World Journal of Pharmaceutical research - WJPR!

Manish Gunjan World Journal of Pharmaceutical research 

Article Received on 

02 October 2012, 

THE ROLE OF HERBAL MEDICINE AND EXERCISE IN THE 

www.wjpr.net 

MANAGEMENT OF OBESITY 

* Manish Gunjan, Tarun Amalnerkar, Shobananair, Toh Su Fen, Hindran Kumar, Asif 

Revised on 15 October 2012, 

Accepted on 26 October 2012 

*Correspondence for 

Author: 

* Manish Gunjan 

Masterskill global college 

Ipoh,Malaysia . 

manish_14us@yahoo.com 

World Journal of Pharmaceutical research 

Iqbal Chittur Mohammed and Vanitha 

Masterskill global college, Malaysia. 

ABSTRACT 

Obesity is the most prevalent, fatal, chronic, relapsing disorder of the 

21st century. It is likely that the increase in obesity will strain our 

healthcare system with millions of additional cases of diabetes, heart 

disease and disability. The aim of this study is to evaluate the efficacy 

and side effect by using herbal formulation and exercise together to 

promote weight loss as compared to placebo or herbal or exercise 

separately to give awareness among people for use of herbal medicine 

and exercise in the management of obesity. We went through 

questionnaire based survey and personal interview with patients, 

doctors, herbalists as well as Physiotherapist. After compiling and 

statistical analysis, we found that improper lifestyle such as lack of 

exercise, unhealthy food intake is the major cause for obesity and herbal medicine together 

with exercise will be a better substitute in the management of obesity instead of taking herbal 

medicine alone. 

Volume 1, Issue 5, 1250-1280. Review Article ISSN 2277 – 7105 

Key words: Diabetes, Folk medicine, Physiotherapy, BMI. 

INTRODUCTION 

Obesity is now recognized as the most prevalent metabolic disease world-wide, reaching 

epidemic proportions in both developed and developing countries and affecting not only 

adults but also children and adolescents. The WHO has already declared obesity a global 

epidemic that constitutes one of the biggest current health problems. (1) This abnormality has 

persisted throughout the centuries, which have been characterized by markedly different 

environmental stresses and dietary habits .(2) Obesity is the most common metabolic disorder 

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of human and onc of the oldest documented diseases. An estimated 35 to45 percent of all 

U.S. women and 20 to 30 percent of all U.S. men are trying to lose weight at any given time, 

spending up to $40 billion each year to do so. Some of these people do not even need to lose 

weight. Others need to lose weight but not successful. Still others are successful. Weight- loss 

advice, then, does not apply equally to all overweight people. Some people may risk more in 

the process of losing weight than in remaining overweight. Others may reap significant health 

benefits with just modest weight loss. (4) The overweight problem is due to an actual increase 

in the fat component, or it can be due to malfunctioning glands. Today, it is estimated that 

there are more than 250 million obese people worldwide, equivalent to seven percent of the 

adult population. (5) In the United States, data from the second National Health and Nutrition 

Examination Survey (NHANES II) were used to define obesity in adults as a BMI of 27.3 

kg/m2 or more for women and 27.8 kg/m2 or more for men. These definitions were based on 

the gender-specific 85th-percentile values of BMI for persons 20 to 29 years of age. The 

WHO classification assigns an increasing risk for comorbid conditions—including 

hypertension, type 2 (non-insulin-dependent) diabetes mellitus, and cardiovascular disease-- 

to persons with higher BMIs (see Table 1) relative to persons of normal weight (i.e., those 

with a BMI between 18.5 kg/m2 and 25 kg/m2).The WHO criteria for overweight is (BMI 

25 kg/m 2 ) and obesity ( 30 kg/m2), 67% of men and 62% of women are overweight . (6) 

