Ramadan and Eating Disorder Recovery
What is Ramadan?
Ramadan is one of the most significant months of the year observed by Muslims around the world. It is the 9th month of the Islamic lunar calendar and is the month in which the holy Quran was revealed. In Ramadan, Muslims observe fasting (Sawm), one of the five pillars of Islam. This includes abstaining from eating, drinking and intimacy from dawn (Fajr) until sunset (Maghrib). Fasting is a mandatory act of worship performed with the intention of attaining spiritual awareness and closeness to God (Allah) known as Taqwah.
Traditionally (and favourably), the fast is broken with dates and water as our Prophet Muhammed (peace upon him) did. After this, it is also favourable to perform the sunset (Maghrib) prayer before enjoying the long-awaited Iftar meal. In most Muslim households, Iftar is a nightly feast where multiple main and side dishes are served with desserts after. For most Muslims, anticipating all the delicious foods awaiting at Iftar is arguably the most exciting time of the day. In contrast, however, sadly, for the Muslim struggling with an eating disorder, this couldn't be further from the truth. While everyone else is celebrating breaking their fast with food, they are overwhelmed by the abundance of food choices at the table while simultaneously having their eating disorder scream a million food rules through their mind, making Iftar the most anxiety-provoking event of the day. This struggle can make the person suffering from an eating disorder feel guilty, lonely and excluded for being unable to share the same happiness and joy as others.
In this blog post, we will be addressing the challenges of being a Muslim struggling with an eating disorder during Ramadan. We will also discuss ways to make you (the individual or the carer) feel more empowered and confident in managing these challenges. We also hope to provide you with ideas on how to observe a meaningful Ramadan, allowing you to maintain your religious and spiritual identity despite having an eating disorder.
Why can Ramadan be so hard for a person struggling with an eating disorder?
While Ramadan fasting is a time of increased spirituality for most Muslims, ironically (as portrayed above), this can be a time of increased emotional turmoil for the one with an eating disorder (or who has had a history of an eating disorder). This is mainly due to Ramadan being a time of year where emphasis is put on eating and lack of eating simultaneously, both of which can be triggering.
To further elaborate, Ramadan fasting can be triggering for several reasons including the following:
Trigger warning ahead- mention of eating disorder behaviours and dieting
Restrictive eating: While the act of fasting may seem harmless to a healthy person especially when done for the sake of Allah and with sincere intentions. For the person with an eating disorder, it is not as straightforward. Sadly, struggling with an eating disorder may mean being vulnerable to misusing fasting (the same act of worship performed for the sake of Allah) as an eating disorder behaviour of restriction for the purpose of satisfying the eating disorder’s commands. If this occurs, it can strengthen the eating disorder and ultimately compromise recovery efforts. Alternatively, for an individual who has had a history of an eating disorder, restrictive eating through fasting may trigger an episode of relapse whereby the eating disorder is triggered once again. A gentle reminder that this is very hard and that if you have these thoughts, it is not your fault!
Food and social eating are stressful: Food and social eating, which was once a source of joy and connection starts becoming frightening and anxiety providing for the one with an eating disorder. On a regular day, eating meals is challenging in and of itself. In Ramadan, this is further exacerbated due to the large amounts of food available and sometimes due to the availability of variety and new foods that may be considered ‘unsafe’ options. Additionally, as it is very common to have Iftar social gatherings in Ramadan including inviting and being invited by family, friends and relatives, this can be extremely anxiety-provoking as eating in the presence of unfamiliar others can be very stressful and uncomfortable.
Sensations of fullness: It is very natural and common to engage in eating past fullness cues at Iftar especially after abstaining from food and drink the entire day! The sensation of fullness or bloating after eating and drinking at Iftar is very normal. However, for a person struggling with an eating disorder, these sensations can be challenging to tolerate, in turn, potentially triggering disordered eating behaviours of restriction and/or purging after to compensate. A reminder that this is involuntary and is by no means any of your fault!
Binge eating: On the other hand, restrictive intake and the long hours of fasting can be the biggest triggers for binge eating behaviours after breaking the fast. This can feel extremely overwhelming and can trigger feelings of immense loss of control around food. Again, a gentle reminder that you did not cause this and that it is not your fault!
Diet talk: Unfortunately, it is very common for many to use Ramadan as an opportunity to ‘diet’. It is also very unfortunate that many tend to speak about food in a negative manner, associating it with guilt. It is very sad that food, a blessing from Allah meant to be enjoyed (Tayib) is now hijacked by diet culture and made to be ‘evil’ and ‘bad’. It does not require much thought to conclude that ‘diet talk’ in Ramadan is extremely harmful and triggering for an individual with an eating disorder or who has had a history of an eating disorder. We will be further discussing this later.
To fast or not to fast?
