This post has been generously contributed by psychologist Zahra Abou-Ghaida

Ramadan is a holy month for Muslims worldwide and is a month of fasting, prayer, reflection and community. For those living with an eating disorder, making the decision of whether to partake in fasting or not can bring about a lot of guilt, confusion and worry due to concerns over relapsing.

In Islam, there are several exemptions for fasting including that of a medical illness, such as an eating disorder. However, the cultural stigma associated with eating disorders can prevent many from being open about it and feeling they need to hide their diagnosis from family and friends, making it even more challenging to decide whether they should or shouldn’t fast.  

Why can Ramadan be challenging for those with an eating disorder?

There are many reasons why someone living with or in recovery from an eating disorder may choose not to fast. These reasons are helpful to understand, particularly if you are supporting someone with an eating disorder during this Holy Month.  

Some of the main principles of eating disorder recovery include: 

Food and eating recovery principles: 

• Eating from a variety of food groups 
• Eating an adequate amount of food to promote normal growth and development 
• To eat when hungry and stop when full 
• To be flexible about what foods are eaten and at what times of the day  

 (NSW Eating Disorders Toolkit – NSW Health 2018)  

Mental health and wellness recovery principles:

• Self-reflection, connecting with one’s needs 
• Build self-compassion and self-respect/esteem 
• Improve quality of life and connectedness with those around you/loved ones 

Fasting from sunrise to sunset naturally will increase feelings of hunger and for those with an eating disorder, this can place them at a higher chance of engaging in bingeing behaviour at the sunset meal, due to the psychological response triggered after periods of restriction and struggles with recognising fullness cues.  

Individuals with an eating disorder may also experience more difficulty accepting physical symptoms of bloating and stomach discomfort that can happen after introducing food to an empty system. These physical symptoms can give rise to a series of unwanted thoughts for those with an eating disorder, such as fear around weight gain, and feelings of panic, shame and guilt. Such feelings may drive someone with an eating disorder to engage in unhealthy behaviours to get rid of these feelings such as restricting food, purging, over-exercising, and laxative or diuretic use.   

Making the right decision for you

Learning to get comfortable sitting with these difficult feelings is a continuous journey and it is alright if you don’t feel confident that you are at the right stage of your recovery to be able to handle the physical and mental demands that come with fasting. It is important to remember that there are still other aspects of Ramadan that you can focus on if you are unable to fast this year such as prayer, supplication, charity and embodying the personal attributes that make a good Muslim.  

When deciding whether to fast or not, it is important to consult with your relevant health professionals (GP, Psychologist, Dietician). You should not have to make this decision alone. If you do feel that you would like to try fasting, your treating professional can provide you with tailored strategies and regular check-ins to support you throughout the month. Be sure to lean on trusted family and friends throughout the month too, as a big part of Ramadan is to nurture the relationship with our loved ones.  

 Reference: 

(2018) NSW Eating Disorders Toolkit – NSW Health. Available at: https://www.health.nsw.gov.au/mentalhealth/resources/Publications/nsw-eating-disorders-toolkit.pdf (Accessed: 25 January 2024).