Food intake is modified by a multitude of factors – physiological, psychological, and social, 

etc. Meal size seems to be controlled by a feedback loop in which signals from the 

gastrointestinal tract are transmitted to the hypothalamus after relay in the brainstem. An 

important afferent signal is cholecystokinin – a peptide secreted by the duodenum in response 

to mechanical and chemical stimuli. Cholecysokinin acts locally on cholecystokinin receptors 

in the gastrointestinal tract, the signal being transmitted to the brainstem by the vagus. The 

effect is to decrease food intake. Circulating cholecystokinin does not cross the blood-brain 

barrier but the peptide is also a neurotransmitter and acts on cholecystokinin B receptors in 

the brain to function as a satiety factor. Insulin stimulates leptin release from fat cells and it 

enters the CNS where it can decrease food intake by affecting the actions of NPY. However, 

insulin may also, in some circumstances, increase food intake, presumably indirectly, by an 

effect on blood glucose. Thus patients with type 2 diabetes mellitus usually gain weight when 

treated with insulin or sulfonylureas – an effect that is clinically important. (7) Current 

management of obesity by pharmacotherapy includes noncentrally acting antiobesity agents 

such as Orlistat (Xenical), which inhibits the action of the intestinal lipase enzymes and 

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hence blocks the absorption of fat in the intestines. The most common adverse events of 

Orlistat include oily faecal spotting, abdominal pain, and flatus with discharge, faecal 

urgency, fatty/oily stool, increased defecation, and faecal incontinence (8) . Another 

pharmacotherapy is the centrally acting antiobesity agent, namely, Sibutramine (Reductil), 

which produces unwanted side effects such as trouble sleeping, constipation, and dry mouth 

as well as increased heartbeat, increased blood pressure, awareness of the heartbeat 

(palpitations), headache, anxiety, or dizziness (9–11) . Consequently, the Food and Drug 

Administration (FDA) of the USA withdrew Sibutramine in October 2010. Surgical 

procedures such as gastric bypass operations are generally reserved for people with morbid 

obesity (BMI > 40) who instituted but failed an adequate exercise and diet program (with or 

without adjunctive drug therapy) or patients presenting with comorbid conditions such as 

hypertension, impaired glucose tolerance, diabetes mellitus, hyperlipidaemia, and obstructive 

sleep apnoea (12) . In addition to an increase in total body fat, a proportionally greater amount 

of abdominal fat compared with fat in the lower extremities or hips has been associated with 

increased risk for diabetes, hypertension, and risk factors for heart disease in both men and 

women. Current guidelines categorize men at increased relative risk for coronary artery 

disease, diabetes, and hypertension if they have a waist circumference greater than 40 inches 

(102 cm); women are at increased risk if their waist circumference exceeds 35 inches (88 

cm). Thus, an overweight person with abnormal fat patterning may be at high risk for these 

diseases even if that person is not considered obese by BMI criteria. (13) . 

MATERIAL AND METHODS 

Respondents were interviewed face- to- face using a survey questionnaire. Respondents 

needed to answer questions to test their awareness on the treatment using herbal medicine and 

physical activity for obesity. 

QUESTIONNAIRE 

The questionnaire was developed based on a literature of other similar surveys in the region. 

The questionnaires were made available in English. The respondents include allopathic 

doctor, herbalist, physiotherapist and patients. After we went through the questionnaire we 

concluded that major cause of obesity is lifestyle and we proposed some treatments by using 

herbs and exercise. 

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BMI = Wt (kg)/Height(m 2 ) 

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STATISTICAL ANALYSIS 

After getting the answer, we followed the typical statistical analysis (bar graph) for proper 

analysis of data. Data was analyzed on the basis of MCQ`s. 

RESULT AND DISCUSSION 

TREATMENT 

HERBAL MEDICINE 

Sr.NO. BOTANICAL 

NAME 

1 Commiphora 

mukul (14) 

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FAMILY 

NAME 

PART 

USED 

Burseraceae Whole 

Plant. 

MOA FIGURE 

Guggul possesses strong 

disinfecting properties and 

is a weight loss and fat 

burning agent. It lowers 

elevated serum cholesterol 

and triglycerides, while 

maintaining or improving 

the HDL to LDL ratio. 

Studies report that it 

increases the production 

of thyroid hormone. Since 

this hormone breaks down 

cells of protein, fat and 

carbohydrates, this herb is 

believed to be promoting 

weight loss. 

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2 Garcinia 

cambogia (15) 

3 Panax ginseng 

(16) 

4 Cissus 

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(17) 

quadrangularis 

Guttiferae Gum resin - Garcinia 

Cambogia is a natural 

suppressor for appetite. It 

helps to suppress the 

Appetite and boost up the 

metabolism naturally. It 

acts on elimination of 

excess fat from the body 

as it does not allow body 

to store excess of fat. 

