Ramadan fasting risks for people with eating disorders
As the Muslim holy month of Ramadan begins, Habiba says she is “terrified” at the thought of fasting this year.
After her erratic eating pattern developed into bulimia and binge eating disorders in her mid-teens, her habit of abstaining from food and drink from sunrise to sunset exacerbated the need to limit her eating further, leading to toxic You risk falling into a cycle, she says.
But making the decision to refrain from practicing makes her feel like she’s ignoring an important part of her faith, she says.
“I know I’m not confident about continuing the fast…I’m starting to enjoy the feeling of hunger and[fearing]what it will do to me,” said the 30-year-old.UK A Muslim editor based in , who asked CNN to use only first names for privacy reasons. “I’m really sad. I feel like I’m missing out on a really spiritual experience.”
Habiba said she first had the urge to get sick when she was nine years old. By age 16, she was skipping meals, tracking her calories, fainting as a result of hunger, exercising too much, and vomiting at least 15 times a day.
“I don’t want anything like bulimia in anyone in particular because it’s like an addiction.”
Habiba is not alone in her experience. A growing number of Muslim doctors and psychologists are trying to bridge the gap between religious leaders and worshipers like Habiba. They say they are marginalized when trying to access support within their own communities and in the public health system.
“Minorities are underrepresented. It’s not that they don’t have or suffer from an eating disorder, but there’s a lot of stigma like this around people who come to them for help.” These are “invisible and promiscuous” diseases that transcend age, religion, gender and sexuality, she added.
“Protecting your body and health is an act of worship, so seek the appropriate help you need,” she said.
Creation of “BINGE PURGE CYCLE”
During Ramadan, it is recommended that Muslims eat a well-hydrated and balanced diet before sunrise, break the fast with dates and water at sunset, and eat more afterward. , we also engage in other forms of practice, such as increased prayer, giving to charities, volunteering, and participating in communal meals.
But daytime fasting may mask restrictive eating patterns associated with eating disorders, Naseem said. Exercising control and experiencing hunger while fasting can create a desire to eat large amounts of food quickly in iftar (breaking the fast after sunset). “It slows recovery,” she added.
According to the Qur’an, sick and traveling people do not need to fast as long as they fast when they are healthy or they feed disadvantaged Muslims during the month.
Therefore, if someone has an illness or condition that is confirmed by a medical professional, they do not need to fast.
For example, children, the elderly, pregnant women, menstruating women, or those who require daily medication are exempt from fasting.
But mental health ailments are discredited in the same way as physical ailments because they are viewed as taboo by communities and society at large, Naseem and Ali said. That means those who choose not to fast because of mental illness face “guilt and shame” from their communities and wider society, Naseem added.
Habiba said she has childhood memories of her body being constantly inspected by members of her extended family. This, she says, is a sign of the cultural pressures South Asian and Muslim girls face when becoming women.
When she was 15, she remembers her uncle telling her she was “fat” after returning from a family trip to Turkey. “Comments like that stay forever,” she said.
At the same time, she remembers being told by relatives that she could no longer play outside or skateboard with her cousins. Instead, she was encouraged to hang out with her girl buddies and play with makeup.
Despite having “liberal” parents, she says her eating disorder is part of her reaction to pressure to fit into the rigid gender roles assigned by her community and wider society. I believe
When she was about 16, Habiba said her eating disorder symptoms got worse until her parents took her to a local doctor. She received psychiatric outpatient care in a pediatric psychiatric ward until she was 18, after which she was transferred to an adult psychiatric ward.
But cultural differences between her and the white therapist she saw meant she couldn’t understand the subtle pressures she faced as a woman in the community, she says. and how they were intrinsically tied to her eating disorder.
“I had a white therapist who didn’t understand what I wanted to talk about or what I was struggling with and was really very condescending.”
Farheen Hasan, a 27-year-old research psychologist based in Bristol, South West England, agrees that therapists need to understand certain cultural pressures.
