Role of Udaka in the Pathogenesis and Management of Sthaulya (Obesity): Integrative Ayurvedic Perspectives with Anatomical correlation – A Narrative Review

Abstract

Sthaulya is a Santarpanottha Vikara marked by increased Meda buildup, limited movement, decreased
vitality, and a higher risk of metabolic issues. The Charaka Samhita and other fundamental writings highlight
the significance of Kapha, Meda, Agnimandya, and Srotorodha in the etiology of the disease. Nonetheless,
in current integrated discourse, the contribution of Udaka—the physiological fluid principle that causes
Kleda (moisture) and tissue hydration—continues to be understudied. This narrative review aims to link
traditional Ayurvedic descriptions with anatomical, physiological, and metabolic data in order to evaluate
the function of Udaka in the pathogenesis and treatment of Sthaulya. Primary Ayurvedic sources like the
Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya were used in a narrative integrative review. The
pertinent references to Udaka, Kleda, Kapha, Meda, and Sthaulya were methodically taken out and put
together thematically. In a similar vein, contemporary biomedical literature was obtained from PubMed,
Scopus, and Google Scholar using various keyword combinations, such as obesity, extracellular fluid,
lymphatic dysfunction, adipose tissue inflammation, and extracellular matrix expansion. The anatomical
and metabolic links between Udaka-mediated mechanisms were identified via conceptual mapping.
According to traditional analysis, Udaka promotes physiological tissue lubrication, Dhatu nourishment, and
Kapha stability. In particular, when combined with Agnimandya and Santarpana Ahara, the excessive rise
of Udaka is pathological, leading to Kleda buildup and increasing the likelihood of Meda vriddhi, which
eventually causes Srotorodha and Sthaulya. The reconstructed Samprapti shows a sequential cascade:
Agnimandya → Ama formation → Kapha vriddhi → Udaka vriddhi → Kleda accumulation → Meda expansion
→ Srotorodha. Ayurvedic therapeutic approaches such as Langhana, Rukshana, Udvartana, and Lekhana-
oriented treatments may have clinical advantages, at least in part, by altering tissue fluid dynamics and
metabolic activation. Udaka is a viable conceptual counterpart to obesity-related extracellular fluid control
and fluid-mediated metabolic dysfunction. Including this viewpoint broadens the knowledge of Sthaulya
beyond adiposity and offers a translational framework for future empirical investigations of fluid
biomarkers, body composition metrics, and lymphatic function in obesity phenotypes. To support this
integrative model, thorough clinical validation is necessary.