Araliaceae Root - panax ginseng may 

encourage the body to rely 

on energy stores and burn 

calories more efficiently 

during exercise 

Vitaceae Stem - They also brought 

significant reductions in 

weight, body fat, total 

cholesterol, 

LDLcholesterol, 

triglycerides, and fasting 

blood glucose levels over 

the respective study 

periods in a double-blind 

placebo controlleddesign, 

involving initially 168 

overweight and obese 

persons 

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5 Gymnema 

sylvestre (18) 

6. Zingiber 

7. Radix 

8. 

officinale (19) 

platycodi 

(20,21) 

Erythrina 

vareigata (22) 

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Asclepiadaceae leaves and 

roots 

Zingiberaceae Ginger 

extract 

lowers triglycerides and 

“bad cholesterol 

- The 

phytochemical, gingerol 

and shogaol increase the 

metabolic rate and thus 

help to “burn off” 

excessive fat and also 

suppress the 

absorption of calorie- 

dense dietary fats from the 

intestines. 

Campanulaceae dried root The aqueous extract of 

Fabaceae 

Leaf 

extract 

Platycodi radix may 

inhibit the intestinal 

absorption of dietary fat 

by inhibiting its 

hydrolysis 

- hypolipidaemic, 

anti obesity effect in 

Siddha system of 

medicine 

- Leaf extract has a 

high total phenol content, 

beneficially altered lipid 

parameters and reduced 

body weight. 

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9. Nigella sativa 

Linn 

10. Achyranthes 

aspera (23) 

11. Allium 

sativum (24) 

12. Acorus 

calamus (25) 

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Ranunculaceae Seeds - reduce cholesterol, 

Amaranthaceae Whole 

plant 

Alliaceae Whole 

plant 

triglyceride and glucose 

levels 

- The alcoholic 

extract of this plant at 

100mg/kg dose, lowered 

total serum cholesterol 

(TC) and phospholipid 

(PL), triglyceride (TG) 

and total. lipid (TL) levels 

by 60, 51, 33 and 53 

percent, respectively in 

triton-induced 

hyperlipidemic rats. 

- Lower blood 

cholesterol (fat) levels 

Araceae Tannins - Tannins from this 

plant at 10mg/kg dose 

decreased the serum 

cholesterol and 

triglyceride levels in rats 

fed with atherogenic 

diet.At a dose of 20mg/kg 

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13 Coleus 

forskohlii (26) 

14 Hemidesmus 

indicus (27) 

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Lamiaceae whole 

plant 

Asclepiadaceae Cell 

culture 

extract 

both triglycerides and 

serum cholesterol were 

brought back to the 

baseline. 

- This plant extract (10% 

forskolin) at a dose of 500 

mg showed significant 

decrease in body weight 

(66.33 ± 3.00 to 63.96 ± 

3.10, p=0.0038), fat 

content (29.64 ± 2.19 to 

27.77 ± 2.27, p=0.0038), 

lean body mass (44.34 ± 

2.98 to 43.93 ± 3.01, 

p=0.0044) and basal 

metabolic rate (1379.1 ± 

74.4 to 1363.9 ± 77.5, 

p=0.0254) when given to 

fifteen volunteers twice a 

day with meals in an 8- 

weeks open-label study. 

This indicates that C. 

forskohlii extract has 

potential effect as an 

adjunct therapy in the 

treatment of obesity. 

- Cell culture extract 

of H.indicus (2, 4 and 16 

mg/kg, p.o) showed 

significant treatment 

reduction (p


15 Hibiscus 

sabdariffa (28) 

16 Lagerstroemia 

speciosa (29) 

17 Momordica 

charantia (30) 

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Malvaceae Hibiscus 

extract 

atherogenic diet for first 

30 (l-30) days. When 

atherogenic diet and cell 

culture extract were given 

together for 60 (l-60) days 

there was significant 

(p


18 Myristica 

fragrans (31) 

19 Panax 

20 Piper 

(32, 33) 

japonicus 

nigrum (34) 

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and VLDL-CH levels in 

serum samples. 

Myristicaceae Seed - It lowered the 

lipoprotein lipid levels, 

total cholesterol, LDL 

cholesterol and 

triglycerides. HDL 

cholesterol was not 

significantly affected. 

