Metabolic syndrome (MetS) is a well-known collection of
interrelated metabolic conditions that identifies patients at increased risk of
developing cardiovascular disease, eventually leading to increased morbidity
and mortality with advancing age. These conditions include diabetes mellitus,
high blood pressure, obesity and dyslipidaemia.1 Though the
pathogenesis of MetS is not well-understood, central obesity and insulin
resistance are generally acknowledged as important causative factors.
The excess body fat accumulation in obesity may have an
adverse effect on health and together with the afore-mentioned conditions may
lead to a reduced life expectancy. Clinical measurements that are used to reliably
assess and quantify obesity include waist circumference and body mass index
(BMI)2.
Obesity is most commonly caused by a combination of
excessive caloric intake and lack of physical activity although a genetic
susceptibility plays a part too. Bad habits that contribute to obesity include
overeating, a sedentary lifestyle, poor sleep habits and stress. The mainstay
of effective treatment is behavioral weight loss counseling that includes
dieting and regular exercise, but these are easier said than done. In reality,
many obese people are unable to achieve the targets that are set for them3.
The World Health Organization (WHO) estimated in 2008 that
approximately 500 million adults over the age of 20 were obese4.
Worse still, in 2010, it was estimated that more than 40 million children under
the age of 5 were overweight. Previously considered a high-income country
problem, obesity is now on the rise in low and middle-income countries. Many
people in Muslim countries are suffering from obesity despite living in abject
poverty. This may seem paradoxical but poverty, malnutrition and food insecurity
have been linked to obesity and described as a state of overnutrition5.
This condition exists because the diets of poor people have adequate
kilocalories from cheaply available carbohydrates to meet or exceed energy
requirements but lack the resources to acquire the necessary quality to ward of
diseases and promote optimal health.
In Malaysia, the prevalence of obesity has matched that of
developed countries with obesity and overweight people being 14% and 29% of the
population respectively6. Among the Gulf States, 70% of women are
considered obese7 and the top countries of obese population are
Qatar, Saudi Arabia, The West Bank and Gaza and Lebanon8.
Apart from the well established and previously alluded to
complications, the implications of obesity on Islam are rather less documented
but no less debilitating.
The Holy Prophet (peace and blessings of Allah be upon him)
warned us about the dangers and health hazards of overeating. He
advised us to fill our stomach with 1/3 food, 1/3 for drink, and 1/3 for air.
On the authority of Al-Miqdaam ibn Maadiy-Karib who said: I
heard the Holy Prophet (peace and blessings of Allah be upon him) saying: “No
human ever filled a vessel worse than the stomach. Sufficient for any son of
Adam are some morsels to keep his back straight. But if it must be, then one
third for his food, one third for his drink and one third for his breath.”
[Ahmad, At-Tirmidhi, An-Nasaa'I, Ibn Majah – Hadith sahih]
He also warned us about the perils of overeating. On seeing
a fat man, the Holy Prophet (peace and blessings of Allah be upon him said: “If
you did not have a paunch (belly fat), it would be better for you. He also
said: Overeating does not go with good health.” [Al-Haythami]
Obesity makes it
harder to have a good posture during prayers, interrupting proper kneeling and
prostration. Good posture and joint and muscle flexibility are a prerequisite
for good spiritual experience during prayer. The obligatory pilgrimage is a
hard physical exercise and can only be enjoyed by those physically fit and
able. These and other situations exemplify the disruption of fulfillment
obesity causes on ones faith.
The body is a gift from Allah that we must all treat in the
best way, just like all gifts. To abuse and neglect it is akin to abusing and
neglecting a gift from the Almighty. Might this not be considered a sin?
A person who is obese
and prone to diseases will spend a considerable amount of his time, effort and
money dealing with his problems. These resources could best be used towards enriching
life, family and attaining spiritual goals. Thus it is one’s duty to look after
their body.
The literature abounds with data suggesting that diet and
exercise are effective in combatting the scourge of obesity. However, Allah
almighty preceded all scientists and researchers in solving this problem as He
says: (and eat and drink but waste not by extravagance, certainly He (Allah)
likes not Al-Musrifûn (those who waste by extravagance)) (Sûrat
Al-A‘râf-verse31), here Allah almighty tells us that extravagance in foods and
drink is a sin that should be avoided by us. He ordered us to make a balances
in all things even in food and drink as He almighty says about believers and
the slaves of God: (And those who, when they spend, are neither extravagant nor
niggardly, but hold a medium (way) between those (extremes).)(Sûrat
Al-Furqân-verse 67.
