Evidence-Based Evaluation Of Lekhana Basti In Obesity, Sthaulya And Dyslipidemia: A Systematic Review And Synthesis Without Meta-Analysis

Abstract

Background: Lekhana Basti is an Ayurvedic therapeutic enema used in clinical contexts described by terms such as Sthaulya and Medoroga and, in contemporary research, investigated in obesity and lipid disorders. Published studies report anthropometric, biochemical, patient-reported and exploratory molecular outcomes, but the evidence base is heterogeneous and incompletely reported.

Objective: To systematically evaluate the clinical effectiveness, safety, risk of bias and mechanistic evidence relating to Lekhana/Lekhan Basti in obesity, Sthaulya, hyperlipidemia and dyslipidemia, and to determine whether the available evidence supports quantitative meta-analysis.

Methods: The review was structured according to PRISMA 2020, PRISMA-S, Cochrane methodological principles and SWiM. Eligible human evidence included randomized/comparative clinical studies, pilot interventional studies and mechanistic clinical investigations. Outcomes included body weight, BMI, circumferences, skin-fold/body-fat measures, lipid parameters, quality of life, symptoms, adverse events and molecular biomarkers. Randomized studies were appraised using RoB 2 principles and outcome-level certainty was considered using GRADE domains. A key review-level limitation was identified: complete historical search exports, deduplication files and screening audit trails were not preserved; therefore, unrecoverable upstream PRISMA counts are not reconstructed and must be generated by a documented final rerun.

Results: Seven principal studies formed the retained evidence base: six comparative/clinical studies and one small mechanistic prospective study. Recurrent favorable changes were reported for body weight/BMI, circumferences and selected lipid parameters, particularly total cholesterol and LDL-C. However, several reports emphasized within-group significance, used heterogeneous formulations and comparators, or lacked complete between-group estimates and confidence intervals. Safety reporting was inconsistent. Molecular studies were exploratory and involved very small samples.

Conclusion: The literature provides a recurrent but low-certainty signal of possible benefit in selected anthropometric and lipid outcomes. Definitive comparative effectiveness has not been established. A pooled meta-analysis is not currently justified across the full evidence base because compatible effect estimates and variance data are inconsistently available. A final auditable database rerun, prospective registration of future reviews, standardized Lekhana Basti reporting and adequately powered randomized trials are required.