Total cholesterol, HDL 

and LDL: HDL ratios 

were also significantly 

lowered. It lowered the 

level of total cholesterol 

in the heart and liver. 

Aralioideae Rhizomes They inhibit intestinal 

Piperaceae Seed 

absorption of dietary fat 

through the inhibition of 

pancreatic lipase activity. 

- 

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21 Plumbago 

zeylanica (35) 

22 Solanum 

melongena & 

Solanum 

gilo (36) 

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Plumbaginaceae Root - Antihyperlipidemic 

Solanaceae Whole 

fruit 

- The aqueous extract at all 

doses demonstrated a 

significant (p


24 Hoodia 

gordonii 

(38) 

25 Coccinia 

grandis or 

kundru (39) 

26 Triphala (40) 

27 Cabbage 

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Apocynaceae 

Cucurbitaceae 

Stems and 

roots 

Combretaceae Fruit taken 

digestion and assimilation 

of foods. 

- appetite suppressant 

- This active ingredient 

is a steroidal glycoside, 

due to which the brain 

does not sense hunger. 

Fruit - Increasing Energy, 

without 

seed 

Improving Digestion, and 

weight loss and are non- 

FDA reviewed or 

approved, natural 

alternatives, to use for 

Obesity. 

- Help in proper 

distribution of fat. 

Brassicaceae Leafy head - Inhibits the 

conversion of sugar and 

other carbohydrates into 

fat. 

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28 Tomato 

29 Rhamnus 

30 Aloe 

purshlanus / 

cascara (41) 

barbadensis / 

aloe vera (42) 

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Solanaceae Fruit - Fruit pectin and 

other edible fibers in 

tomato are easy to 

produce satiety feel, 

helping to absorb 

redundant fat and excrete 

together, and so reducing 

food fat intake. Edible 

fibers also help to 

promote motility of 

stomach and intestine, 

reducing constipation. 

Rhamnaceae Bark - Works as a laxative 

Asphodelaceae Central 

part 

- Increase bowel 

movement 

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31 Allium cepa / 

onion 

32 Zea may’s / 

corn 

33 Ma huang (43) 

34 Dandelion (44) 

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Lilliaceae Bulb - lowers blood 

Poaceae Whole 

corn 

Ephedraceae Stem and 

branches 

cholesterol level 

- provides low 

calorie 

- Boost your 

metabolism 

- Suppress your 

appetite 

- Increase your 

energy 

- Turn your body 

into a calorie burning 

furnace through 

thermogenics 

Asteraceae Roots - It is an excellent 

diuretic leads to weight 

loss by reducing the water 

content of 

the body 

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35 Green tea (45) 

36 Grape seed (46) 

EXERCISE FOR OBESITY (47) 

1. Pranamasana - salute. 

2. Hastauttanasana 

3. Padhastasana 

4. Ashwa Sanchalnasana. 

5. Parvatasana - mountain pose. 

6. Sashtang dandawat - lie down. 

7. Bhujangaasan - cobra pose. 

8. Parvatasana. 

9. Ashwa Sanchalasana 

10. Padhastasana 

11. Hastuttanasana 

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Theaceae Leaf - This means that 

these leaves, when 

consumed, can raise the 

body’s metabolism. 

Clinical studies show that 

green tea can boost your 

energy levels, increase the 

metabolism, and thereby 

promote weight loss. 

Vitaceae. Seed - grapes and grape 

seed extracts contain 

potent antioxidant and 

anti-inflammatory 

properties that may 

improve overall health 

and also prove to be an 

effective tool in fighting 

obesity and assisting in 

weight loss. 

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12. Pranamasana 

13. Garudasana (Eagle pose) 

14. Gamukhasana (Cow's face pose) 

15. Parighasana (Gate pose) 

16. Pavanmuktasana (Gas releasing pose) 

17. Aerobic dance (48) 

18. Fitness walking (49) 

19. Jumping rope 

20.Types of Exercises (50) 

Walking 

Running/Jogging 

Swimming 

Cycling 

SURVEY BASED RESULTS 

PATIENT 

1. Which is your favorite snack? 

What are you favourite snack? No. of 

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Respondents 

(A) Salty snack: chips, cracker 3 14.5 

(B) Baked food: cookies, donuts 6 28.5 

(C) Other sweet: candy, chocolate 6 28.5 

(D) All of the above 6 28.5 

Percentage (%) 

Based on the above data it is clear that most of the patients like snacks, chips, cookies, 

crackers, sweet, candy and so on. 28.5% patients said that these are their favorite food. 

