1. Malnutrition is a physical problem. The kids we see have been injured. Some had inadequate oxygen during birth and are brain damaged, making it hard for them to chew and swallow or reach for food or share a bowl or hold a cup or explain their hunger. Some were fed imbalanced or harmful diets. Most have been made worse through acute and chronic infections. Some in the eating disorder category are depressed, their neurotransmitters are genetically disordered, or their vitamin and mineral levels are inadequate. It is not their fault.
The physical problems need medical therapies, like blood tests and vitamins and high-calorie feeds, like physical therapy or hospitalization or antidepressants. This is the part we usually think of. But it is only the tip of the iceberg.
2. Malnutrition is a social problem. Injustice drives hunger. Women who don't have safe antenatal care or skilled delivery attendants produce injured babies. Families without land for gardens, or jobs for income, lack food. Parents who did not attend school don't make informed decisions about nutrition. Extreme maldistribution of wealth and medical care means the neediest can not get it. On the other end of the starvation spectrum, the culture of physical perfection, unhealthy model-weight bodies, blatant sexual advertising, pressure to conform, bombards our teens.
The social problems need concerted united action, advocacy for the poor, responsible voting and laws, sacrificial generosity from churches, bold initiatives in education and health care and water engineering. Refusal to buy our five-year-olds sexualized clothes or dolls, protecting our pre-teens from magazines and messages.
3. Malnutrition is a spiritual problem. Our world is broken, and the vast majority of our fellow citizens wrest their survival by the sweat of their brow. Floods and drought wreak havoc. Child-bearing is fraught with danger and mishap. For those that survive, Satan whispers as he did to Even in the garden, you aren't good enough. You won't be loved unless you look this way, control this urge.
The spiritual problems cry out for prayer and sacrificial love. Discipline and money alone will not solve these problems.
4. Malnutrition is a personal problem. We are created in the image of God, which fundamentally means we have wills and choices. Families with injured, sick, infected children, with unemployed and under-educated parents, with oppressive spiritual issues, still make decisions. Sometimes those decisions lead to greater harm, as family income is poured away in alcoholism, or fatalistic apathy paralyzes action. Teens with dangerous family histories who have been poisoned by advertising and pestered by doubt, still make decisions. Sometimes those decisions are for self-harm, or secrecy, or escape instead of healing.
This means the victims still have responsibility in their response. Which is good news. It means we have hope, because each family and child can make new choices, can be freed.
Malnutrition in all its forms, rickets, marasmus, kwashiorkor, anorexia, bulimia, obesity . . . is a frustrating illness to treat, but also perhaps the most satisfying to cure. Because it is multifaceted, the analysis and solution draws upon the entire spectrum of medical, social, and spiritual insight. The patient must be treated along with the family. The approach requires team work. And the long-term prevention requires big-picture thinking about politics and justice and truth.
The Kingdom is described as a feast, a banquet, a meal. The Fall from Grace occurred in an act of eating, and redemption comes the same way. Jesus gives Himself to us in bread and wine. So it is no surprise that much of the harm in our world comes through the mis-use of food. If we could return to its holiness and wholesomeness, we would be closer to real LIFE.