Ramadan and Eating Disorders: A Month of Triggers or Healing?

Ramadan is the ninth month in the Islamic calendar. It is a period of prayer, fasting, charity-giving, and self-accountability for Muslims across the world. Fasting in Ramadan is prescribed only for healthy and adult Muslims – weak, the sick, children, travellers, and menstruating or pregnant women are among those exempt.  

Since 2013, western media have seemingly taken a keen interest in Ramadan and its impact on the mental health of people suffering from eating disorders. This put the month of Ramadan under great scrutiny as the focus was placed on how fasting can be triggering and harmful for individuals with eating disorders. 

The main debate surrounding Ramadan is whether people suffering from eating disorders should take part in this holy month or not. The month is a challenge for most people due to social aspects, long periods of fasting, and eating together. 

Many of the questions surrounding Ramadan are:

-Doesn’t Ramadan make one’s eating disorder worse?

-Isn’t Ramadan an excuse for people to go on an aesthetic diet?

-Won’t Ramadan result in a relapse for those in recovery from their eating disorder?

During the COVID pandemic, we’ve seen an unprecedented number of people suffering from serious mental health problems; a sad beginning of a trend that is anticipated to continue into the future. The pandemic also saw an increase in the number of people suffering from eating disorders, mainly young people. Currently, eating disorders affect 9% of the world’s population.

Eating disorders are serious mental illnesses that come from more than the desire to be thin or look good. We don’t have a clear-cut answer for what causes an eating disorder. Medical and psychiatric studies have looked at the diagnosis for decades, but most come up inconclusive as to the underlying main cause.

The real irony is that eating disorders don’t come in one shape or size and are not limited to a specific culture, religion, race, socioeconomic status, or gender. The surprising fact about eating disorders is that it has little to do with food and more to do with mental health.

It often begins with anxiety around weight and negative body image resulting in restriction of food, compulsive exercise or healthiness, or something else. Eating disorders are more common in females than males and have the highest mortality rate of any mental disorder due to severe health complications and suicide. People suffering from eating disorders also end up suffering from depression, a lack of self-esteem, relationship problems, and social withdrawal. 

Currently, the DSM-IV recognizes the following types of eating disorders:

Anorexia Nervosa: Refusal to maintain a healthy body weight. People with this disorder refuse to eat to lose weight.

Bulimia Nervosa: People with Bulimia appear at normal weight. This disorder comprises of repeat binge eating followed by self-induced fasting, extreme exercise, or laxatives. 

Eating Disorder not otherwise specified: This includes all other eating disorders that do not fit the criteria for bulimia or anorexia, such as Binge Eating Disorder, AFRED, Pregorexia, Orthorexia, Bigorexia etc. 

It’s just not Ramadan but any time of the year, associated with traditions and celebrations, many of which revolve around food and social gatherings, for people suffering from eating disorders this can be an extremely challenging and stressful time, a source of great anxiety and emotional strain. The reason people struggle with this illness throughout the year is due to its profound impact on mental, physical, and spiritual health.

Our body needs vitamins, minerals, and calories in order to survive. When your body does not get sufficient minerals or does not get its balanced nutrients, it becomes compromised. As a result of this imbalanced diet, one suffers problems with the gastrointestinal tract, reproductive system, bones, and heart.  

On average, we think about our bodies 8 times a day and on any given day, 45% of women are on a diet and what’s worse, 40% would trade 3 to 5 years of their lives to achieve weight loss goals.

“…A man should say to his soul every morning, ‘God has given thee twenty-four treasures; take heed lest thou lose anyone of them, for thou wilt not be able to endure the regret that will follow such loss.’” Al-Ghazali, The Alchemy Of Happiness

Eating Disorder Fasting vs Ramadan Fasting

We must distinguish between Ramadan fasting and Eating Disorder fasting.

Ramadan fasting is very different from eating disorder fasting. Muslims practice fasting periodically for spiritual cleansing and for fulfilling one of the requirements of Islam. When fasting no longer becomes a requirement to fulfill religious obligations and begins to border an eating disorder, then there is a serious issue. 

Fasting for your eating disorder is about giving up food in order to achieve a materialistic scale goal. Fasting spiritually is about giving up something simply for the pleasure of Allah.

In eating disorders, food is viewed in a negative light, as a weapon to deal with certain emotions. In Ramadan, a person abstains from food not because the object offered up is bad, but because it is good. He offers it up for something greater – that is Almighty Allah.

A normal Muslim will approach Ramadan as a month of self-discipline, self-restraint, charity, redemption, and blessings. A person with an eating disorder will approach Ramadan as a month to restrict their food intake, as they will already have fasted for a period of time throughout the year, and for them, Ramadan fasting becomes simply about losing or maintaining weight. 

