We are now in the midst of Ramadan, the Islamic holy month. During this time, many Muslim people observe by fasting (i.e., not eating or drinking anything) from sunrise to sunset each day.
Fasting is a part of many faiths, including Judaism (for example, on Yom Kippur) and Catholicism (as in Good Friday). For many people with eating disorders, observing these holidays in this way presents a real conflict.
If someone is currently suffering from a restrictive-type eating disorder – as in anorexia nervosa or ARFID – or has a history of one of these conditions, fasting may carry physical, behavioral, or psychological risk. In some cases, it can lead to increased restriction after the holiday and other forms of relapse. For individuals with binge eating and purging behaviors, engaging in strict dietary restriction and not eating for many hours can add to the risk of binge eating later in the day.
People with eating disorders who are religiously observant may feel stuck and confused during these periods. They may feel very connected to their faith and thus (erroneously) decide that they are a “bad”, sinful, or unworthy member of this faith if they do not fast. At the same time, they may realize the risks inherent in fasting and be apprehensive about possibly becoming more entrenched in their eating disorder.
To navigate these murky waters, we offer some ideas and questions to reflect upon, to clarify your intentions, values, and goals, and ultimately to decide whether or not fasting is appropriate for you:
Talk it through with someone. If you are connected to a mental health or medical professional, it is worth your while to bring up the issue of religious fasting or dietary restriction with them (ideally, well in advance of a given holiday). They can help you think about the pros and cons of each choice and provide information about eating disorders and fasting. Talk through your reasons for wanting to fast and your reasons why it might not be a great idea. For example, are you struggling with any dysfunctional thoughts that could be challenged? Is a part of your desire to fast rooted in a desire to restrict for purposes that serve your illness more than your faith? Be honest with yourself and discuss these thoughts with your healthcare providers so that they can be in the best position to help you.
If you are in contact with a trusted community leader in your religious faith (e.g., an imam, rabbi, pastor), you might also find it useful to consult with them regarding fasting when one has an eating disorder. Many faiths already offer guidance about whether fasting is suggested for everyone or if there are exceptions. For example, during Ramadan individuals struggling with an illness are excused from fasting, and those struggling with physical or mental illness are exempted from fasting on Good Friday.
Learn how others have handled this dilemma. Many people of faith with eating disorders have written about their experiences and thoughts about whether or not to engage in religious fasting. Articles that may be helpful include this piece on Jewish fast days and this post on eating disorders and the blessings of Ramadan.
What is my intention with fasting and can it be achieved some other way? For many individuals, fasting during religious observance is intended as a way to achieve a cultural connection or to remember and pay homage to those who have suffered in the past or who are currently suffering. If this is the spirit underlying a proposed period of fasting, think through whether there are other acts you can participate in, rather than fasting, that can achieve this same overarching goal.
Can you participate in activities helping those who are less fortunate than you, either within or outside of your religious community? Perhaps there are non-food-based sacrifices you can make, such as limiting television or time on your smartphone. If part of the appeal of fasting is that it is a way to bond with other members of your family and religious community or simply a long-standing tradition, perhaps you can speak with those close to you about creating a new tradition that you can partake in together.
No matter what you decide, we at the Columbia Center for Eating Disorders wish you a meaningful and recovery-consistent holiday.