According to the literatures these foods contain more fat and carbohydrate which can lead to 

obesity, hence should consume in little amount. 

2. Do you take any of the following steps when you feel your weight goes beyond a certain 

threshold? 

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Do you take any of the following steps when 

you feel your weight goes beyond a certain 

threshold? 

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No. of 

Respondents 

(A) Reduce food intake 11 55 

(B) Increase physical activity 4 20 

(C) Take medication 0 0 

(D) My weight does not change 5 25 


55% students said that they reduce food intake when they feel their weight goes beyond a 

certain threshold. whereas 20% students feel that they should increase their physical activity. 

According to the literature review, we found that an obese patient should reduce the food 

intake and increase their physical activity. Reduce food intake should be the first step an 

obese patient should do. 

3. Do you know what obesity is and how it affects human health? 

Do you know what obesity is and how is 

affects human health? 


Respondents 

(A) Yes 12 60 

(B) Something I know about obesity 8 40 

(C) I don’t know about obesity 0 0 


most patients are aware about obesity.60% patients answered that they know very well about 

obesity and 40% of patient knows something about obesity. From this bar graph we can 

discuss that most patients have the knowledge on what is obesity. 

4. What is the main cause of obesity? 

What is the main cause of obesity? 


Respondents 

(A) Lack of exercise 6 28.5 

(B) Unhealthy food 3 14.5 

(C) Stress 0 0 

(D)All of the above 12 57.0 


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28.5% patient answered lack of exercise, 14.5% patient answered unhealthy food and 57.0% 

patient answered all of the above. To avoid that the students should eat healthy food like 

vegetable, fruit and cereal and increase physical activity like aerobic, running, cycling. Thus, 

exercise will also reduce stress. Based on the literature, all the above three answer is the 

cause of obesity. Hence,most of the patient answered correctly that cause of obesity is lack of 

exercise, unhealthy food and stress. 

5. How to get good healthy lifestyle? 

How to get good healthy lifestyle? 

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Respondents 

(A) Visit doctor to monitor your health 17 85 

(B) Smoking 1 5 

(C) Drinking Alcohol 0 0 

(D) Just eat the food that you like 2 10 


Most of the patients choose visit doctor to monitor your health from the data we can conclude 

that the patients have knowledge about their healthy lifestyle and aware about their health. 

6. Do you think weight management is important in healthy lifestyle? 

Do you think weight management is important 

in healthy lifestyle? 


Respondents 

(A) Yes 16 80 

(B) No 4 20 


80% patients answered yes and 20% patients answered no. Most of patients answered yes 

because they are aware that obesity can lead to many diseases. That shows that patients are 

aware of disease concern to obesity. 

7. What are the disease caused by obesity? 

What are the disease caused by obesity? No. of 

Respondents 

(A) Diabetes 10 45.5 

(B) Hypertension 7 31.8 


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(C) Cancer 0 0 

(D) All of the above 5 22.7 

45.5% patients answered diabetes, 31.8% patients answered hypertension and 22.7% patients 

answered all of the above. According to literature review, we found that the main disease that 

causes obesity is diabetes. From the above data we can conclude that most of the patient 

answered correctly that diabetes is the disease caused by obesity. 

8. Do you think that physical activity is lacking among Malaysians? 

Do you think that physical activity is lacking 

among Malaysians 

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Respondents 

(A) Yes 16 80 

(B) No 4 20 


80% of patients think that physical activity is lacking among Malaysians, whereas 20% of 

patient answered no. According to the literature, physical activity is lacking among 

Malaysians because of their stressful work and less time. They suggested that physical 

activity like walking, cycling, swimming for about 30 minutes can reduce weight. 

9. How often do you exercise? 

How often do you exercise? No. of 

Respondents 

(A) Everyday 2 10 

(B) Weekly once 9 45 

(C) Monthly once 0 0 

(D) None 9 45 


45% of patient do exercise weekly once and the equal amount of patient do not do exercise at 

all. According to the literature, we should do exercise three times a week for 30-60 minutes. 

