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Illustration Marianne Wilson

What is Ramadan like for Muslims with eating disorders?

The holy month of Ramadan can be a time for celebration and community – but for some Muslims, it can be triggering too

If you’ve ever been in South or Middle-East Asia during Ramadan, you’ll be familiar with the delectable scents that waft through the streets during iftar: aromatic spices being thrown into opulent kadais of slow cooked haleem, the giddying sweet smell of shahi tukda doused in saffron and cardamom milk, and rows of hefty meat gently marinated, ready to be thrown into the fryer. These fragrances serve as a welcome reminder of sunset and the long-awaited end to the day’s fast for Muslims across the world who abstain from food, drink and sexual activity during the spiritual month of Ramadan. 

Still, only a handful are aware of the anxiety and agitation these smells can trigger in practising Muslims who live with eating disorders. “I remember my stomach would twist and churn every time my mother entered the kitchen to cook for the evening,” says 23-year-old Sakina*. “My thoughts would rush into overdrive trying to create a new excuse for why I needed to eat alone in my room – so I could hide the food – instead of breaking my fast with the whole family.” Presently in treatment for bulimia, she spent years viewing the fast for Ramadan as an easy way to mask her eating disorder. Nobody could question why she skipped meals if the whole community did it together. 

Instead of abstaining to feel closer to her religion, Sakina shunned food to fit into the baby blue kurti her mother gifted her when she was 14 – a signifier that she hadn’t outgrown her “goal weight”. Sakina isn’t alone: about 9 percent of the global population has an eating disorder, and in the Arab world risks for the illness go as high as 54.8 percent, making fasting during Ramadan a tricky practice for some. 

21-year-old Asheeza spent her early teens engulfed by bouts of disordered eating and undiagnosed anorexia. After years at doctor’s clinics for low BMI and constant fatigue, she decided to amend her relationship with food during Ramadan. “In the past, my weight would fall drastically at the end of the month but my reasons for fasting were twofold: yes, there were religious sentiments but it was also driven by a need to lose weight,” she confesses. Her body was trained to feel uncomfortable by the sight of lush feasts at iftar time, so it took some effort to feel grateful for food once again. 

For Asheeza, breaking her fast with fruits and a glass of milk or lemonade helps her ease into heavier meals. Additionally, if she falters or finds herself gravitating towards thoughts of disordered eating, she finds solace in Tumblr threads where people from similar cultural backgrounds share their experiences. “I approached my school counsellor earlier but her solution was to stop my fasts and since she comes from a different faith, I don’t think she understood the religious significance entirely,” she says, adding that as a result, online platforms became her safe space. For Sakina, planning meals in advance has helped her, especially when she’s away from home. For example, while interning in Mumbai last year, she subscribed to an iftar meal delivery service to ensure she didn’t skip meals despite hectic work days.

“One of the challenges we face is to make people understand that an eating disorder cannot be ‘thought away’. It’s not a lifestyle change, it's a mental illness” – Dr Omara Naseem

Asheeza and Sakina’s experiences aren’t unusual, confirms Dr Omara Naseem, a licensed Scottish-Pakistani psychologist with an expertise in treating eating disorders. Having noticed a dearth in resources for minorities, she created an accessible and cohesive guide to assist people with eating disorders during Ramadan. “One of the challenges we face is to make people understand that an eating disorder cannot be ‘thought away’. It’s not a lifestyle change, it's a mental illness,” says Dr Naseem. As a practising Muslim, she asserts that skipping fasts does not reflect badly on the person’s religiosity and stresses that the period is about strengthening your relationship with Allah through prayer, reflection, quality time with family and those less fortunate. Fasting is one way to achieve this, but not the only path. Dr Naseem also emphasises that the Quran excuses those who are unwell from the tradition. 

Family intervention and support also play a key role in creating a safe space for dialogue and recovery, especially as iftar parties with extended family are commonplace as everyone breaks their fast together. Having a family member’s support to explain that you are unwell makes the process a lot more bearable for a fragile person in recovery. For those who are unable to bring their family to therapy, Dr Naseem recommends the ‘explainer for friends and family’ by Beat, the British eating disorder recovery charity. Family can also keep an eye out for signs of relapse, including increased attention to weight, rapid changes in moods, a need for reassurance, skipping meals and isolation could be a few. 

Although online support groups can be beneficial, Dr Naseem says a trained moderator must be present to facilitate the discussion safely. ‘The Sanctuary’, a virtual chat room by Beat, ‘Muslims and Eating Disorders’, a public platform for information and support by Maha Khan and ‘The Lantern Initiative’, a UK-based non-profit that raises awareness about mental health in the Muslim community are among resources that she recommends. Dr Naseem also adds that having the support of spiritual leaders such as Imams could make all the difference to normalise not fasting with an eating disorder through Ramadan. “Diabetes UK got Imams on board to assert that diabetes patients can be excused and this does not weaken their faith,” says Fareeha Jay, a licensed dietician based in the UK. “We want to achieve the same for people with eating disorders.”

If you are struggling with an eating disorder, you can reach out to Beat here, Dr Omara Naseem here and Fareeha Jay here. You can also read Maha Kahn‘s tips on navigating Ramadan with an eating disorder here.

*Name has been changed