BACKGROUND: Obesity, metabolic syndrome, and diabetes mellitus are increasing to epidemic proportions globally. Prameha is a syndrome described in the ancient Ayurvedic texts that includes clinical conditions involved in obesity, prediabetes, diabetes mellitus, and metabolic syndrome. MATERIALS AND METHODS: Various dietary, lifestyle, and psychologic factors are involved in the etiology of Prameha, particularly in relation to disturbances in fat and carbohydrate metabolism. RESULTS: The Ayurvedic management of Prameha emphasizes dietary and lifestyle recommendations and herbal preparations, in accordance with the psychophysiologic constitution of the patient. Ayurveda also addresses the management of psychologic factors that contribute to the development of Prameha. Ayurvedic treatment known as Apatarpana (balanced diet with restricted calories) and Santarpana (highly nutritious, high-calorie diet intended to increase weight) are recommended for patients with type 2 and type 1 diabetes, respectively. Various Ayurvedic herbs and herbomineral formulations are utilized, based on the stage and type of disease as well as the psychophysiologic constitution of the patient. A large body of research has been conducted on these Ayurvedic herbs. CONCLUSIONS: Integrating the theory and modalities of Ayurveda in the management of these disorders may prove to be beneficial.