Role of Udaka in the Pathogenesis and Management of Sthaulya (Obesity): Integrative Ayurvedic Perspectives with Anatomical correlation – A Narrative Review

Sthaulya is a Santarpanottha Vikara marked by increased Meda buildup, limited movement, decreasedvitality, and a higher risk of metabolic issues. The Charaka Samhita and other fundamental writings highlightthe significance of Kapha, Meda, Agnimandya, and Srotorodha in the etiology of the disease. Nonetheless,in current integrated discourse, the contribution of Udaka—the physiological fluid principle that causesKleda (moisture) and tissue hydration—continues to be understudied. This narrative review aims to linktraditional Ayurvedic descriptions with anatomical, physiological, and metabolic data in order to evaluatethe function of Udaka in the pathogenesis and treatment of Sthaulya. Primary Ayurvedic sources like theCharaka Samhita, Sushruta Samhita, and Ashtanga Hridaya were used in a narrative integrative review. Thepertinent references to Udaka, Kleda, Kapha, Meda, and Sthaulya were methodically taken out and puttogether thematically. In a similar vein, contemporary biomedical literature was obtained from PubMed,Scopus, and Google Scholar using various keyword combinations, such as obesity, extracellular fluid,lymphatic dysfunction, adipose tissue inflammation, and extracellular matrix expansion. The anatomicaland metabolic links between Udaka-mediated mechanisms were identified via conceptual mapping.According to traditional analysis, Udaka promotes physiological tissue lubrication, Dhatu nourishment, andKapha stability. In particular, when combined with Agnimandya and Santarpana Ahara, the excessive riseof Udaka is pathological, leading to Kleda buildup and increasing the likelihood of Meda vriddhi, whicheventually causes Srotorodha and Sthaulya. The reconstructed Samprapti shows a sequential cascade:Agnimandya → Ama formation → Kapha vriddhi → Udaka vriddhi → Kleda accumulation → Meda expansion→ Srotorodha. Ayurvedic therapeutic approaches such as Langhana, Rukshana, Udvartana, and Lekhana-oriented treatments may have clinical advantages, at least in part, by altering tissue fluid dynamics andmetabolic activation. Udaka is a viable conceptual counterpart to obesity-related extracellular fluid controland fluid-mediated metabolic dysfunction. Including this viewpoint broadens the knowledge of Sthaulyabeyond adiposity and offers a translational framework for future empirical investigations of fluidbiomarkers, body composition metrics, and lymphatic function in obesity phenotypes. To support thisintegrative model, thorough clinical validation is necessary.