Obesity in the Ummah – The Struggle For Wasat

Let’s talk about overeating.  It’s a touchy subject, so I’ll start.  Over the span of 13 years I gave birth to 5 children and I also gained quite a lot of weight.  I’d like to blame the extra pounds completely on my pregnancies and the stress of motherhood, but that would be disingenuous. The truth is, I became overweight primarily because I turned to food — which is supposed to be healthy fuel for my body — as a source of comfort, happiness, stress relief, and indulgence. I consistently consumed more calories than I burned off, and I ate too many foods that were high in sugar and fat, but low in nutrients.  It wasn’t that I had zero willpower; every Ramadan, I could summon up the necessary self control to fast from dawn until sunset, like billions of other Muslims. Yet somehow, for the rest of the year, I couldn’t stop myself from saying “yes” to every chocolate chip cookie I met. 

Why couldn’t I control my eating on a consistent basis? Why did my willpower go out the window as soon as Ramadan was over?  I have always understood that our deen is one of wasat, or balance, and that we should not go to extremes in anything, including how much we consume.  Our Prophet (peace and blessings be upon him) famously said, “The son of Adam does not fill any vessel worse than his stomach. It is sufficient for the son of Adam to eat a few mouthfuls, to keep him going. If he must do that (fill his stomach), then let him fill one third with food, one third with drink and one third with air.” (al-Tirmidhi). 

Was I lacking faith? Was there something inherently wrong with me that made me overindulge?  Would I ever reclaim the fit, trim body of my youth and reestablish a healthy relationship with food?   

It turns out that Muslims like me who have struggled with overeating and/or obesity are certainly not alone.  According to a 2018 report by the World Health Organization, worldwide obesity has nearly tripled since 1975. Muslim-majority countries have the dubious distinction of leading the pack. Currently nine of the twenty most obese nations on earth are, ironically, countries where the majority of residents spend an entire month of each year fasting!  Kuwait, Jordan, Saudi Arabia, Qatar, Libya, Turkey, Egypt, Lebanon, and the United Arab Emirates all share undesirable positions among the highest ranks of the world’s fattest nations.  

One 2013 medical study claims, “Adolescent obesity has reached a critical level in the Arab countries. Therefore there is an urgent need to establish programs to prevent and control obesity among schoolchildren in these countries.” In Pakistan, the outlook is similarly grim, according to a medical review undertaken in 2016 which concludes,  “Pakistan is currently suffering from an emerging epidemic of obesity. Effective interventions are required at population level to prevent and control this emerging public health issue.”

For most Muslims who grew up in the West, unhealthy food has been around for as long as we can remember.  Those of us who are currently middle aged have been surrounded by junk food — or at least images of it — since we were born.  If we watched TV, we grew up seeing thousands of clever, seductive commercials for Coke, McDonalds, Doritos, Oreos, and dozens of other processed and highly addictive foods. We have been exposed to these temptations nearly everywhere we have gone: school cafeterias, supermarket checkout lines, shopping malls, parties, sporting events, movie theaters, and even book stores. 

Isra Hashmy sees the ramifications of this lifestyle in her position as a Board Certified Family Nurse Practitioner at Massachusetts General Hospital where she has managed the diabetic patient population in a primary care clinic. Hashmy says, “The Muslims in the West, whether born and raised or immigrated, have adopted the fast food culture. They get food from drive-thrus, donuts before work, and order pizza at night. Due to the busy, fast-paced life of living in the West, they eat out more, which means more fried foods, high fructose, saturated and trans fats.” 

“Their lifestyle,” Hashmy adds, “does not lend itself to burning all the extra calories and fat they are consuming. They sit for eight or more hours and then get into a car, sit in traffic, and go home only to eat, and go to bed soon after. The issue is there is no movement and no nutrient-dense foods.”

The problem of fast food is not limited to people in the West, Hashmy says. “Having traveled to Morocco, Turkey, Egypt, Saudi Arabia, UAE, there is a common thread among them that I’ve seen which is food delivery services are incredibly popular. Families will order food from restaurants around town to bring the food home, and now there is not even a need to go out. The lifestyle also does not help to burn the extra calories. The weather has made it such that people sleep very late, eat at late hours, and then wake up late.” 

And yet, East or West, not all people are obese.  Why is this? Do some people just have stronger willpower?  A higher level of imaan?  Good genes?

Though weight loss programs have been trying to unlock that secret for nearly six decades (one of the first, and most famous, Weight Watchers, was founded in 1963), obesity is still on the rise in most parts of the world.  Every year new trends tap into the weight loss niche and promise results, but few seem to deliver lasting solutions. Some fads are difficult to follow and others have questionable health benefits. For people hoping to lose weight, it can be very hard to know which plan will actually work, and which one will be sustainable in the long run.  There are also stigmas attached with being overweight that make some people afraid to seek help for their problem.  