This is one of the vital factor which can lead to obesity. 

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10. What type of exercise you do daily? 

What type of exercise you do daily? 

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Respondents 

(A) Walking 10 43.5 

(B) Jogging 5 21.7 

(C) Gym exercise 1 4.5 

(D) None 3 13.0 

(E)Other 4 17.3 


43.5 % students choose walking, 21.7% students choose jogging, 4.5% students choose gym 

exercise, 13% students choose none and 17.3% students choose other. There are many 

physical activities one can do like swimming, yoga, aerobic, skipping, handball, basketball, 

golf etc. we can conclude that most of the students like to walking as a exercise. According 

to the literature survey, we should do exercised three times a week for 12 weeks for duration 

30-60 minutes. 

11. Do you think herbal medicine is good in the management of obesity? 

Do you think herbal medicine is good in the 

management of obesity? 


Respondents 

(A) Yes 15 75 

(B) No 5 25 


75% students answered yes and 25% students answered no. Herbal medicine is good because 

it doesn’t have much side effect to our body. We can use herbal medicine as a supplement to 

reduce body weight. From the data obtained we can conclude that herbal medicine is good in 

the management of obesity. 

12. Have you tried any modern medicine in your weight management? 

Have you tried any modern medicine in your 

weight management? 


Respondents 

(A) Yes 7 35 

(B) No 13 56.5 


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35% students answered yes and 56.5% students answered no. This data shows that some of 

the students did not tried modern medicine because they are aware of side effects of modern 

medicine. Some of the students answered that they use the herbal life product. 

13. Do you agree that exercise and herbal medicine together in management of obesity will 

be better and effective than using only exercise or herbal medicine separately? 

Do you agree that exercise and herbal 

medicine together in management of obesity 

will be better and effective than using only 

exercise or herbal medicine separately? 

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Respondents 

(A) Yes, I agree 16 70 

(B) No, I am not agree 4 30 


exercise and herbal medicine together in management of obesity will be better and effective 

than using only exercise or herbal medicine separately. 70% students answered yes, I agree 

and 30% students answered no, I am not agree. According to research published in scientific 

esteemed journals, combination of the both is more effective than using only exercise or 

herbal medicine separately. 

DOCTOR 

1. Which one of BMI range is consider obesity? 

Which one of BMI range is consider obesity? No. of 

Respondents 

(A) < 18.5 0 0 

(B) 18.5 -25.0 0 0 

(C) 25.0- 30.0 4 31 

(D) >30.0 9 69 


69% doctors answered correctly which is >30.0. 31% of doctors’ answer 25.0- 30.0. Body 

mass index should be expressed as weight (kg) divided by height (m 2 ), according to this 

formula we can calculate a person`s BMI. The correct answer for obesity according to BMI 

table in literature is > 30.0 

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2. What is the common reason for obesity? 

What is the common reason for obesity? No. of 

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Respondents 

(A) Unhealthy eating 9 56 

(B) Lack of physical activity 7 44 

(C) Starvation 0 0 

(D) Other 0 0 


56% doctors consider unhealthy eating is the common reason for obesity but 44% doctors 

answer that common reason for obesity is lack of physical activity. According to literature 

review, common reason for obesity are genetic factors, over consumption, sedentary lifestyle, 

stress, health factor. Obesity is a silent killer. From the graft we know that answer given by 

doctors is accurately. 

3. What do you suggest your patient to do to reduce weight? 

What do you suggest your patient to do to 

reduce weight? 


Respondents 

(A) Diet 11 48 

(B) Exercise 7 30 

(C) Take herbal medicine 4 18 

(D) Take modern medicine 1 4 

(E) Other 0 0 


doctors suggest diet for their patient to reduce weight. 30% doctors suggest exercise, 18% 

doctors suggest taking herbal medicine and 4% doctors suggest take modern medicine. Diet is 

deliberate selection of food to control body weight or nutrient intake. Exercise is any bodily 

activity that maintains physical fitness , overall health and wellness. Conclusion is most of 

the doctors will suggest diet and exercise to their patient to reduce weight. 

4. In your opinion which medicine will give more side effect in the treatment of obesity? 

In your opinion which medicine will give 

more side effect in the treatment of obesity? 


