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.
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.