In an article called “Are physicians biased against overweight patients?,” author Rita Rubin, MA, asserts, “A 2015 review of literature on weight bias in healthcare found considerable evidence that negative attitudes and stereotypes about people with obesity influence physicians’ judgment, behavior, patient perceptions and even decision-making. Research has found doctors show less respect for overweight patients, spend less time with them in the exam room and feel justified to address excess weight ‘every chance they get.’”

Hashmy believes that Muslims face some additional challenges: “One stigma I find in Muslims who want to lose weight is they feel they are being vain, and it’s not in the religion to care about looks. A lot of education is needed to let them see, this is basic health. This is not about being vain, it’s about taking care of yourself, which is a requirement of our deen.”

Shabana Haxton, a Registered Nurse, Certified Diabetes Educator, and Certified Cognitive Behavioral Therapist who works with patients with diabetes as well as bariatric surgery candidates, agrees that Muslims might have to overcome some extra obstacles.  In her profession she has worked with numerous Muslim clients who want and need to lose weight. “I believe emotional eating is very common in our community,” Haxton says. “We show love via food. If you go to someone’s house and do not eat a lot, it is an insult to the host. The host keeps putting food on your plate, etc.”

It’s clear that Muslims tend to love and treasure their native cuisine.  Whether it’s biryani, maqlooba, kebab, bastilla, roti, or shawarma, the traditional food of a Muslim’s heritage is usually cherished, shared, and enjoyed with gusto.  While Allah SWT has forbidden recreational drugs and alcohol, most foods are halal. Therefore at almost every Muslim celebration — from Eid and iftaar parties to weddings to aqeeqas — food is always present, in abundance, taking center stage.  With cultures that celebrate primarily with food, plus a religious tradition that might seem to downplay the importance of physical appearance, plus the other stigmas that overweight people in general face, Muslims are in a particular bind.  What is the first step they should take, if they need to lose weight?

Hashmy suggests, “My first advice is to switch your meals. Generally, most people have their biggest meal at night, at dinner. I tell them to make lunch their biggest meal and dinner something lighter. Due to the fact that they are most likely less active at night, there is a greater chance of burning the calories consumed from lunch than a dinner they had at 9:00 pm or later.”

Haxton asserts that first — and crucially — overweight people must “Admit that they have a problem. Seek help. Over-consumption of food is not just a physical problem. It is a biological, social and emotional problem. Until we all get to the root of the problem we will not be able to succeed.”  She warns, “If we do lose weight by a fad diet, it will come back because the root cause is not fixed.” 

My own experience confirms Haxton’s opinion.  Over the years I’ve tried several diets, but none addressed the core issues — my addiction to sugar and my emotional dependence on food.  Alhamdullilah, last May, a friend told me about a book that would change my life and my way of thinking about food: Bright Line Eating:  The Science of Living Happy, Thin, and Free by Susan Peirce Thompson, Ph.D.  

Bright Line Eating (known as BLE) is based on the science of addiction and was developed by Thompson, a former professor of Brain and Cognitive Sciences who focused her doctoral studies on the elusive topic of weight loss.  In her book, Thompson describes how sugar and flour act like drugs in our brain, causing some people — particularly those who are highly susceptible — to be addicted to them in the same way others are hooked on heroin or cocaine. Thompson lists concrete steps we can take to overcome food addiction and to reclaim our health. Her four “Bright Lines” are clear boundaries we must not cross, and by following them diligently we rewire our brain to help us eat in a healthier way, with less cravings, less stress, and less reliance on fickle willpower.    

It is no exaggeration to say that Bright Line Eating has transformed my life.  I now understand why I overindulged for many years, and why the temptation to eat unhealthy foods was so great. “Moderation” is nearly impossible for an addict. One bite of an addictive food makes your brain crave more.  I had gained weight not because I was weak, lazy, or uncommitted to my faith or my health. It was because of the two drug-like substances — sugar and flour that were making my brain beg me for the next “hit.” 

Alhamdulillah, as of this writing I have followed Bright Line Eating for nearly eight months. In that time I have lost a substantial amount of weight, healed many weight-related health problems, and improved my relationship with food so that I no longer feel desperate for unhealthy options. I now enthusiastically recommend Thompson’s book to everyone who questions me about my very visible, very positive transformation.

To my overweight brothers and sisters, I send encouragement and hope.  There are solutions to your problems, professionals who are willing to help with compassion and knowledge, and weight loss plans that do work. Do not feel that you are a weak Muslim or an unworthy person if you struggle with overeating.  Scientists and doctors are still discovering what causes unhealthy eating patterns, and they increasingly realize that obesity is not due to laziness or any other character flaw.  If you are struggling with your weight, know that your Creator gave you a body as an amanah and that seeking help to improve your health is a sign of gratitude to Him.