Being underweight is just as much a problem as being overweight. However, there is loads of matter written about obesity, yet leanness is grossly neglected. A major contributing factor in this is the media which projects lean male and female models as the symbols of perfect beauties. Hence, people who are lean think of their leanness as an asset rather than an impediment.

To an extent, leanness is okay. But it becomes an issue when it begins to interfere with the person’s health. In most cases, a lean person has less bodily resistance and thus it can be an invitation to diseases.

This article attempts to explain leanness and its effects over the human body, along with its causes and methods of treatment.

Karshya is the condition of being excessively lean. These people are also termed as underweight. Their weight is below standard values, and sometimes even height. Their bodies are characterized by the following:-

(i) Poor weight

(ii) Less muscle mass, known as shushka in Sanskrit

(iii) Sunken skin, leading to a ‘skin and bones’ body, which is known as ati krusha in Sanskrit

(iv) Poor development of chest, limbs and buttocks

In medical terms, excessive leanness is also known as emaciation.

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Leanness of karshya can be caused due to a wide variety of reasons. Some of these reasons are as follows:-

(i) Feeding habits during younger days – People who are not fed well as infants or during their early adolescence generally grow up to be quite underweight. This may happen due to ignorance on the part of the mother, or if the mother herself is undernourished. Due to nutritional deficiencies in the mother, there may be a deficiency of the necessary fat cells that are required for producing breast milk. As a result, the child has a high probability of growing up lean.

(ii) Poor eating habits – A very high proportion of people all over the world have very poor eating habits. This includes eating unhygienic or unbalanced food, eating at wrong times, eating less in proportion to the work done, etc.

(iii) Diseases – Two dietary diseases – bulimia and anorexia nervosa – are directly responsible for people losing weight and becoming lean. Anorexia nervosa is the condition in which a person does not feel hungry. Due to this, there is no increase in the body weight of the person. Patients of debilitating diseases such as cancer tend to lose their weight. Even patients of AIDS and hepatitis become lean.

(iv) Hyperthyroidism – Hyperthyroidism or excess secretion of the hormone thyroxin is one of the prime medical causes of karshya. People who suffer from hyperthyroidism are unable to gain weight, and so they remain quite below their standard weight values.

(v) Psychological factors – Stress, anxieties, heavy workload, etc. can reduce a person’s desire for eating nutritional food. Due to this, the person will lose weight and become lean.

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Leanness is a relative term. For an obese person, a medium sized person could be lean, while for a lean person, a medium sized person could be obese. There are no clinical or medical parameters by which leanness can be measured. However, excessive leanness can be adjudged by the following factors:-

(i) The body is extremely thin. The ribs and the clavicle (collar bone) show out through the chest.

(ii) There is no mass of flesh over the chest, abdomen and buttocks.

(iii) Pinching the skin brings a very thin skinny mass into the fingers.

(iv) The body weight is much less than the normal values.

(v) The person is prone to fall sick often and takes longer time to recover than average weighed persons.

(vi) The person has poor stamina and bodily resistance.

(vii) There is often some or the other physical ailment in the body, such as regular coughing, sneezing, runny nose, or something else. Eyes and skin are very sensitive.

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Emaciation is an invitation to diseases. Since the person is lean, there is no proper development of the body of the person. He or she will likely have a low count of leukocytes (white blood corpuscles), which are the blood corpuscles that fight against attacking microorganisms. As a result, there is a chance that the person can suffer from major diseases soon.

On a simpler note, excessive leanness is detrimental to the wellbeing of a person because of the following reasons:-

(i) The person will get tired easily as he or she has low stamina.

(ii) The person will not be well-suited to do any sort of heavy or excitable activity.

(iii) The person will have a good chance of suffering from heart ailments.

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Since karshya is not a disease but a bodily condition, there is no question of transmission through any contagious or infectious factors. However, it is known that karshya runs in families. Hence, there is a chance that the condition may be genetic. As such people with leanness among their close family members should take stricter precautions to avoid becoming emaciated.

