And put a knife to thy throat, if thou be a man given to appetite.” Proverbs 23:2
“Neither can they please God if they bring sickness upon themselves by the disregard of nature’s laws.” –Child Guidance, p. 105
Obesity is defined as a chronic and often progressive condition, with many negative impacts on one’s health. It is a disease of lifestyle choices—noncommunicable and largely preventable—therefore educating people on how to prevent obesity from occurring in the first place is the healthiest and most economical option. This effect on economics not only impacts the obese individual in lost income due to time off work because of illness, but also the healthcare system that must take care of someone who is ill.
“If we pursue a course to lessen our vitality, and sickness and death are the result, it is a violation of the law of God. To shorten life by self-murder is a breach of the sixth precept of God’s law. He has not granted us permission to commit suicide gradually any more than He has given us a permit to commit suicide suddenly. While one puts out existence at once, the other does the work according to approved fashion. The fashionable suicides, by wrong and sinful habits, commit suicide gradually, prolonging their own suffering, and casting a heavy burden upon sympathizing friends. Which is the greater sinner?”—The Health Reformer, January 1, 1873. When a person is not well, it not only affects themselves but also their loved ones who have the burden of care placed on them.
AT A GLOBAL LEVEL
The phrase “global burden of obesity” is truer now than ever. Obesity is recognized as a growing health problem world-wide. It is no longer a disease of the developed countries alone. Therefore, strategies need to be advanced world-wide to address the growing numbers of obese people, and obesity-related illnesses. Going back in history, in recognition of the problem, the first discussions on the need for an organization addressing obesity took place in Great Britain as early as 1961. Later, in the 1970’s, research into obesity increased worldwide. In the 1980’s, the International Association for the Study of Obesity (IASO) was created. In 1995, the International Obesity Task Force (IOTF) was formed, to alert the world to the growing health crisis threatened by soaring levels of obesity.
Since that time, many initiatives and strategies have been developed in many different countries to address the growing problem of obesity. In 2005, the IASO spearheaded a new Global Alliance, which created the first ever global action program to address the issues surrounding the prevention of obesity and the chronic diseases related to obesity, with a particular focus on childhood obesity. In 2014, IASO changed its name to the World Obesity Federation, an umbrella organization for 52 national obesity associations, representing 56 countries. The World Obesity Federation looks at four main strategic goals which are: doing research, creating policies, practical training through educational programs and collaborating with other organizations in the global community. What this plan looks like within each country may be different, but the goals are the same. The main goals that they address are nutrient intake and physical activity as an effective means in reducing the risk of disease from obesity.
Also, the World Health Organization (WHO) has developed a Global Strategy on Diet, Physical Activity and Health. The Global Strategy has 4 main objectives:
- Reduce risk factors for chronic diseasesthat stem from unhealthy diets and physical inactivity through public health actions.
- Increase awareness and understanding of the influences of diet and physical activity on health and the positive impact of preventive interventions.
- Develop, strengthen and implement global, regional, national policies and action plansto improve diets and increase physical activity that are sustainable, comprehensive and actively engage all sectors.
- Monitor science and promote researchon diet and physical activity.
The WHO acknowledges that globally the burden of lifestyle diseases is rapidly increasing with unhealthy diets and physical inactivity among the leading causes of the major noncommunicable diseases, including cardiovascular disease, type 2 diabetes and certain types of cancer, which contribute substantially to the global burden of disease, death and disability. The most important risk factors include high blood pressure, high concentrations of cholesterol in the blood, inadequate intake of fruit and vegetables, overweight or obesity, physical inactivity and tobacco use. Five of these six risk factors, except tobacco use, are related to diet and physical activity. With diet, risks of disease include increased consumption of energy-dense, nutrient-poor foods that are high in fat, sugar and salt.
Regarding physical activity, compounding the problem is that many people live sedentary lives. Advances in technology have made sitting a big part of people’s leisure activities; these advances have also contributed to making daily chores and the jobs that people hold, much less physically tasking.
It is interesting how modern day medical science is now understanding the connection between diet, exercise and health, creating global policies to address obesity. This is something that the Spirit of Prophecy, through the writings of Ellen G. White, wrote about over 100 years ago.
