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Introduction: Obesity, known as Atisthoulya in Ayurveda, is a complex metabolic disorder characterized by excessive fat accumulation that increases the risk of comorbidities such as diabetes, cardiovascular diseases, and hypertension. While modern medicine emphasizes caloric imbalance, sedentary lifestyle, and genetic predisposition, Ayurveda addresses doshic imbalances, particularly Kapha vitiation, impaired Agni (digestive fire), and accumulation of Meda (fat) and Ama (toxins). Methods: A systematic literature review was conducted using PubMed, Scopus, Web of Science, and classical Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridayam). Inclusion criteria encompassed clinical trials, observational studies, and review articles on obesity management. Exclusion criteria included studies lacking methodological clarity or not directly addressing therapeutic interventions. Results: Ayurvedic interventions for Atisthoulya involve a combination of dietary regulation (Pathya Ahara), lifestyle modifications (Vyayama), herbal formulations (Medohara dravyas), and Panchakarma therapies like Virechana and Udvartana. Modern medicine employs dietary therapy, physical activity, pharmacotherapy, and bariatric surgery. Evidence suggests integrative approaches combining Ayurvedic and modern methods improve weight management, metabolic profiles, and patient quality of life. Discussion: Integrating Ayurvedic principles with contemporary treatments addresses both symptomatic and etiological factors of obesity. Personalized strategies based on doshic constitution and metabolic assessment may enhance long-term outcomes. However, standardization, rigorous clinical trials, and safety validation are necessary.

KEYWORDS: Ayurveda, Atisthoulya, Obesity, Therapeutic Approaches, Weight Management