For Muslims with eating disorders, Ramadan can pose dilemmas

CAIRO

When the Islamic holy month of Ramadan begins, a battle rages in Habiba Khanom’s mind: If she goes without food or drink, is she doing it for God or because of her anorexia? Deep down she knows the answer, and it saddens her.

“If I did fast, it would be for my eating disorder,” said Khanom, a 29-year-old London resident. The religious duty that many Muslims find soul-nourishing can, in her case, offer “permission ... to fall back into my old habits and lose weight and kind of not get judged for it because everyone is doing it.”

A time of worship, contemplation and joyous gatherings with family and friends, Ramadan is also a month when food plays a central role, from the ritual daytime fasting to celebratory iftar meals to break the fast.

For Muslims grappling with eating disorders, navigating those religious and social rituals can pose unique challenges. It’s a struggle that they and the specialists treating them say is often largely invisible to broader society, which at times can make it all the more difficult.

“Understanding of eating disorders in general is minimal,” said Ghena Ismail, director of the eating disorders program at the American University of Beirut Medical Center in Lebanon. “People are just beginning to appreciate mental illness.”

Fasting from sunrise to sunset during Ramadan, which this year started in early April, is a religious obligation, one of the Five Pillars or fundamental beliefs and practices of Islam. The faith allows for exceptions, however, such as for young children and sick adults.

The advice Ismail gives to Muslims with eating disorders depends on each individual’s stage of treatment. For those with severe symptoms, she recommends not fasting. She holds one-on-one discussions about the purpose of fasting and alternative ways to feel connected to the faith, such as reading the Quran and focusing on the charitable giving element of Ramadan. Self-compassion is key.