At 18, Hasan said she began exhibiting disordered eating patterns in the form of avoiding meals, exercising excessively and obsessing over healthy eating. She says she has an internal dispute with her every year over whether or not to fast during Ramadan.
“I think we need access to a therapist who understands our culture, our religion and our struggles and who can provide professional guidance and support,” she told CNN in an email.
ask for help
Habiba and Hasan’s story reflects the systemic challenges people in underserved communities face broadly in accessing mental health support.
Despite having higher rates of some mental health disorders than whites, people of color face wide disparities in getting help due to systemic and interpersonal racism and stigma. Blacks, Indigenous peoples, and people of color are significantly less likely to be asked about their eating disorder symptoms by a doctor than whites, and are half as likely to be diagnosed or treated, according to the Diabetes Association. Become. Neuroses and related diseases.
Halima Eid, a licensed professional clinical counselor and co-founder of AMALY, a California-based nonprofit dedicated to challenging mental health prejudices in the Muslim community, said those spaces of people said it can be difficult to access the information they need.
Eid founded AMALY in 2020 to provide accessible therapy services, workshops, support groups, and educational talks tailored to the local Muslim community in San Diego, California. She also offers services online that reach out to Muslims around the world.
Last spring, she launched a virtual support group to help Muslims with eating disorders as they get through Ramadan. She said about 30 people were initially enrolled in two cohorts, including Muslims from the United States, Australia and the United Kingdom, after the screening process.She plans to run the same groups this year.
“It’s a very lonely experience to suffer sickness and disability on your own,” she said. We challenge Islamic perfectionism, perfectionism as Muslims during Ramadan, because many people struggle.”
Eid and UK-based counseling psychologist Naseem draws on her knowledge of Islam and medicine to help Muslims seeking support from mental health professionals with similar life experiences as women practicing Islam. provides services to.
“I am able to offer a unique perspective…that puts my skill set to work for groups that are uninterested or uncomfortable speaking to people who do not have their own background. has created a Ramadan guide that provides nutrition and faith-based advice for Muslims with eating disorders.
break the chain of shame
Habiba says her bulimia began a few years ago when she came home from a friend’s baby shower and ate cakes and sweets and felt sick.
“I just look at my body and I don’t like it. I don’t like the way I look and I don’t think I’ll ever like myself, but I just think it’s necessary to accept it,” she said. said. “I don’t know if I can say I’m fully recovered. I know I still have that voice in my head, but it’s quiet now.”
Now, she said, you can keep eating disorders at bay by identifying your triggers and forcing yourself to eat when you’re drawn to restrictive eating patterns.
Celebrations of Ramadan and Eid can trigger her eating disorders, she said. I received critical comments from family members who may not have.
Hasan, a Bristol-based research psychologist, said Muslims need “social acceptance” from community leaders to be in the position.
“If the community accepts and acknowledges that people are struggling in different ways, it will relieve a lot of stress and mental strain. I need it,” she said.
Habiba still misses the communal aspects of fasting during Ramadan, attending family dinners and counting down to Eid al-Fitr, the celebration that marks the end of Ramadan.
“I feel left out of the club,” said Habiba, hoping in the future to be able to fast again and be confident in his faith rather than a desire to limit himself. Her calorie intake is her motivation.
Ali, an Atlanta-based imam and counselor, encourages Muslims with eating disorders to do things other than fasting, such as reading the Koran, attending nightly Taraweeh prayers, and donating to food programs. I proposed a way to work on the holy month.
He provided guidance for religious leaders and families to recognize the challenges faced by Muslims with mental health issues during Ramadan and to break the intergenerational cycle of shame and guilt that exists throughout society. said that it is necessary to provide
“Islam is a religion that does not want people to risk their lives to attend prayers,” he said. “I think it’s important for us religious leaders to be able to show empathy to the most vulnerable among us.”