Respondents 


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(A) Herbal medicine 4 25 

(B) Modern medicine 6 38 

(C) Combination of both 2 12 

(D) Combination with exercise 4 25 

25 % doctors answer herbal medicine and combination with exercise(herbal medicine + 

modern medicine + exercise) give more side effect. 38% doctors consider that modern 

medicine give more side effect. 12% doctors answer combination of both( herbal medicine + 

modern medicine). The correct answer is modern medicine according to literature and most 

of the doctor is answering correctly. 

HERBALIST 

1. Do you think herbal medicine will be more effective and safer than modern medicine? 

Do you think herbal medicine will be more 

effective and safer than modern medicine? 

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Respondents 

(A) Yes 5 100 

(B) No 0 0 


100% herbalist think that herbal medicine will be more effective and safer than modern 

medicine. We found that if herbal medicine correct selection of the corresponding therapeutic 

strategies and principles that guide the choice of herbs and herbal formulas. Then, it is 

prepared and used appropriately, it can be more safe and effective compare with modern 

medicine. Natural health medicine has been documented to have less or no side effects when 

compared to its chemical counterparts. That is because natural health medicine is generally 

made with products taken out of nature without being refined. That means that the medicine 

is made out of natural ingredients that will work in conjunction with the body; whereas their 

refined counterparts might have an adverse affect. Option A is choose by most herbalist and it 

is correct. 

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2. Do you aware of any of this herbal medicine which is used for obesity? Tick as much as 

you know. 

Do you aware of any of this herbal medicine 

which is used for obesity? Tick as much as 

you know. 

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Respondents 

(A) Aloe vera 5 14 

(B) Gymnema 5 14 

(C) Parsley 3 8 

(D) Kundru 4 11 

(E) Cascara 1 3 

(F) Commophora mukul/guggul 1 3 

(G) Hoordia gordonii 3 8 

(H) Zingiber officinale 4 11 

(I) Garcinia cambogia 3 8 

(J) Evening primrose oil 1 3 

(K) Marijuana/cannabis sativa 1 3 

(L) Pananx ginseng 5 14 


Most herbalist think that Aloe vera, Gymnema, Pananx ginseng, Kundru and Zingiber 

officinale are using for obesity treatment. According to literature review, Aloe vera, 

Gymnema, parsley, Kundru, Cascara, Commophora mukul/Guggul, Hoordia gordonii, 

Zingiber officinale, Garcinia cambogia and Pananx ginseng all are the herbal drug which is 

used to treat obesity. Juice of aloe vera is rich in several vitamins, minerals, trace elements 

and amino acids. Internal intake of this juice as well as its external application can be used in 

treatment of many diseases like weight loss, hypertension, diabetes, high cholesterol, acne, 

eczema and some other skin disorders. Gymnema is one of the plants with potent anti diabetic 

properties and used for controlling obesity in the form of Gymnema tea. Kundru has 

antioxidant property, anti diabetic property and most important is its hypoglycemic action 

because of which its aqueous and ethanolic extracts can be used for control of obesity. 

Hydroxycitric acid, the active ingredient in the herbal compound Garcinia cambogia, 

competitively inhibits the extramitochondrial enzyme adenosine triphosphate-citrate (pro- 

3S)-lyase. As a citrate cleavage enzyme that may play an essential role in de novo lipogenesis 

inhibition, G cambogia is claimed to lower body weight and reduce fat mass in humans. 

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Antiobesity effect of wild ginseng in male obese leptin-deficient mice was evaluated. Pananx 

ginseng able to loss of body weight and decrease in blood glucose levels .From this we able 

to know that most herbalist got the right answer. 

3. Have you suggested any of your patients to use herbal medicine in combination with 

exercise? 

Have you suggested any of your patients to 

use herbal medicine in combination with 

exercise? 

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Respondents 

(A) Yes 3 60 

(B) No 2 40 


60% herbalist answer yes, they will suggested any of their patient to use herbal medicine in 

combination with exercise. 40% herbalist answer no. The correct answer is yes according to 

literature because herbal medicine(collection of descriptions of plants put together for 

medicinal) and exercise put together for medicinal purposes which produce therapeutic effect 

on controlling weight gain and reducing weight. Most herbalist answer correctly because 

combination of herbal medicine and exercise in management of obesity is more effective 

compare with only use herbal medicine or only exercise to reduce weight according to 

literature. 

