes and lifestyle habits. Ayurveda suggests that eating warm, light, astringent foods like turmeric and barley while avoiding eating Abhishyandi, such as cold, oily, and heavy foods from the diet, can improve Kapha dosha.
• Lekhana:  It is known as scraping therapy. It is a process of reducing tissue stiffness or fat metabolism by giving herbs and formulas like Triphala, Arogyavardhini Vati, and Medohar Guggulu.

Ayurvedic Assessment

According to Ayurveda, these conditions are diagnosed using a multi-step Ayurvedic assessment that focuses on organ health. These assessments include:

• Darshana (Observation), Sparshana (Palpation), and Prashana (Interrogation): In this, the doctor observes the physical marks (dark spots) on the patient's skin, in advanced cases feels the abdomen, and understands the patient's lifestyle, sleep patterns, and appetite, etc., by interrogating them.
• Nadi Pariksha: It helps in understanding the movement of Vatta, Pitta, and Kapha by reading the pulse. This is part of Ashtavidha Pariksha.
• Assessing Agni (digestive fire): Practitioners focus on weak metabolic fire (Agnimandya) and nutritional fluid (Ahara rasa), which results in abnormal fat accumulation.
• Determining Ama (toxins): Slow metabolism creates Ama that can clog the body. By identifying Ama, we can manage it.

• Ashtasthana Pariksha: Ayurvedic doctors examine the abdomen, overall body mass, and skin.

• Technical methods: Tests including Abdominal ultrasound, LFTs such as ALT and AST, and Metabolic blood profile tests can help in understanding total fat accumulation in the body.

Prevention Or Progression

Ayurveda focuses on maintaining a healthy lifestyle and preventing the accumulation of Meda (fat tissue) and Ama (toxins) and balancing Agni (digestive fire). Here’s how you can prevent the risk of obesity and fatty liver:

• Understanding the connection
• Stay physically fit
• Manage excess weight
• Avoid eating sugars and processed food
• Strictly limit alcohol.
• Eat according to your Agni (digestive fire)
• Be careful with medicines
• Maintain a daily routine
• Prioritise sleep 

Red Flags

These red flags are easily avoidable in the first place; that's why, if you notice any of these, kindly pay attention, and if you need professional help, consult with Jiva Ayurveda:

• Extreme fatigue or weakness
• Rapid weight changes
• Swelling in abdomen or legs
• Yellowing of eyes and skin
• Unusual bleeding
• Easy bruising
• Brain fog or confusion
• Pain in upper abdomen  
• High ALT and ASTs

References

Obesity and Nonalcoholic Fatty Liver Disease: Biochemical, Metabolic and Clinical Implications - PMC

Obesity and Non-Alcoholic Fatty Liver - Therapies in Ayurvedic Medicines

Obesity | CDC

Nonalcoholic Fatty Liver Disease and Obesity Treatment - PMC