Humans were not created to develop unhealthy obsessions with food, weight, and body: “Know, O beloved, that man was not created in jest or at random, but marvellously made and for some great end. Although he is not in form everlasting, yet he lives for ever; and though his body is mean and earthly, yet his spirit is lofty and divine” ― Imam Ghazali

In today’s times, there is a tendency to emphasize exclusively on the social aspect of fasting, and let’s not forget that people suffering from eating disorders find all social aspects of any gatherings very triggering. 

The social dimension is so strongly emphasised today that it seems as if other dimensions, which give higher value to the month of Ramadan have been forgotten or set aside. Sadly, people who are not fasting during this month simply focus on the social dimensions, such as eating with family, social gatherings, and being judged for not fasting.  For some, this may only cause mild anxiety and worry, while others are more deeply affected to the point of becoming spiritually, mentally, and socially paralyzed. 

Personal Story:

Monica Holc from London always finds Ramadan very challenging. She feels secluded as everyone always talks about the spirit of fasting and iftar parties. She did try to fast in past, but it made her eating disorder worse. She didn’t fast last year and felt that she was judged and misunderstood. This year Monika once again is not fasting but she’s looking forward to participating in this month for spiritual reasons. She looks forward to deepening her connection with God and looks forward to embarking on a journey of self-discovery. When Allah has exempted you from fasting, then who are the people to pass such judgement?

Should People with Eating Disorders Fast?

If you are struggling to choose recovery, finding your “key to life” can help you stay firm in your resolve to recover no matter what obstacles seem to stand in your way.

If your aim in life is seeking nearness to Allah Almighty then don’t forget this cannot be achieved through eating disorder behaviours. You need to free yourself from the slavery of your eating disorder.

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The word of God is the Medicine of the Heart.”

Imam Ali (ra)

People suffering from eating disorders should NEVER fast without professional supervision; otherwise it will merely become a disordered journey, a self-destructive exercise. You starve both your spirit and your body and find yourself discouraged and frustrated instead of being benefited from the fast. 

Having an eating disorder during Ramadan can be difficult and can sometimes feel conflicting. Debra Safer, a professor of psychiatry and behavioural sciences at Stanford University said that people with a troubled relationship with food should think twice before fasting. Research shows that patients with eating disorders do best when they eat regular meals and snacks.

According to Safer, “Intermittent restriction of intake is often one of the behaviours that people with eating disorders engage in as part of their eating disorders – and it often sets them up to binge and purge. For people with eating disorders, fasting is ‘potentially risky in that it disrupts attempts to build and maintain hard-won normalized eating patterns.’” 

Personal Story:

In 2021, Sabrina was told by her medical team in Algeria not to fast during the month of Ramadan, because of her deteriorating physical and mental health and low weight. A very strong part of Sabrina wanted to observe the month simply for its physical aspects, where you fast from dawn to dusk. In past she had fasted without a medical supervision and subsequently it resulted in deteriorating physical and mental health. Sabrina found the time not fasting very distressing, but it was also a wakeup call. She realised that she was so focused on Ramadan and food that she forgot all about the spiritual side of Ramadan.  After a hiatus from Ramadan last year, this year she is fasting but her fasting is accompanied with prayers, time with family and brining a real change in her life, developing healthy habits that will extend outside Ramadan and last life time. Her younger sister has taken a role of her carer and will be helping Sabrina to spend the Ramadan in best way possible.

The Month of Recharging your Soul

Every morning, try to wake up with an intention to get rid of one eating disorder thought.

Wash your heart every morning with salat, then warm it up with dhikr. Approach life with hope and faith. Every day do your best, Allah will do the rest.”

Wael Abdelgawad

This much has been established that Ramadan can present a risk of relapse for anyone in recovery and can exacerbate one’s eating disorder. But let’s not forget the most important side of Ramadan – the only time of year where a profound change can happen as spiritual energy around earth shifts making it easier for an individual to embark on a journey of recovery and healing.

Ramadan provides a safe, sacred space for you to quiet your restless self and let your soul find its voice. This is a deeply transformative journey designed to return you back to your essence. 

Fasting in itself doesn’t change us, but the focus on spiritual aspects of Ramadan and focusing on a higher degree of fasting, where one fasts with their limbs and heart changes us and positions us in a better place where we gain a deeper understanding of ourselves and our relation with God. 

Ramadan is not about food and feasting and social gatherings, it’s about you and your inner healing and your personal time with Allah (swt). Every act that is done for the pleasure in this month spiritually energizes the faithful to lead a new life, opening a new era of peace and blessings. And those who are fasting, you must accompany your fast with extra prayers, reading of Qur’an and charitable acts otherwise it simply becomes a weight loss program. 

Allah is flexible and has ordained for you ease and not hardship, it’s your illness that ordains pain and hardship and certainly not eases. 

So when you have decided, then place your trust in Allah; surely Allah loves those who can trust.”

(Quran, 3:159)

If feeling triggered or restless about the day, you must devote yourself to Allah’s company, even during those times you feel weak, vulnerable, or irritable. Create a set time to read Qur’an, meditate, do dhikr, listen to lectures, and offer extra prayers. 