Deciding whether or not to fast the holy month of Ramadan is undoubtedly one of the hardest decisions to make. Ramadan fasting is significant due to being associated with one’s Islamic identity and the thought of not engaging in the fasts can induce fear of being left out, feelings of guilt for not being ‘a good enough Muslim’ and even fear of being judged by others who may not understand what you are going through.
Despite your thoughts and feeling around the matter, it is important to remember that sickness is one of the valid exemptions to fasting according to the Quran as Allah does not want to make matters harder for you [Reference Quran Verse 2:184].
Having said the above, it is still understandable that deciding whether or not to fast is not an easy matter. The following are some guidelines that can assist with this decision:
Medical stability: Being in a medically stable condition, including having a healthy heart rate, blood pressure, weight and blood tests is a non-negotiable if you decide to fast.
Consult your medical team: You are medically stable and considering Ramadan fasting? Hold it right there. Before going any further, it’s best to discuss with your treatment team to assess whether fasting is safe and would not compromise your recovery. The eating disorder will always make you believe that you are not ‘sick enough’. Your treatment team can help support you make an informed decision as well as assess the intentions behind your desire to fast. On a similar note, if you consider yourself recovered, it is still worth re-visiting your previous treatment team to assess and to have a relapse prevention plan in place if you decide to fast.
Fasting for Allah or for the eating disorder?: It’s very easy for the eating disorder to hide behind religion and to use Ramadan to its advantage. Before deciding to engage in fasting ask yourself: Am I doing this for the sake of Allah or am I doing this for the eating disorder? This question can be very confronting and may even feel conflicting and confusing. Remember, having an eating disorder is not your fault and does not make you any less of a Muslim. If you are feeling conflicted, as mentioned above, it is best to discuss with your treatment team to help you assess your intentions and to make an informed decision.
Not being able to fast: You have spoken to your treatment team and it was deemed unsafe for you to fast? This can be a really hard pill to swallow and can understandably cause immense grief. You are not alone. Remember, you are not doing anything wrong by not fasting (if anything, not fasting is probably the harder thing to do!). Again, it is not your fault for having an eating disorder and it is important to remember that Allah sees you and your struggle. It is not all gone for you will be rewarded for your intentions to please Him.
How to participate in Ramadan when not fasting?
You are not fasting Ramadan this year? Now what?
Great question!
You probably already know this, but a gentle reminder that fasting is not the only way to participate in Ramadan! You can still make the most out of the holy month by using it as an opportunity to attain closeness to Allah in different ways. You can still use this month as an opportunity to spiritual re-set and strengthen your faith and to increase your engagement in good deeds (reminder all good deeds are multiplied by 10 in Ramadan!). You still have access to that!
Here are some example acts of worship to consider:
Salah (Islamic prayer): Whether performed at home or at your local Masjid (mosque), Salah is one of the most favourable and most beloved acts of worship you can engage in.
Duaa (supplication): There is no better time than the holy month of Ramadan to ask Allah for what you truly want and desire! Sincerely and wholeheartedly speaking to Allah is a sure way to make you feel closer to Him.
Thikr (remembrance of Allah): Not only is the repetitiveness of thikr very relaxing, grounding and therapeutic but you will be greatly rewarded for it!
Sadaqah (charity): Ramadan is the month of generosity, giving and kindness. While financial charity is favourable and greatly rewarded, Sadaqah is not limited to that! Sadaqah also includes acts of kindness as simple as offering a smile, a kind word, or even the act of helping and supporting one in need such as being there for a friend, supporting your parents at home or even volunteering your time for a good cause.
Quran: Ramadan is the month of the holy Quran. Whether you decide to read it in Arabic or try to deepen your understanding through the study of Tafseer (Quran explanation), you will be rewarded. Bonus points for implementing Quran teachings into your everyday life!
Getting to know Allah: One of the best ways to attain spiritual closeness to Allah is to learn about Him not only through the Quran, but to also know and understand His traits through His 99 names. What better time than Ramadan to do this?!
The list above is not exhaustive as there are plenty more examples and ways to attain rewards and spiritual closeness to Allah. Having said this, it’s a great idea to choose a few acts of worship you’d like to engage in throughout Ramadan and to incorporate these into your Ramadan routine. Apart from helping you feel spiritually fulfilled, it can also help in keeping you grounded during this hard time.
How to take care of yourself during Ramadan
Ramadan is a time of the year when our whole lifestyle is dramatically flipped and changed for an entire month. Having said this, and as much as we all love Ramadan, self-care is essential to prevent burn-out and overextending ourselves during the holy month. Self-care can look very different from person to person and needs to be individualised to your own needs and potential triggers. Below are some ideas and suggestions you can incorporate into your Ramadan routine:
Self-care if fasting:
Adequate and regular eating at night: If you are medically clear to fast, it is very important to ensure adequate eating throughout the non-fasting hours of the night. Ramadan should not mean eating less than usual. Make sure you have a plan around spreading your meals and snacks throughout the night. This also means that waking up for Suhoor (the pre-dawn meal) is a non-negotiable part of fasting. If you’d like information about adequate eating in Ramadan, it’s best to speak to your dietitian about this.