PHYSIOTHERAPISTS 

1. Do you think that physical activity is lacking among Malaysians 

Do you think that physical activity is lacking 

among Malaysians 


Respondents 

(A) Yes 9 90 

(B) No 1 10 


90% physiotherapist answered yes and 10% physiotherapist answered no. Based on the data 

we can assume that exercise is important for obese patient to reduce their weight. Physical 

activity among Malaysia is lacking because of the busy lifestyle. They do not concern about 

their health and does not spend time for exercise 

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2. What are the exercises you suggest for obese patient? 

Most of the physiotherapist stated that aerobic exercise will be more helpful to reduce 

weight.Most of the physiotherapist suggested aerobic exercise like jogging, walking, cycling, 

and swimming. From literature review there are many exercise that you can suggest to obese 

patient for example indoor activities- sport games: basketball, handball, korfball (Dutch 

sports game), field hockey; outdoor activities- Triathlon: Subsequently exercising on either a 

normal bicycle or a mountain bike and a kick board followed by swimming and water polo 

and aqua jogging/aqua fitness. Based on the evidence from the physiotherapies are correct. 

3. How long we should exercise per day? 

The physiotherapist suggested that duration obese people should exercise between 20-60 

minutes per day depend on person’s health statusand also depend on our B.M.R.and Age. 

From literature review we should exercise three times a week for 12 week. The time duration 

is 30-60 minutes. The answer from the phsiotherapist are correct. 

4. Is there any side effect in doing certain exercise? If yes what are they? 

Yes, the side effect are muscle fatigue, muscle soreness, extreme heavy exercise can lead to 

heart failure in underlying ischaemic heart disease patient, jogging is not encouraged as if 

causes damage to hip, knee and ankle joint. When you exercise too vigorous and not suitable 

to your muscle strength. Precaution should be taken for cardiac patients asthamatic. If you are 

old and have some underlying bone related problem, avoid bearing exercises. According to 

the literature review side effect in doing certain exercise may contribute to further lowering 

of BP by attenuating the sympathetic nervous activity in the trained state. 

5. What are the food supplement we should take after exercise? 

The food supplement we should take after exercise that suggested by physioterapies are 

lemon water, light meal, egg(avoid yellow part), soup protein rich diet, supplement of 

carbohydrate and vitamin, taking balance diet include vegeatable, fruit and cereal, energetic 

liquid diet and nutritional supplement. Based on literature review food supplement should 

increase consumption of grain, cereals and fibre as well as vegetables and fruit, and to 

substitute low-fat dairy products and meats for full- or high-fat alternatives. The answered 

from physiotherapies are correct. 

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CONCLUSION 

We have done a survey on role of herbal medicine and exercise in the management of 

obesity. After going through the questionnaires, we can conclude that improper lifestyle such 

as lack of exercise, unhealthy food intake and stress is the major cause for obesity and also it 

is a multifactorial disorder. The age onset of obesity is late teens. According to the survey we 

got to know that most of the patients are consuming unhealthy food like snacks, chocolates, 

sweets which is the mainly causing obesity. Foods with high amount of carbohydrate also can 

cause obesity. Other than that, based on our interview with doctor they suggest that diet and 

exercise for the treatment of obesity. Herbalist suggested few herbal medicines such as aloe 

vera, Gymnema and panax ginseng will be more effective for obesity. Many more plants are 

there which have effect on obesity. Herbal medicine may be a vital tool to fight against 

obesity and prevent such diseases like hypertension, MI, diabetes Melitus before their 

occurance. Herbal medicines are much safer than modern medicines. Most of the herbal 

medicines have fewer side effects. Apart from that patients also lack of exercise which than 

leads to obesity. Whereas after the survey to the physiotherapist, they suggested that aerobic 

exercise will be effective in the management of obesity. Moreover, physical activity is 

lacking among Malaysians. 30 min/day of physical activity has a clear positive impact on 

cardiovascular health. Obesity is a serious problem, especially for its attendant cormobidity, 

and exercise is well suited to minimize several of these morbid processes in the masive obese 

patient. Hence we can conclude that herbal medicine and exercise together will be helpful in 

the management of obesity. 

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