Still struggling with an eating disorder? Just remember: “Your Lord has not forsaken you, nor has He become displeased. And surely what comes after is better for you than that which has gone before. And soon will your Lord give you so that you shall be well pleased.” [Qur’an 93:3-5]

Meditate when you wake in the morning and glorify Him throughout the day with His names. Inshallah, you’ll see Allah will enable you to observe His worship to pray without ceasing as you seek Him. 

When I am feeling low and downtrodden I just find a quiet place and sit alone with my favorite book (the Quran)! When I turn each of its miraculous pages my heart begins to feel lighter and the world around me brighter! The love, warmth, and security of each word sets in and it is in these very moments that I know for sure in my heart how much Allah really loves me! Alhamdulillah! Subhanallah! Allahu Akbar!”

Asmaa Deanna-Dee

In episode Is Gluttony still a sin? The seven deadly sins in the modern world with Sheikh Hamza Yusuf, Anna Bonta Moreland, and William Cavanugh, they discussed disordered eating and fasting diets. According to Anna Bonta Moreland, there are two extremes happening in our right now – she spoke about students on campus, in that either they are eating too much or going on excessive fast diets too much. In this episode, we see that fasting has become a modern-day norm with the emergence of various fasting diets that have no basis in spirituality.

Ramadan is also fast becoming one of the most neglected spiritual disciplines because it’s not easy to do a real inventory of yourself and bring about a change that will last a lifetime. But then everything that matters and counts is not easy. 

Sixteen-year-old Rabyanur Sevinc from Egypt will be fasting this month, when asked she said,

“I will fast this Ramadan, last year I was very ill and in the depth of my eating disorder but I fasted despite all of that. Maybe a part of me wanted to lose more weight then, but this year I want to fast just for God and not for my ED, I became aware of that even though my ED makes it difficult to differentiate between them. I’m trying to get close to God. I have always loved Ramadan since I was a child, it’s spirit gives me a kind of euphoric feeling, but when I developed an ED it stopped me from having this feeling, all I thought about was how many calories I will eat next iftar/sohour, or how to get through the day without keeping anything down, how much weight I will lose. All I thought about was numbers, I remember last Ramadan I fasted it all but due to having intense ED behaviours I ended up in ICU the day after Eid. And I never want to go through that again; I promised myself I’m going to make this Ramadan better than previous ones, starting it with a new mindset, a body that is starting to finally breathe again. My biggest challenge is to beat rumination syndrome that I developed 2 years ago, which nearly killed me. I’m trying to learn how to digest again. Also what’s really challenging is having family gatherings, and especially in Egypt all it revolves around is food, (iftar then desserts then snacks….)

“So it’s really challenging and can be so triggering in some ways, but what I need to do is to be aware of that and try to enjoy time with my family, and not let the monster’s voice creep in, because it always does in any occasion. Unfortunately here in Egypt people are not educated about ED, they can’t even think about it, all Egyptians care about is food, what and when to eat, at the same time they bully when they see someone heavier than them, I even experienced that type of bullying as a chubby child, I used to get called ugly names that really fed my ED voice more. I wanted to lose weight to prove them wrong, but I’m the only one who got harmed, last year after MANY hospital admissions and refusing to get help or start recovery I gave myself a chance to try, that I have nothing else to lose, and found a really good psychotherapist that is specialized in eating disorders, rarely found in Egypt, helped me start my recovery, and made me believe that life is more than caring about my size, ever since starting recovery I had many ups and downs, lapses and relapses but always got up and continued, because no one ever regretted starting recovery, I’m not recovered yet nor weight restored, but I’m sure I will get there soon Insha’Allah, I believe that God made me go through all of that for a reason, he gave me a message, to help people who are scared to speak up, who are suffering in silence, and have no hope, I really feel their pain because I’ve been there and I’m not mad about what happened to me, I’m sure everything happens for a reason.”

As someone who is recovering from an eating disorder, it may be exhausting looking for the finish line, wondering when your battle with this vicious disease might finally come to an end. Though everyone’s recovery journey may look different, there is hope in the process of recovery.

Recovery from an eating disorder is indeed a journey and not a destination. Each day you commit to your recovery and fight your eating disorder, you are lessening the stronghold it has over you and empowering yourself to truly find freedom and lasting happiness.

Eating disorders can be beaten. If we have faith, we believe in Allah, and when we believe in Allah, we know that everything is from Him. The tribulations won’t and don’t go away, but we deal with them in a different way because of this faith and belief in Allah. We cope with the tribulation better because we have chosen to believe in His reassurances and promises to us: “Allah does not impose upon any soul a duty but to the extent of its ability” [Qur’an 2:286]

Now with some organizations talking about this mental illness, we hope the increased awareness will help to create more awareness about eating disorders in Muslim world. We have a long way to go more professional support and treatment is necessary to set people suffering from eating disorders on a path to recovery.  We need mental health practitioners and religious leaders to work together in raising awareness and educating the community about eating disorders.