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The diet that a lean person consumes must be targeted at increasing the body bulk. Some foods are more fattening than others. There are some other foods which can increase the tissue and muscle mass, and thus increase the body bulk. A proper dietary regimen is a very strong treatment method for people with karshya.

The following constituents must be integral parts of all lean people’s diet:-

Lean people must not shy away from eating food. They should preferably have a double course meal. The carbohydrates such as rice or wheat products must be consumed in the first course with simple vegetables or pulses. Later a second course must follow with richer foods, which could be vegetarian or non-vegetarian depending on the dietary preferences of the person.

A salad must always be included in the meals. Salads add body bulk and also provide several nutrients.

Starchier vegetables must be given preference as they increase the bulk of the body. Potatoes, yams, carrots are very good in adding weight.

Rice must be preferred to wheat, as rice is starchier.

The person must avoid drinking fluids before meals as it will make the stomach feel full. Similarly, it is not advisable to have soups before meals.

Some people feel that wine increases the appetite. This is a personal preference, but must be done in moderation.

Some light snacks could be had before retiring to bed.

Dietary fats such as milk, curds, raw sugar, jaggery, black gram, ghee and meats must be incorporated more in the diet. Fats have several benefits in lean persons. The following are the five major functions dietary fats perform in the body:-

Fats are a source of energy to the lean person. A single gram of fats can provide up to 9 kcal of energy.

Fats form a layer under the skin, which helps in thermoregulation of the body.

Fats form a layer around the vital organs, which help in protecting the body from shocks and injuries.

Fats help in the circulation of important fatty acids within the body. They also regulate several aspects of fat metabolism.

Fats increase the palatability and satiety value of the food. This makes the food more appealing to the frugal eater.

Thus, the diet that an emaciated person must follow is the exact opposite of that which is suitable for an obese person.

The manner of taking the diet is also very important. A thin person must eat little quantities at regular intervals during the day instead of having just a few heavy meals per day. The dietary regimen given below is ideal for a person who is looking out to gain some weight:-

(i) Early morning – Diet of a food rich in vitamin C such as oranges or grapes.

(ii) Morning – Have a breakfast that is rich in carbohydrates to add to the bulk of the body. Brown bread is preferable. Some protein-rich food like an egg is suitable, or even bread and butter will do.

(iii) Mid morning – A nutritious and filling food, salad or soup will be ideal.

(iv) Lunch – Can be moderately heavy. Supplement the rice or wheat products with at least two different kinds of vegetables. One flesh food can be included if allowable. A fruit salad would be the best dessert.

(v) Mid afternoon – A cooling food must be taken to counter the effects of the climate. A milkshake or cold coffee is advisable.

(vi) Evening – A beverage with some light snack can be taken.

(vii) Dinner – Must be rich in nutrition but easy to digest. It can have more variety than the lunch. Avoid spicy and oily foods in the night as they can interfere with sleep.

(vii) Bedtime – An apple or a plantain would help to digest the food eaten during the day.

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Sushruta Samhita advises people with karshya to treat the problem by removing the cause itself. Most of the times, the problem of leanness is due to some internal malady such as hyperthyroidism, bulimia or anorexia nervosa. Hence, Ayurveda remedies the problem of leanness by treating the internal disorder first. This requires a proper diagnosis of the ailment.

Certain steps that Ayurveda prescribes for increasing the weight are as follows:-

(i) Eat heavy meals, but allow time for exercise, or there could be proper utilization of the food and prevents the complications.

(ii) Keep the mind free from all worries and tensions that might interfere with the digestion of food.

(iii) A deep sleep at night and a light nap in the afternoon are a must. This keeps the body metabolism functioning better.

(iv) Do not involve yourself in dexterous and heavy duty activity.

(v) Mingle with your peers and exchange ideas. Do not be embarrassed of your condition.

In Ayurveda, there are a few herbs that are known to cause increase in weight. A list of all these herbs with their actions on the human body are given below:-

Some Ayurvedic preparations that have been proven effective in the treatment of excessive leanness, i.e. karshya, are as follows:-

• Amritaprasana Ghritam
• Chagalyadi Ghritam

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