Obesity (Sthaulya) is a chronic lifestyle disorder described in Ayurveda as a condition associated with Medo Dhatu Vruddhi and Srotorodha. This randomized clinical trial aimed to evaluate and compare the efficacy of Agnimantha Shilajit Yoga (AS) and Bilvadi Yoga (BY) in the management of obesity. Sixty clinically diagnosed patients were randomly allocated into two groups: Group A received AS (0.5g twice daily), and Group B received BY (5g twice daily with 10 mL honey). Both groups were assessed on subjective and objective parameters over the treatment period. The study population was predominantly male (53.34%), aged between 36-47 years (51.70%), mostly married (85%), with a preference for spicy food (50%), Krura Koṣta (63.35%), Viṣamagni (88.30%), and a mixed diet (95%). Group A showed statistically significant improvement in subjective symptoms such as reduction in pendulous body movements, heaviness, excessive perspiration, thirst, and hunger (p < 0.001). Objective parameters such as body mass index – BMI (Decreased from 3.60 to 2.00 (p < 0.001), indicating a marked reduction in weight status), lipid profile (Mean value of total cholesterol reduced from 244.68 to 189.04), liver enzymes (AST, ALT, ALP), creatinine levels, waist and hip circumferences also improved significantly (p < 0.001).
Group B demonstrated notable reductions in localized adiposity, including mean value of thigh circumference (from 57.56 to 54.50 cm) and mean value of arm circumference (from 34.86 to 31.46 cm) (p < 0.001), though improvements in other parameters were less pronounced compared to Group A. Intergroup comparison revealed that AS was significantly more effective in most essential obesity-related parameters, while BY was more effective in targeted fat reduction. Both formulations were found to be effective in managing obesity, but AS demonstrated a broader and more comprehensive efficacy in the Ayurvedic management of Sthaulya.

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