Obesity is a complex disease involving an excessive amount of body fat. Obesity isn't just a cosmetic concern. It's a medical problem that increases the risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.

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2. Dr Shivam Mishra
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3.  Non communicable diseases (NCDs) are on the rise and
have been reported to kill about 38 million people annually.
 Along with the already existing communicable diseases,
increase of non communicable diseases is pushing the world
to facing a double burden.
 NCDs are associated with various behavioral risk factors,
which in turn precipitate several physiological and
metabolic risk factors.
 These risk factors also are intimately related and one factor
is often associated with one or more other factors.
 Obesity is one of the most important metabolic risk factors.
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5.  Major risk factor of many non communicable diseases, the
most important of these are:
cardiovascular diseases (mainly heart disease and stroke)
diabetes;
musculoskeletal disorders (especially osteoarthritis);
some cancers (endometrial, breast, and colon).
 Major contributor to mortality and morbidity
 Has more than doubled in the world since 1980.
 In 2014, 39% of adults aged 18 years and more were
overweight and 13% were obese.
 With increasing BMI, risk of the associated NCDs also
increases.
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6.  Inadequate physical activity
 Unhealthy diet
 Excessive and regular intake of alcohol
 Stress and anxiety through
release of glucocorticoids and catecholamines which alter
appetite regulation and metabolism
increased intake and unhealthy diet
harmful use of alcohol
 Depression leads to
decreased physical activity
increased intake of food
harmful use of alcohol
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7. Inadequate
physical
activity
Increased
food intake/
unhealthy
diet
Excessive
alcohol
intake
Depression
Stress/
anxiety
OBESITY
Cardiovascular
diseases
Diabetes
Musculoskeletal
disorders
Cancers
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8.  Originated in India
 The first references of these found in scriptures of sixth
century BC
 Recently under research and gained popularity all over the
world
 Many benefits in several lifestyle disorders
 Helps to develop a more positive attitude towards life and
thus reduce stress
 Most widely used complementary and alternative medicine
practices
 Recently introduced into mainstream medicine
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9.  Worldwide, yoga is regularly practiced by about 30
million people
 In America, nearly 14 million (6.1% of the US
population) reported that yoga had been recommended to
them by a physician or therapist.
 In 2002 use of relaxation techniques and yoga was
reported by 14.2% and 5.1% of US adults.
 In the UK, yoga is promoted by the National Health
Service as a safe and effective approach, in health and
illness.
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10.  In India, traditional systems of medicine have been
promoted by the government since long.
 In March 1995, Department of Indian Systems of
Medicine & Homeopathy (ISM&H) was created under
the Ministry of Health & Family Welfare,
 In November 2003, it was renamed as Department of
Ayurveda, Yoga, Unani, Siddha & Homeopathy (AYUSH)
 In November 2014, Ministry of AYUSH was formed
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11.  Bring a holistic way of life
 Lead to a state of complete physical, mental, social,
and spiritual well-being, as recommended by the World
Health Organization.
 Cost effective interventions to prevent and control risk
factors for NCDs including obesity.
 Used for primary and secondary prevention of modern
epidemic diseases
 Used as nonpharmaceutical measures or complement
to drug therapy for treatment of these conditions
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12. YOGA
MEDITATION
STRESS OBESITY
Hypersecretion of
cholesterol
“Comfort foods”
Binge eating
Alcohol
Emotional eating
External eating
Stimulation of
Vagus nerve
HPA axis
primary and secondary prevention of obesity
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13.  Yoga - Sanskrit word yuj meaning to unite or to yoke.
 A psycho-somatic-spiritual discipline
 Union and harmony between mind, body, and soul
 Ultimate union of our individual consciousness with the
universal consciousness.
 Improve one’s inherent power in a balanced manner
 Attain complete self realization
 Eight traditional forms of yoga have been described.
 These are japa yoga, karma yoga, gyana yoga, bhakti yoga,
raja yoga, swara yoga, kundalini yoga, nadi yoga
 Other common forms are kripalu yoga, kriya yoga, laya
yoga, mantra yoga, vinayasa yoga and many more.
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14.  Meditation - Latin word meditor meaning, to reflect,
ponder over, consider.
 A mind-body practice with many methods and
variations
 Silence and stillness of compassionate, nonjudgmental
present moment awareness
 Main types of meditation include transcendental
meditation, mindfulness and Sahaja yoga
 Other common types are zen meditation, omkara
meditation, amrita meditation and many more.
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15.  Another traditional method followed is Pranayama
 The word pranayama is derived from two Sanskrit
words, namely, prana, which means vital force or life
energy, ayama means to prolong
 It is basically a combination of several forms of
breathing exercises
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16.  Yoga was systemized by the ancient Indian sage Patanjali in
the Yoga Sutras (300–200 B.C.)
