Wednesday, September 19, 2012

Rethinking healthcare through overcoming obesity

Obesity in America is bringing about a rethinking of what is meant by “healthcare.”  The problem seems bigger than the present system of disease-care can handle.  Could a more spiritual approach change the picture?


In August the Centers for Disease Control and Prevention (CDC) released their latest report on obesity indicating that again, as in recent years, a third of American adults are obese.  Worldwide, obesity has more than doubled since 1980.  Medical science links a number of diseases to obesity including heart disease, stroke, diabetes, and cancer. 


What does poverty have to do with it?

Obesity is stated as a condition of excess body fat.  The term obese conjures up pictures of people eating more than is useful for their body condition.  And certainly, we Americans in this fast food nation eat lots.  (Notice the NYC ban on large sugary drinks.)  However, obesity seems as related to too little as well as too much.  Poverty and obesity are linked.


Poverty is a lack of something desired or needed.  It may be seen as a lack of financial support and the great preponderance of obesity occurs where income is low or absent.  


“Part of this [obesity] is due to lower incomes and education, which … also reflects lower public investment in education, public transportation, and recreational facilities.  The bottom line: cheap, unhealthy foods mixed with a sedentary lifestyle has made obesity the new normal in America. And that makes it even harder to change.”  So says Walter Willett who chairs the department of nutrition at the Harvard School of Public Health as reported in “Why we’re so fat” by Rachel Pomerance in


Poverty may alternatively be a lack of hope or purpose such as in the story of Jennifer Bonner.  Following an accident involving her brother, Bonner relates a sense of hopelessness.  She compensated for a lack of fulfillment with heavy eating.  From 334 pounds she got herself to a sustainable weight in the 100’s.  The change, in short, was that she fought back against transferring her weighty practices to her newly born daughter.  She found her joie de vivre anew.  Healthy thinking and living are connected.


The need to fight back

"It will take time and resources to win in the fight against obesity," said Dr. William Dietz, director of CDC's Division of Nutrition, Physical Activity and Obesity. "This epidemic is complex and we must continue to change the environments that make it hard to eat healthy, and make it hard for people to be active. By doing this, we not only help today's adults, we also invest in our children and grandchildren, so they won't have to endure this serious and costly health burden."


Healthcare or disease-care?

As reported in, “Dietz believes that beating obesity may even require a recasting of our entire healthcare system, since obesity needs to be prevented rather than treated after it happens. ‘We can't afford to treat obesity and its consequences,’ Dietz says. ‘So this begs the question whether it's time to move from a disease-care system to a real healthcare system.’"


Is the fight with obesity one to be addressed by added resources or are there other approaches?  Isn’t the thought that there are insufficient resources to fight obesity another kind of belief in poverty?


It’s interesting to contemplate what could be meant by a real healthcare system as distinct from a disease-care system.  The disease-care system is familiar.  It starts with disease as a fact and manages it, such that disease is always present until or unless the disease is cured.  By contrast, a healthcare system or wellness system could be one that starts and stays with health, preventing disease.  The focus is not so much on the body as on useful, fulfilling activity.


Models of whole health care are found in communities today in which attention is not so much on health as on caring for each other and the environment.  Although these models may not be the direction of a healthcare system we will see developed, they provide useful insight into alternative ways of thinking about health.


Dan Buettner in his book The Blue Zones illustrates how communities composed of individuals having a sense of purpose and a spiritual connection have a longer than average life span where obesity is not an issue.  Individuals so occupied have a more fulfilling engagement with life and little focus on the physical body.  The result, at least in the communities his team studied, was longer, healthier, happier life.


Buettner also identified diet as a factor.  Yet, the foods taken were more of what was available than selections of items specifically chosen for health.  Diet was not a prime consideration about being healthy, but was generally a result of engagement with the environment and culture.


The individual picture

Let’s narrow the focus from the community to the individual.  What is the picture of the ideal?  The model in a magazine ad?  A star athlete?  Even if I admire the appearance of these individuals, appearance is all I get unless I get to know them.  If I know them, their physical appearance becomes of less importance to me than our relationship.  The individual is more than a biological specimen. 


To me the ideal is the man of God’s creation, namely “the image and likeness of God,” from Genesis 1, verses 26 & 27 in the Bible.  I am not suggesting of thinking of God as having a physical body in a human form and then imagining man as having the same form.  Quite the opposite, I am referring to man with spiritual qualities of goodness such as beauty, strength, liveliness, intelligence, honesty, integrity and spiritual purpose.  Whatever illustrates those qualities is Godlike to me.  The beauty of a happy smile can be more engaging than a statuesque body.  Intelligence solves problems.


Are these qualities in each individual and can they be uncovered if hidden?  I have found that, just as a rose in my garden responds to sunlight, virtually everyone responds to respect and the kind of love that recognizes their inherent good qualities.  I have found that response in prisons, hospitals, workplaces and family life.  To me this Godlike picture or package of good qualities is not just a distant or future possibility but the reality of the individual now.


Plunging beneath the external picture to find the core value is like finding a treasure. 


I ask myself whether I can look at every individual and find elements of value that transcend the labels attached to them, whether it is race, body condition, religion, wealth or something else.  That may be hard if they are culturally diverse from my experience or have practices that I have been taught are undesirable.  Yet, if I am able to look beyond the label to see the fundamental value, the items being labeled become less prominent.  Years ago I worked as an engineer in Puerto Rico with a young woman who would have been labeled obese.  Women were not easily accepted in engineering at that time in the ‘70s and it was not an easy road for her.  However, as her manager at the time, I was able to assign her to teams working out some of the toughest problems.  Her competence as an engineer and a team contributor brought about solutions.  When new teams formed, she was among the most requested talent.  As the labels of sex identity and size became less noticed, her size reduced.  She eventually left the firm to join a Silicon Valley software firm of national prominence where her stature as an engineer grew.


Knowing that each adult and child has something precious to contribute to the whole is a useful way to think of whole health.  Those individual contributions make a purposeful community that fosters good life. 


For me, starting with God and Godlike qualities in His creation is far more helpful than starting with an unhealthy picture.

George Gregory is a Christian Science Practitioner living and blogging in Iowa