These days, out of sheer pressure and an increase in diseases related to our lifestyle, Nigerian doctors are forced to open weight loss clinics. What we once thought was due to the poor eating habits of the West has become prevalent in our backyard, with men, women and children becoming increasingly obese.
Every time a patient comes to me with issues relating to weight loss, I ask the magic question: “Have you tried eating less?”
To date, no obese person I have ever met admits to gluttony. Their replies are always: “Ha! I don’t eat much fa!”, “It’s just coke!” “This is all baby fat, it will go,” “The fat is because of my pregnancies and CS,” ‘This belly is hereditary, there is nothing in there,” and my personal favourite: “Wallahi doctor, I have always been fat my whole life, I was born this way. I only eat once a day o!”
“Once a day”, but when you ask what they ate, the caloric content of that meal alone, when changed to naira, can buy a flight ticket from Abuja to Lagos. They say “once a day” but if you witness the snacking that goes on in between the meals, it will be enough to feed a small army.
Many years ago, a girl went to extreme measures in her weight loss journey. She had temporary sutures on her lips to close them, and for a month could only drink fluids (smoothies, pap, protein shakes, etc) with the aid of straws. She lost 11kg in a month. Even though her actions were overly dramatic and not medically advised, it gave credence to the saying that: “It is food that makes us fat and not the air we breathe.”
A major caveat though: This only applies to the majority of cases where obesity is NOT caused by a medical condition like hypothyroidism, hormonal imbalance and side effects of medication.
Gluttony is described as excessive eating, drinking and indulgence, and also covers greed. It is the simple act of eating too much even after we are satisfied. The human stomach is designed like a balloon, the more you eat, the more it expands. The trick is to eat to your fill.
Where gluttony is concerned, the two major religions and science agree. In Christianity, it is labelled as among the seven deadly sins along with pride, greed, wrath, envy, lust and sloth. In Islam, it is also firmly frowned upon and supported by hadith: Miqdam bin Madikarib (RA) said, “I heard the Messenger of Allah say: ‘A human being fills no worse vessel than his stomach. It is sufficient for a human being to eat a few mouthfuls to keep his spine straight. But if he must (fill it), then one-third of food, one third for drink and one third for air.” – Sunan Ibn Majah 3349, Book 29, Hadith 99.
The Prophet (PBUH) is also reported as saying: “The food of two persons suffices for three, and the food of three suffices for four.” – Sahih al-Bukhari, 5392, Book 70, Hadith 20.
What this hadith means is that food meant for two people can clearly accommodate a third person when eaten moderately. Example, if two wraps of swallow, e.g. Semovita, are divided equally for three people, it would be enough for them all.
The problem arises when one person decides that he or she can eat three to four wraps of two alone. And before you crucify me, yes, I have seen someone eat six wraps of tuwo at a dinner.
Non-Communicable Diseases (NCDs) are a group of conditions that include cardiovascular disease, chronic respiratory diseases, cancers, diabetes and mental illness. Six of the top 10 leading causes of death in 2012 were NCDs, including the top three (ischemic heart disease, stroke and chronic obstructive pulmonary disease). Almost all of these conditions are related to obesity.
For the purpose of this discussion, I will take stroke (a common illness in our environment characterised by paralysis of one side of the body) as an example.
In what ways can stroke as a medical condition be seen to be at the centre of a moral discourse? Working to prevent the occurrence or recurrence of stroke has facilitated the emergence of a distinct moral injunction in the type of advice that physicians have been offering their patients over the last three centuries. Much of this advice in the past concerned judgements regarding patients’ lifestyles, where behaviours linked to the implied cause of disease were often interpreted as demonstrating a lack of self-control or the possession of low moral standards. Physicians in the 18th and 19th centuries referred to gluttony and sloth as causal factors and recommended adherence to the “regimen”. This tendency has not disappeared. In the 21st Century, stroke physicians now maintain that obesity is linked to stroke and this prompts the recommendation that individuals who are at risk regulate their weight through diet and exercise and thus aid the strategy of prevention (Scadding and Gibbs 2002, Clarke 2005, Allen et al. 2006, Gubiz 2007).
Some faith traditions clearly label it as a sin, while some others just discourage or prohibit gluttony. Gluttony has been nicknamed by a few people as a “killer”, while some are of the view that gluttony eats the glutton. In some traditions, eating eagerly or at an inappropriate time; eating exotic, expensive and luxurious food; and pursuing delicacies also fall under the umbrella of gluttony.
Whenever I see men and women carrying pot bellies and claiming middle age, I am reminded of this Hadith of Ja’dah. He reported: The Prophet (PBUH) saw a man with a large belly. The Prophet (PBUH) pointed to his belly and said, “If this had been placed elsewhere, it would have been better for you.” Source: al-Mu’jam al-Kabīr 2140. Al-Ghazali said, “Meaning, it would have been better if you had advanced it for your hereafter and preferred others over yourself.”
We all know what this Hadith means. The mighty plates heaped with chicken, beef and all sorts of orishirishi at weddings. The buffets where we go for second, third and even fourth rounds. The boxes of cakes and doughnuts. The packets of sweets and chocolates hidden in our wardrobes. These resources used to stuff our face that carry no nutritional value other than to make us fat and increase our risk of disease can be channelled to charity.
The weight loss industry is a multi-billion dollar business. Obesity is already a global tragedy affecting millions of people of all ages. Overeating is leading people to a variety of illnesses from heart disease to diabetes, arthritis to asthma, from nightmares and insomnia to depression and anxiety, just to name a few. The way to stop eating too much is to stop gradually. If a person is used to eating a lot and he stops all of a sudden and starts eating very little, he will become weak and his appetite will increase. So, he should reduce it gradually by eating less and less of his usual food until he reaches a moderate intake.
Nobody is begrudging you the occasional slice of cake or bowl of pepper soup. The key is to eat in moderation and eat ONLY when hungry.
The Japanese have a rule called Hara hachi bu. It’s a term meaning: “Eat until you’re 80 per cent full.” It originated in the city of Okinawa, where people use the advice as a way to control their eating habits. Interestingly, the Japanese have one of the lowest rates of illness from heart disease, cancer and stroke, and a fairly long life expectancy.
So, the next time you look at your plate, apply the Hara hachi bu rule, or better yet, mentally divide your stomach into three, one third for food, one third for drink and one third for air.