 Patanjali defined the purpose of yoga as knowledge of the
true “Self” and outlined eight steps for direct experience of
“Self.”
 The eight steps or limbs of yoga are as follows:
 Yama: Codes of restraint, abstinences, self-regulations
 Niyama: Observances, practices, self-training
 Asana: Meditation posture
 Pranayama: Expansion, regulation, control of breath
 Pratyahara: Withdrawal of the senses, bringing inward
 Dharana: Concentration
 Dhyana: Meditation
 Samadhi: Deep absorption, meditation in its higher state,
the state of perfect concentration
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17.  It combines physical postures (asanas), breathing
exercises (pranayamas), and meditation or relaxation
exercise, along with spiritual teaching.
 Concept of yoga by Patanjali, which includes physical
postures, breathing exercises and meditation.
 Also known as hatha yoga, which includes asana,
mudra, pranayama, and is very commonly practised all
over the world.
 Qigong, a Chinese technique, integrates physical
postures, breathing techniques and focused intention
 Integrated form is more beneficial for physical,
psychological and spiritual well-being
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18.  Health effects of Hatha Yoga:
reduction of stress, overall improvement of physical
fitness and reduction of some risk factors for
cardiovascular diseases.
prevention of cardiac arrhythmias, hypertension,
insomnia, cardiopulmonary disorders, depression and
anxiety, epilepsy, cancer, menopause symptoms and
chronic back pain.
 Mindfulness, subjective well-being, healthy body mass
index, fruit and vegetable consumption, vegetarian
status and vigor.
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19.  A form of mind-body medicine, most importantly in its
integrated form, that can
address the physical, psychological, and spiritual
aspects, and
assist with behavioral change, weight loss, and
maintenance,
thus playing an important role in primary and
secondary prevention of obesity.
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20.  Aim of the present review is to throw light upon the
role of yoga and meditation in prevention and control of
obesity, through:
regulation of release of stress hormones
reduction of harmful behavioral risk factors
development of healthy lifestyle.
 The objectives of the review are:
To study the role of yoga and meditation in the
prevention of obesity,
with particular attention to some of the factors that
are directly or indirectly related to obesity, like
stress
eating behaviour
alcohol intake.
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21.  Study design – Narrative review
 Key words - A combination of key words for
intervention related term: yoga/meditation AND
outcome related term: obesity/ anthropometry/ stress/
anxiety/ depression/ eating disorder/ binge eating
disorder/ eating behavior/ alcohol use/ alcohol
dependence AND
study design related term: intervention/
experimental/ trial
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22.  Search strategy –
Most commonly used scientific search engines were
searched for identification of studies.
Title screened based on pre-specified inclusion
criteria.
Abstracts and full texts of potentially eligible articles
were identified.
Review articles were read to extract cross references.
Articles that fitted into the exclusion criteria were
excluded from the review.
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23.  Without a control group comparison cannot be made.
 In the absence of randomization of subjects into
intervention and control groups results can be biased.
 Presence of multiple interventions done simultaneously
makes the effect of any particular intervention difficult
to assess.
 If control subjects are given some other intervention
the ultimate effect size of the interventions under study
may be reduced.
 Hence such research work was not considered in the
present review.
 However, continuation of treatment as usual for
controls was considered.
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24. Inclusion criteria
Language - English
Type - Original article
Design - Intervention
Participant - Healthy adult
Intervention -
 Yoga and/or
 Meditation
Outcome - Reduction of
 Stress/Anxiety/Depression
 Eating disorder
 Alcohol use
 Obesity
Exclusion criteria
Design - Not RCT
 Intervention - Multiple
intervention techniques used
simultaneously
Participant - controls given
some other intervention
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25. Potentially relevant articles identified,
based on Inclusion Criteria:-
(N= 38)
Language - English
Type - Original article
Design - Intervention
Participant - Healthy adult
Intervention - Yoga and/or Meditation
Outcome - Reduction of
• Stress/Anxiety/Depression
• Eating disorder
• Alcohol use
• Obesity
Studies included:-
(N= 15)
Articles removed on the basis of
Exclusion Criteria:-
Study design - not Randomized
Controlled Trial
(n= 12)
Intervention - multiple techniques used
simultaneously
(n= 8)
Participants - controls given some other
intervention
(n= 3)
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26. RESULTS
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27. Yoga and meditation are techniques that bring
about relaxation of mind and body and hence
reduce stress.
Both these techniques have been reported to
reduce stress and anxiety in subjects of the
intervention group significantly more than that
in the control group, by several authors.