“What influence does overeating have upon the stomach?—It becomes debilitated, the digestive organs are weakened, and disease, with all its train of evils, is brought on as the result.” –Healthful Living, p. 62. “The Lord has instructed me that as a general rule, we place too much food in the stomach. Many make themselves uncomfortable by overeating, and sickness is often the result. The Lord did not bring this punishment on them. They brought it on themselves; and God desires them to realize that pain is the result of transgression.” –Counsels on Diet and Foods, p. 136
“Exercise quickens and equalizes the circulation of the blood, but in idleness the blood does not circulate freely, and the changes in it, so necessary to life and health, do not take place.” –Counsels to the Church, p. 218. “Those who do not use their limbs every day will realize a weakness when they do attempt to exercise. The veins and muscles are not in a condition to perform their work and keep all the living machinery in healthful action, each organ in the system doing its part. The limbs will strengthen with use. Moderate exercise every day will impart strength to the muscles, which without exercise become flabby and enfeebled. By active exercise in the open air every day, the liver, kidneys, and lungs also will be strengthened to perform their work.” –Child Guidance, p. 339
The aim of prevention strategies should be at reducing risk for all, not just in high-risk individuals. Addressing the population has a whole will have the best results.
Healthy diets and physical activity together are the most effective strategy to contain the mounting threat of diseases caused by the risk factors, most of which can lead to obesity. One way to address the problem is by increasing awareness of the health risks of obesity by health promotion on a global level, through government programs that are aimed towards increasing awareness of the increased risks to health; thus individuals and also healthcare professionals who treat individuals can develop effective strategies to reduce risk.
In the church, we also have a responsibility to share the message of health reform to those around us who are not well. While we are to help others in our sphere of influence, in the church obesity can also be a problem. “In nine cases out of ten there is more danger of eating too much than too little. . . . There are many sick who suffer from no disease. The cause of their sickness is indulgence of appetite. They think that if the food is healthful, they may eat as much as they please. This is a great mistake. Persons whose powers are debilitated should eat a moderate and even limited amount of food. The system will then be enabled to do its work easily and well, and a great deal of suffering will be saved.” –Child Guidance, p. 399
Progress has been made through various initiatives and programs in many countries in reducing premature death rates from coronary artery disease, cerebrovascular disease and some tobacco related cancers. However, the overall burden and number of patients remain high,
and the numbers of overweight and obese adults and children, and of cases, especially of type 2 diabetes, are growing in many developed countries. Even in developing countries, the prevalence of obesity is increasing.
We have much to do in bearing the health message (the right arm of the message) to a sick world. In this way their minds can be clear and more readily able to grasp the truths of this time.
AT AN INDIVIDUAL LEVEL
Education: is the best method to encourage people to make lifestyle changes. People need to be educated to increase their awareness and understanding of the influences of diet and physical activity on health and the positive impact it will have for preventing obesity and its harmful effects before they get obese. In many parts of the world, the health message is used as an entering wedge to preach the gospel. Many people more will readily listen to the health message before they are willing to hear the gospel message.
Energy: Our bodies are constantly working and using energy to complete tasks. We also use energy automatically to keep our bodies functioning, such as breathing. Even when we are sleeping, we use energy; this is known as the basal metabolic rate. Each person has their own basal metabolic rate which varies depending on their age, height, illness and activity. We use energy for conscious tasks such as walking, lifting and talking. We use more energy when we exercise; the more exercise we do the more energy we will burn off. When we stay the same weight, the energy our body gets from food equals the energy we burn off through automatic and conscious activity.
Metabolism: is the rate at which people burn calories. An individual’s metabolism can change, depending on circumstances, and thus can affect one’s ability to maintain weight. Everyone is different. Some people who eat significant amounts of food never gain weight, while others eat the smallest amount of extra calories and gain weight.
Weight Gain: As we age, our bodies are less responsive to the typical way of losing weight, which is less calories in and more calories out. Age-related weight gain has very little to do with maintaining a balance between calories consumed and calories used and much more to do with the changes in the aging body combined with adverse environmental and lifestyle factors.
By the age of 30, the body starts to lose lean body muscle, and gain fat. More food energy gets stored as body fat, which is redistributed to the belly. This weight gain occurs even if a person maintains their normal calorie intake. Reducing calories and increasing exercise to maintain muscle mass is important in weight management. Other factors which contribute to weight gain as people reach their midlife are the loss of vital factors such as hormones, nutrients, sleep, insulin sensitivity and metabolic efficiency (our metabolism slows down) coupled with a gain in stress, unfavourable gut bugs, and environmental toxins. The gut flora is comprised of bacteria that co-habitate our bodies, many of which are critical to our survival. The overgrowth of unfavourable gut bacteria play a vital role in using, extracting and storing energy, contributing to diet-related obesity. A high fat, high sugar diet triggers an overgrowth of a group of bacteria known as the Firmicutes which harvest refined sugar, importing glucose into the body and converting it to fat. Some people are known to have a specific gene that can increase the risk of diet-induced obesity and diabetes.
