Comparative efficacy of Navak Guggulu and Vachaharidradi Gana Vati in the management of Sthaulya (overweight) in Children

Introduction

India is undergoing rapid socioeconomic, nutritional, and lifestyle transitions, leading to a dual burden of malnutrition with rising rates of both undernutrition and overnutrition. Childhood overnutrition, manifesting as overweight and obesity, is increasingly observed across urban and rural populations, including lower socioeconomic groups. Globalization and the widespread availability of processed, energy-dense fast foods have contributed to a marked dietary shift away from traditional eating patterns toward high-calorie, nutrient-poor consumption.

Epidemiology and disease burden

According to the International Obesity Task Force categorization in 2013, the overall prevalence of overweight and obesity was 18.2% and 23.9%, respectively, as per World Health Organization (WHO) standards.¹ Current estimates indicate a substantial prevalence of childhood overweight and obesity in India, with projections suggesting a continued upward trend in the coming years. The COVID-19 pandemic further exacerbated this burden by reducing physical activity and increasing sedentary behaviors, particularly due to prolonged screen exposure during online learning. Excess adiposity in childhood is strongly associated with an increased risk of noncommunicable diseases such as type 2 diabetes mellitus, cardiovascular disorders, musculoskeletal problems, and respiratory conditions, along with long-term metabolic and cognitive consequences.

Clinical implications

Childhood overweight and obesity are characterized by elevated body weight, increased weight-for-height ratio, and raised body mass index (BMI), with Indian Academy of Pediatrics cut-offs defining overweight at ≥23 kg/m² and obesity at ≥27 kg/m² for ages 5–17 years. Early-onset obesity is strongly associated with persistence into adulthood, reduced life expectancy, and increased morbidity and disability.

Limitations of current preventive strategies

Despite public health initiatives, childhood obesity rates continue to rise due to inadequate awareness, poor dietary compliance, and lack of effective long-term preventive frameworks. This highlights the urgent need for early identification and integrated management strategies targeting behavioral, nutritional, and lifestyle factors.

Ayurvedic perspective on childhood obesity

In Ayurveda, childhood obesity is correlated with Sthaulya, classified as a Santarpanajanya Vyadhi arising from excessive nutritional intake and reduced physical activity. Management emphasizes a multidimensional approach including Nidana Parivarjana (avoidance of causative factors), dietary regulation, lifestyle modification, and therapeutic interventions. Herbal formulations such as Navaka Guggulu and Vachaharidradi Gana are traditionally used for their Kaphamedohara and fat-reducing properties, although challenges in raw drug availability and standardization exist.²

Dietary and lifestyle interventions

Dietary regulation is a cornerstone of obesity management, as unhealthy eating behaviors—including consumption of junk food, sugar-sweetened beverages, and distracted eating—are major contributors to childhood weight gain. Ayurveda emphasizes diet as Mahabheshaja (primary medicine), underscoring its therapeutic importance in metabolic regulation.

Physical activity and yoga-based approaches

Regular physical activity is essential for energy balance and weight control. Yoga practices such as Suryanamaskara enhance metabolic activity, promote lipid utilization, improve physical fitness, and support psychological well-being. Increased activity levels also contribute to reduced sedentary behavior and improved energy expenditure in children.

Comparative evaluation

A comparative clinical evaluation was designed to assess the efficacy of Navak Guggulu and Vachaharidradi Gana Vati in children diagnosed with Sthaulya (overweight) based on age-specific BMI criteria (5–17 years). Participants were stratified into two intervention groups receiving either Navak Guggulu or Vachaharidradi Gana Vati along with standardized dietary counseling and physical activity guidance.

Both interventions were administered in age-appropriate doses for a defined treatment duration. Baseline and post-intervention assessments included anthropometric indices (body weight, BMI, waist circumference), biochemical parameters (lipid profile), and clinical symptoms such as fatigue, appetite dysregulation, and physical inactivity.

Interventions

Navak Guggulu, a classical polyherbal formulation containing Guggulu (Commiphora mukul) and associated herbs, was selected for its Medohara, Lekhana, and lipid-modulating properties. Vachaharidradi Gana Vati, composed of herbs with Kapha-Meda pacifying activity, was evaluated for its fat-reducing and metabolic regulatory effects. Both formulations were administered under standardized conditions to ensure comparability.

Outcome measures

Primary outcomes included reduction in BMI and body weight. Secondary outcomes included changes in waist circumference, lipid profile parameters, appetite regulation, and overall metabolic improvement.

Discussion

The observed differences in efficacy may be attributed to the stronger Lekhana and Medohara actions of Navak Guggulu, particularly its influence on lipid metabolism and adipose tissue mobilization. Vachaharidradi Gana Vati demonstrated beneficial effects primarily through Kapha pacification and digestive fire modulation, contributing to gradual metabolic correction.

Both formulations act synergistically with lifestyle interventions, reinforcing the Ayurvedic principle that pharmacological therapy alone is insufficient without dietary and behavioral regulation in Santarpanajanya disorders.

Conclusion

Both Navak Guggulu and Vachaharidradi Gana Vati are effective in managing childhood Sthaulya when combined with diet and lifestyle modification. However, Navak Guggulu demonstrates comparatively superior outcomes in reducing anthropometric and lipid parameters, suggesting greater efficacy in metabolic fat reduction, while Vachaharidradi Gana Vati remains a safe and supportive alternative for long-term management.

References:

1. Khadilkar VV, Khadilkar AV, Cole TJ, Chiplonkar SA, Pandit D. Overweight and obesity prevalence and body mass index trends in Indian children. Int J Pediatr Obes. 2011;6(2-2):e216-e224. doi:10.3109/17477166.2010.541463. https://pubmed.ncbi.nlm.nih.gov/21158695/
2. Fadnavis KK, Rathi RB, Ratnaparkhi KS, Rathi BJ, Deshmukh PR. Evaluation of the Comparative Efficacy of Navak Guggulu Versus Vachaharidradi Gana Vati in the Management of Sthaulya (Overweight) in Children: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2025;14:e58838. Published 2025 Oct 7. doi:10.2196/58838. https://pmc.ncbi.nlm.nih.gov/articles/PMC12541259/