Break the fast on time: Remember, there is no merit in pro-longing the fast past the Maghrib Athan (Maghrib call to prayer). If you notice having urges to continue fasting/restricting, discuss this with your treatment team!
Adequate sleep: Since it is very likely that sleep patterns will be interrupted during Ramadan, make sure to at least get 7-8 hours of sleep in total throughout the day. Whether this is through going to bed a little earlier, getting in a few z’s after Fajr (dawn prayer) in the morning or even through having daytime naps to fill in sleep gaps (if possible)- try your best to prioritise sleep as a form of self-care.
After Ramadan: While many Muslims joke about how eating on the first day of Eid (celebration after the end of Ramadan) feels ‘illegal’ due to being used to fasting in the day, it is very important to not continue meal skipping after Ramadan! The best way to do this is to have an eating plan as soon as Ramadan ends with the aim of returning to having adequate and regular main meals and snacks. Remember, fasting is not the norm! If you’re feeling stuck, consult your dietitian for support.
Self-care if not fasting:
Ramadan routine: Develop a Ramadan routine incorporating meaningful non-fasting acts of worship to help you stay grounded and connected.
Follow your meal plan: Continue following your meal plan as agreed upon with your dietitian. Do not skip meals even if no one else is eating! It’s so easy for the eating disorder to get away with meal skipping during Ramadan!
Be at the Iftar table: Be present at the Iftar meal with your family nightly. Being at the table is one way to feel included, connected and to help you get into the spirit of Ramadan!
Coping and grounding skills: Having said the above and as Ramadan and Iftar can be a triggering time, please make sure you have a few coping skills under your sleeve when it feels too overwhelming. It’s a great idea to brainstorm some coping skills that work for you with your treatment team.
How to support a person with an eating disorder during Ramadan?
Being a carer or support person for an individual with an eating disorder is certainly not easy. Eating disorders are very complex and the person struggling may find it extremely difficult to ask for help and support. To make this easier, here are some suggestions to help and keep in mind:
Be gentle and supportive: Take the time to research and understand the nature of the eating disorder. Offer to non-judgementally listen to your person’s struggles and concerns as this can be a very hard time for them. In addition to lending an ear, offering encouragement and kindness go a long way.
Plan in advance: One of the best ways to support a person with an eating disorder is to plan meals in advance so they know what to expect and to prevent surprises at Iftar. Part of planning also means ensuring safe food options they can enjoy are available to them. Meal planning is also an opportunity to ensure advice and mutual agreements made by the person and their dietitian is incorporated at Iftar and at the rest of their meals.
Involve them: As missing out on the fasts can feel very isolating and lonely to the person with an eating disorder, a way to make them feel included is to encourage them to be as involved as possible. This can range from including them in food preparation (if safe to do so), cleaning, engaging them in non-food related, conversations, congregational acts of worship and so on.
Support before, during and after mealtimes: As urges to engage in eating disorder behaviours may arise around Iftar time, it is important and helpful to provide supervision and distractions to support. This can include providing motivation and encouragement to eat at Iftar and making sure the person is occupied and not left alone after e.g. continuing conversations after Iftar, watching a TV show together, asking the person to assist with chores etc.
No diet talk: Ban negative commenting on food and all forms of commenting on bodies at all times, as this can easily spiral the eating disorder out of control. Set boundaries with relatives, family and friends and inform them to respect the ‘no diet talk’ rule to protect your struggling person’s recovery.
No dieting: In addition to ‘no diet talk’, do not diet yourself! Do not intentionally restrict your intake, make comments on your own body and eating or engage in self-weighing. Set a good example by focusing on the purpose of Ramadan which is Taqwa (attaining spiritual closeness to Allah) rather than making it about food and bodies!
Duaa (supplication): Make duaa asking Allah to cure, make it easy and to grant your struggling person a full recovery. Let your person know that you have been making Duaa for them as they will greatly appreciate it and will make them feel loved and supported.
Conclusion
We hope that this blog post has been helpful in providing you with ideas on how to navigate the holy month of Ramadan while recovering from an eating disorder. We know that Ramadan can be a very hard time and we want to gently remind you to be kind to yourself and to remember that having an eating disorder is not your fault! Finally, we sincerely and wholeheartedly ask Allah to grant you a blessed Ramadan whereby all your acts of worship are accepted. We also ask Allah that you reach the end of Ramadan feeling you have fulfilled the purpose of Ramadan and have attained spiritual closeness to Allah.
