Acharya Sushruta has mentioned the main constituent of pathogenesis of Shaulya (Obesity) is Dhatvagni Mandya (decrease in the functional efficacy of Dhatvagnigni). Acharya Charaka described Atisthoola is a person having pendulous appearance of Sphika, Udara and Stana due to excess deposition of Meda (Fatty tissue) along with Mamsa Dhatu (Muscle tissue) and having inadequate abnormal distribution of Meda with reduced zeal towards life. The disease Sthaulya originates due to consumption of Kapha Vriddhikara Ahara (Kapha Dosha Vitiating diet), Vihara (exercise) and Manasa Nidana (Psychological Causes). Bilvadi Panchamula (Bruhat Panchamoola) contains Bilva, Agnimantha, Shyonak, Kashmari and Patala which encounters Vata and Kapha Dosha by virtue of its Tikta, Kashay-Rasa dominance and Ushna-Virya. Tikta-Rasa performs Medo-Kledopa- Shoshana action. Sthairya Guna of Madhura Rasa combats Sharira Shaithilya. Ushna-Virya also helps in Kleda and Meda Vilayana action. Tikta-Rasa, Ushna-Virya, Laghu Guna encounters Dhatwagnimandya and potentiates the weakened Dhatwagni and help in Amapachana, thereby alleviates Aparipakwa and Ama Dhatu. Ultimately act as Medohar and breaks the Samprapti of Sthaulya.