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28. Author
Year
Study
design
Number
of
particip
ants
Interventio
n
Outcome Result Significa
nt/ Not
Significa
nt (S/NS)
Puryear
1976
RCT 159 Meditation Anxiety Reduced S
Dillbeck
1977
RCT 33 Meditation Anxiety Reduced S
Javnabhakt
2009
RCT 65 Yoga Anxiety Reduced S
Carei
2010
RCT 53 Yoga Anxiety
Depression
Reduced
Reduced
NS
NS
Garland
2010
RCT 53 Meditation Stress Reduced S
Daubenmier
2011
RCT 47 Meditation Cortisol
awakening
response
Reduced S
vandana
2011
RCT 150 Meditation Adrenaline
Cortisol
Reduced
Reduced
S
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29. Researchers have reported improvement in
eating behavior following intervention with
yoga and meditation.
They have also shown significant reduction of
eating disorder and Binge Eating Disorder.
Physical activity also increases with yoga
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30. Author
Year
Study
design
Number
of
participan
ts
Interventi
on
Outcome Result Significan
t/ Not
Significan
t (S/NS)
Mitchell
2007
RCT 93 Yoga Eating Disorder No change -
Mclver
2009
RCT 90 Yoga Binge eating
Physical
activity
Reduced
Increased
S
S
Carei
2010
RCT 53 Yoga Eating disorder Reduced S
Daubenmier
2011
RCT 47 Meditation Emotional
eating
External eating
Reduced
Reduced
S
S
Alberts
2012
RCT 26 Meditation Food cravings
Dichotomous
thinking
Body image
concern
Emotional
eating
External eating
Reduced
Reduced
Reduced
Reduced
Reduced
S
S
S
S
S
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31. Following courses of yoga and meditation
reduction in alcohol use, craving for alcohol and
dependence on alcohol was reported.
There was improvement in symptoms and
AUDIT scores too.
However, in many of the studies the differences
were not statistically significant.
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32. Author
Year
Study
design
Number
of
participa
nts
Intervent
ion
Outcome Result Significa
nt/ Not
Significa
nt (S/NS)
Bowen
2009
RCT 168 Meditation Alcohol use
Craving
Reduced
Reduced
S
S
Garland
2010
RCT 53 Meditation Alcohol cues
Alcohol
attentional
bias
Reduced
Reduced
S
S
Witkiewitz
2010
RCT 168 Meditation Craving
Alcohol use
Reduced
Reduced
S
S
Reddy
2014
RCT 38 Yoga AUDIT score
Symptoms
Symptom
management
Reduced
Reduced
Improved
NS
NS
S
Hallgren
2014
RCT 18 Yoga Alcohol
consumption
Reduced NS
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33. Statistically significant reduction was observed
in body weight, percentage of body fat, lean
body mass, body mass index, waist
circumference and visceral fat area, by several
authors.
However, there was no difference between the
two groups in overall weight and abdominal
fat/trunk-leg fat ratio as reported by one
researcher.
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34. Author
Year
Study
design
Number
of
participa
nts
Intervent
ion
Outcome Result Significa
nt/ Not
Significa
nt (S/NS)
Mclver
2009
RCT 90 Yoga BMI
Waist
circumference
Hip
circumference
Reduced
Reduced
Reduced
S
S
S
Daubenmier
2011
RCT 47 Meditation Abdominal
fat/trunk-leg
fat ratio
Overall
weight
No difference
No difference
-
-
Jeong-Ah
2012
RCT 16 Yoga Body weight
Percentage of
body fat
Lean body
mass
Body mass
index
Waist
circumference
Visceral fat
area
Reduced
Reduced
Reduced
Reduced
Reduced
Reduced
S
S
S
S
S
S
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35.  Systematic Review and Meta-analysis could not be
done due several methodological deficiencies as follows:
inconsistency in the study methodologies
small sample size
lack of complete information
inadequate description of methods
failure to adjust for lifestyle characteristics
large variation in the nature, duration, intensity, and
delivery methods of the interventions used
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36.  Though a lot of research has been undertaken to assess
the role of yoga and meditation in various parts of the
world, no conclusive evidence can be drawn.
 Most of the studies have several limitations that
compromise the validity.
 More randomized controlled trials with large sample
size are required to be conducted in various settings, to
confirm these findings.
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37. Existing knowledge does point to the benefits
of yoga and meditation as these are:
 cost-effective techniques without side effects
 feasible to be implemented and sustained by the community
Hence focus may be given on mainstreaming
yoga/meditation for primary and secondary
prevention of obesity, which in addition will
provide double benefit by helping to control the
risk factors as well as the major non
communicable diseases.
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38. Thank
you
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