After visiting her doctor, Nancy phoned her rabbi with her lab results still clutched in her hand. “Rabbi, the doctor says I have high blood sugar, a high cholesterol level, high blood pressure, and that I need to completely change how I eat and start walking more. But my husband keeps telling me, ‘Don’t worry so much! Hakol b’yedei Shamayim – everything is in Hashem’s hands.’ Rabbi, is my husband right? Should I just have faith and not worry about all these changes?”
In Your Hands
The Gemara (Ketubot 30a) teaches: “Everything is in the hands of Heaven except tzinnim u’fachim – cold and heat.” Rashi clarifies: illnesses caused by negligence are not decreed from Heaven but stem from human carelessness. The Ritva expands this to all preventable harms – be it reckless behavior or an unhealthy lifestyle. Hashem entrusted us with life. To protect it is to honor the Giver of that life.
Health Is Not Optional
Judaism does not view health as a personal lifestyle preference or a secondary concern. Judaism sees caring for one’s health as a Torah obligation, because one’s state of health directly impacts one’s ability to live and perform mitzvot and hesed. The Talmud (Sanhedrin 17b) lists the ten amenities a Torah scholar must have, including not only a beit knesset but also a physician. The Rambam codifies this into halacha (Hilchot De’ot 4). Yad Ramah adds that a person is obligated to pursue healing so that he may serve Hashem. He cites the verse, “Only guard yourself and guard your soul greatly” (Devarim 4:9), as a direct commandment to safeguard health.
The Rambam explains: “Maintaining a healthy and whole body is among the ways of serving Hashem… for one cannot understand or know anything of the Creator when sick or in pain” (Hilchot De’ot 4:1).
The Sefer Hachinuch codifies this as a mitzvah: Since keeping the body in a healthy, strong condition is a part of the service of Hashem… a person must distance himself from anything destructive and conduct himself in ways that preserve his body (Mitzvah 546).
Health, then, is not a luxury. It is a prerequisite for mitzvah performance. It is part of avodat Hashem.
Metabolic Syndrome
Today, one of the greatest health challenges facing society is metabolic syndrome – a dangerous cluster of conditions including high blood pressure, elevated blood sugar, excess abdominal fat, and abnormal cholesterol levels. This syndrome dramatically increases the risk of heart disease, stroke, and type 2 diabetes.
And yet, the medical consensus is clear: these risks are largely preventable through changes in diet, physical activity, and weight management. Walking every day, reducing sugar and sodium intake, sleeping adequately – these simple habits have life-saving potential.
From a Torah perspective, this is not merely advice – it is an obligation. If Hashem has given us the means to prevent harm, and we ignore them, we have failed in our duty to guard the soul He has placed within us.
Even for those who are busy and don’t have time for major changes, small, consistent improvements – like walking whenever possible or skipping junk food – can make a significant difference.
The Ruling of Hacham Ovadia Yosef
Hacham Ovadia Yosef, zt”l, addresses Nancy’s question in Yabia Omer (Vol. 4, Choshen Mishpat §6): “If a sick person sits idly and does not engage in medical care, he will ultimately die from that illness – even if, at the time he became ill, no such decree of death had been issued upon him. These matters are obvious, and none will deny them except one who lacks understanding.” He teaches that refraining from medical treatment is not an act of faith – it is an act of recklessness. According to halacha, seeking appropriate medical care is not merely permitted, it is an obligation. One who ignores natural means of healing, expecting miraculous salvation alone, may bring upon himself harm that was never decreed from Heaven.
Conclusion
From a Torah perspective, Nancy’s situation falls directly under the principle of tzinnim u’fachim – preventable dangers. Her health outcomes are consequences of choices within her control. This is not merely good advice – it is fulfilling the mitzvah of v’nishmartem me’od l’nafshoteichem, “and you shall guard your lives exceedingly” (Devarim 4:15). The Rambam codifies this as practical law: one must avoid anything that damages the body and cultivate practices that promote health (Hilchot De’ot 4:1). Hakol b’yedei Shamayim? Yes – but some things, Hashem places in our hands.
Rabbi Yehuda Finchas is a worldwide expert, lecturer, and author on Medical Halacha. He heads the Torat Habayit Medical Halacha Institute. His latest book is ‘Brain Death in Halacha and the Tower of Babel Syndrome.” To contact Rabbi Finchas, email rabbi@torathabayit.com.