Environment: Our environment can trigger obesity. Since the end of WWII, over 80,000 industrial chemicals have been created. Many of these chemicals have been classified as obesogens: having the potential to alter metabolic function and lead to weight gain. Some of these chemicals are found as pesticides in our food, and chemical agents in plastic materials. Our environment is not just chemically toxic, but also socially and physically. Many people, in trying to accomplish all the tasks of life, including work and home life, end up over-stressed and under-slept. Too much cortisol (stress hormone) and insomnia contribute to weight gain. There is a relationship between sleep and the way our bodies use nutrients for energy; lack of sleep can affect hormones that control hunger urges. Also, in a fast-paced life, it is easier to provide food for oneself and one’s family by purchasing readily accessible processed foods which are often high in refined grains and sugars, and trans-fats. A shift in diet to foods that contribute to maintaining lean body mass (muscles), such as healthy fats and plant proteins is vital. Lifestyle changes to decrease stress, sleep better and minimize exposure to toxins in the environment all help us maintain a healthy body weight.
While the actual rate at which people can gain weight varies and depends on the individual and their metabolism, age, height, fitness and state of health, obesity does not happen overnight. Obesity occurs gradually when one consumes excess calories, often for many years. For each pound of increased weight, it indicates that 3,500 more calories have been eaten than the body has used. The excess calories are stored as body fat. One-hundred extra calories a day can translate to a 10 pound (4.5 kb) weight gain in a year. It is often when we eat past the point of being full that we are likely to gain weight. Eat slowly and listen to your body, and stop when you feel comfortably satisfied. If you are eating until you are stuffed full, chances are you are eating more than your body needs.
Simply put, prevention of obesity is establishing a balance between the amount of calories taken in, the calories used, and one’s metabolism, taking into account the environmental aspects of our lives that can also affect our weight. To reduce obesity an individual’s dietary choices should permit them to have enough energy and maintain a healthy weight and limiting fat consumption and turning away from saturated fats to unsaturated fats and eventually eliminating trans-fatty acids. The diet should have an increased amount of fruits and vegetables, and legumes, whole grains and nuts. Simple sugars should be avoided and salt limited from all sources.
Physical activity expends energy, and thus is key to the body’s energy balance and weight control. Individuals should engage in adequate exercise throughout their entire lives. “More people die for want of exercise than from overwork; very many more rust out than wear out. In idleness the blood does not circulate freely, and the changes in the vital fluid, so necessary to health and life, do not take place.” –Christian Temperance and Bible Hygiene, p. 101. At least 30 minutes of regular, moderate-intensity physical activity on most days reduces the risk of cardiovascular disease and diabetes, colon cancer and breast cancer. Physical activity also reduces blood pressure, improves the level of high density lipoprotein cholesterol, improves control of blood glucose in overweight people, and reduces risk for certain cancers, even without significant weight loss. Muscle strengthening and balance training can reduce falls and increase overall functioning among older adults. More intense activity will assist in weight control.
Although prevention of obesity is the goal, unfortunately, many people develop obesity over their lifetime. Often a lack of motivation can affect someone’s desire to lose weight and be healthier. When trying to help an obese person be motivated to lose weight, the following factors should be evaluated: reasons and motivation for weight reduction; previous history of successful and unsuccessful weight loss attempts; family, friends, and work support; the person’s understanding of the causes of obesity and how obesity contributes to several diseases; attitude toward physical activity; capacity to engage in physical activity; time availability for weight loss intervention; and financial considerations.
The individual needs to be motivated to be willing to participate in weight loss and treatment by reviewing for them the dangers with maintaining obesity and by describing an approved strategy for weight reduction.
If a person takes good care of their health and carefully follows the health principles, they can remain healthy into their seventh, eighth and ninth decades.
Treatment and prevention of obesity needs to occur at all levels, from an individual’s person’s lifestyle choices, to increased awareness in the healthcare community of the risks of obesity, to government programs that assist at-risk individuals to change behaviours, to the church teaching the health reform message, thus increasing the populations’ awareness to the risks of obesity. Implementing interventions at all levels is key to reducing the global burden of obesity.
“God will not work a miracle to keep those from sickness who have no care for themselves, but are continually violating the laws of health and make no efforts to prevent disease. When we do all we can on our part to have health, then may we expect that the blessed results will follow, and we can ask God in faith to bless our efforts for the preservation of health. He will then answer our prayer, if His name can be glorified thereby. But let all understand that they have a work to do. God will not work in a miraculous manner to preserve the health of persons who are taking a sure course to make themselves sick, by their careless inattention to the laws of health.” –A Call to Medical Evangelism and Health Education, p. 35
NEXT MONTH: FOCUS ON CHILDHOOD OBESITY