ANY unnecessary death is considered to be a tragedy. Stories of stabbings regularly make the evening news and the front pages of newspapers. Yet the premature death rate from obesity in the UK is more than 80 times that of death from violent crime, and amounts to more than 56,000 lives lost every year.
The World Health Organization reports that almost two-thirds (63.7 per cent) of adults in the UK are overweight, and almost one third (27.8 per cent) are obese.
The UK appears to be catching up with the United States in this regard; but bigger is not always better. Being overweight or obese is more serious than requiring larger clothes and being the butt of unkind jokes. Obesity is a risk factor for raised blood pressure, diabetes, heart disease, stroke, depression, dementia, and cancer.
This is because being obese is not just a metabolic problem: it also results in inflammation, which is increasingly thought to be the common soil of these non-communicable diseases.
FOOD is not just fuel. Food is medicine that heals us. Food is information, sending signals to our bodies as it is consumed and broken down into its basic components. Eating well can boost our immune system, improve the control of long-term conditions, reduce the risk of cancer occurring and recurring, and prolong our lives.
It is a bountiful gift, particularly in the developed world, where most live in relative affluence and can afford pretty much anything that they want, whether picked from the field or garden, chosen from the supermarket shelf, or delivered to the door.
But, like any medicine, there is a correct dose: too little or too much is bad for us. So where has it all gone wrong?
It is tempting to resort to fat-shaming when faced with this societal challenge. As a young and inexperienced doctor, I was guilty of simplistic statements about “calories in” and “calories out”, about eating less and moving more.
As a now much more experienced GP specialising in lifestyle medicine, I know that there is much more to it. Life is complicated, played on an uneven playing field. Nowhere is this more obvious than when it comes to the food that we eat. While it is true that we all should take some level of personal responsibility for what we put in our mouths, the biggest determinant of our weight is our environment.
If you are born in poverty, raised by overweight or obese parents, live in a “food desert” (an area where it is very hard to easily obtain affordable real, whole foods), and suffer more adverse experiences in childhood such as trauma, neglect, or other kinds of abuse, then you are more likely to end up overweight or obese.
The Health Survey for England (2018) shows the link between obesity and deprivation: 35 per cent of men and 37 per cent of women in the most deprived areas are affected. In the least deprived areas, the figures are 20 per cent of men and 21 per cent of women.
The influence of Big Food is key here. Its tentacles reach out into television and online advertising, shops, schools, and even hospitals: promoting cheap, accessible, highly processed, sugary, and addictive food-like substances. Once upon a time, to be seriously overweight was a marker of underlying pain and maladaptive eating habits. Now it is almost normal in some parts of our country.
SO MUCH for the problems. What about the solutions? What does the Church say, and what part can it play?
We need to go back to basics. Eating and drinking, at its best, can be a mindful act of worship, connecting us with each other, nature, and our Creator. People need to be fed physically if they are to grow spiritually. Instead of our worrying about diet wars, the emphasis should be on people having enough simple, minimally processed food to meet their basic needs.
As for what the Church says, when was the last time that you heard a sermon about healthy lifestyles? The physical should not be viewed as separate from the spiritual. This should be reflected in teaching and discussions. Visible leadership is vital here.
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I am not suggesting that the clergy should wear Lycra and start services with a high-intensity workout, or that an annual staff appraisal should include a target for hip-to-waist ratio; but there is a need to address the issue openly. If people in positions of leadership are struggling with this aspect of their well-being, they should be honest, supported, and accountable — as should everyone else. Perfection is not required, but there may be some planks that need taking out of eyes.
Conversations about spiritual well-being should be inextricably linked to physical well-being. Ignoring physical health — as if it were a distraction from the spiritual journey, or even something to be sacrificed in the service of God and the community — should be frowned on, and certainly not worn ruefully as some sort of badge of honour.
Thought should be given to how church buildings are used, and whether services could contribute to a healthy lifestyle. Movement is vital for life, and even simply standing for two hours a day reduces the risk of premature death from any cause by ten per cent. Prayers could be said while standing or walking in groups. Services might be conducted outdoors. Zoom services could encourage a few minutes of activity — perhaps away from the camera, and muted.
IF THE Church can get this right, it will become more effective within the community. We are aware how foodbanks have increased the Church’s visibility while engaging with the reality of families who need feeding. In our church, we set up a scheme, “Hearty Hampers”, which gives families in need the basic ingredients and cooking instructions so they can prepare and eat simple meals together.
They come for a chat and a cup of tea or coffee, and bring their children to play. Many then want to engage further with the Church, having seen for themselves that this is done simply out of compassion and with no hidden agenda. This is the Church showing, not telling.
There are many other ways to improve community health. These include traditional children’s holiday clubs, or community fun days — when good food can be served and physical activity encouraged — and engaging in social-prescribing initiatives, such as offering services for mental-health support or debt advice.
This last is important, because of the link between poverty and obesity. My church has a partnership with Christians Against Poverty, providing help with debt, a job club, and life-skills training. There may also be opportunities for churches and other third-sector or voluntary groups to get involved in the ways in which health and social-care services are commissioned and developed in future, with the introduction of integrated care partnerships (ICPs), in which decisions are made by local delivery boards.
TO CAMPAIGN for better health is to campaign for equality. As an institution with political and financial clout, the Church and those leading it can do this in various ways: petitioning the Government over economic and social policy, investing ethically, promoting fair trade, supporting charities and agencies — both national and international — and encouraging congregations to give, both financially and through volunteering.
Christians are commissioned to spread the good news and commanded to love others as themselves. People struggling with obesity should are not to be berated, lectured, or patronised. Instead, they must be supported and encouraged to consider what an enjoyable, purposeful, and healthy life looks like to them, and what simple steps they might take on the way to achieving this. A healthy weight will be an inevitable and beneficial side effect.
Everyone deserves to be as healthy as they can be, and the Church should take every opportunity to promote and encourage this, particularly in a church setting. By supporting — without any ulterior motive or agenda — the community to live such lives, we will see fewer lives cut short, and enjoy deeper and more meaningful relationships with those whom we have been commissioned to serve.
Dr Richard Pile is a GP, and author of Fit for Purpose, published by HarperCollins at £14.99 (Church Times Bookshop £13.49). (Interview, 11 June).