On the other hand the prophet (peace be upon him) asks us
not to eat too much as he says: (A human being has not filled any vessel which
is worse than a belly. Enough for the son of Adam are some mouthfuls which can
keep his back straight: but if there is no escape he should fill it a third
with food, a third with drink, and leave a third empty)[Narrated by
At-Tirmidhi]. This prophetic rule is considered to be one of the basics of
modern medicine which demonstrates the sincerity of our Prophet and that all
what he says is by inspiration from Allah not by himself!.
The Holy Prophet (peace and blessings of Allah be upon him)
said: “Food for one is enough for two and food for two is enough for three and
food for three is enough for four.” [Ahmad, At-Tirmidhi, An-Nasaa'I, Ibn Majah
– Hadith sahih].
The prophet (peace be upon him) encouraged exercise, and
asked Muslims to teach their children swimming, archery and horseback riding.
It was reported that he used to jog and race with his wife Aisha while he was
in his late fifties. He encouraged wrestling competitions among youth. He said,
“The strong believer is better and more beloved to Allah than the weak
believer, while there is good in both.”
Most of the companions were physically fit and strong,
especially Hamza, Omar, Ali, Saad, Khaled, Aisha, Safeyya, Asma and many
others. Female companions participated in defending the community during
different battles. One of the female companions, Umm Umara, was instrumental in
protecting the prophet’s life in the battle of Ohud, which indicates that women
at the time of the prophet were exercising regularly and were very fit that
they fought side by side with men and sometimes won over them in sport
competitions. The Quran described the physical fitness and strength of many
prophets, especially David, Suleiman, Moses and Joseph, and other Qur'anic
figures.
In summary, the Body is a gift from Allah it our duty to
treat in the best way, for if not, we are committing a sin. Eat to the point
you are NOT hungry. Don’t eat to the point of being full. Eat smart, exercise,
good sleep habits, and stress management. Remember the test of Prophet Adam
a.s. Al-Hasan Al-Basree said: “The test of Adam a.s. was food and it is your
test until Qiyamah.”
Remember the story of Adam a.s. who was forbidden from
eating the fruit of a tree. This was his test. Similarly, it is a test for all
of us to control our lust for food, so that our desires do not take control
over us and we are not distracted from our goal of life, which is: Defeating
our Nafs (lusts, desires) and doing good deeds to please Allah and attain
Paradise.
We have to deal with this disease at the community level in
addition to the leadership level. If we put the same energy that we are
putting to address the disease of terrorism, we can easily address this
societal disease that kills many more people than terrorism, war and drugs
combined.
References
1.
Alberti KG, Zimmet P & Shaw
J. IDF Epidemiology Task Force Consensus Group. The metabolic syndrome – a new
worldwide definition. Lancet 2005;366:059–1062.
2.
Willet WC, Dietz WH, Colditz GA
et al. Guidelines for healthy weight. N Engl J Med 1999; 341:427-434.
3.
Yanovski SZ. Obesity treatment
in primary care – are we there yet? N Engl J Med 2011; 365:2030-2031.
4.
WHO Fact sheet. www.who.int/mediacentre/factsheets/fs311
5.
Tanumihardjo SA, Anderson C,
Kaufer-Horwitz M et al. Poverty, Obesity and Malnutrition: An International
Persepective Recognizing the Paradox. J Am Dietetic Assn 107;11:1966-1972.
6.
Institute for Public Health
(IPH) (2008). Nutritional Status. The Third National Health and morbidity
Survey 2006: Nutritional Status (NHMS III), Ministry of Health, Malaysia.
7.
Ng, S. W., Zaghloul, S., Ali,
H. I., Harrison, G. and Popkin, B. M. (2011), The prevalence and trends of
overweight, obesity and nutrition-related non-communicable diseases in the
Arabian Gulf States. Obesity Reviews, 12: 1–13.
doi: 10.1111/j.1467-789.
8.
The Economist September 2005.
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