For Muslims living with an eating disorder, Ramadan poses complex issues and heightened risks — risks that Bahar, a 23-year-old Melbournian, is all too familiar with.
The post-graduate student, who prefers to be known by her first name, has been living with an eating disorder for the past decade.
As a Muslim, her struggle intensifies around Ramadan and Eid al-Fitr, the celebration that marks the end of the month of fasting.
Two years ago, Bahar told her mother about her illness, but few of her friends and family know.
“I’m considered the oldest in the family so I’m meant to have my stuff together,” she says.
“Something my dad’s always said is: ‘We don’t have to worry about you, you’ll always be fine.’ When I actually had to come out to them about it, it was just heart-breaking, because I feel like I’d disappointed them.”
When fasting triggered a relapse
Last year Bahar, thinking she’d recovered, decided to fast for Ramadan.
“I really tried last year to do it properly,” she says. “I had thought I was coming out of my eating disorder, and I thought I was getting good.
“But my mum pulled me up on it … she said: ‘If you’re not breaking fast at sunset, it doesn’t count, you’re still ill.'”
Phillipa Hay, a clinical psychiatrist and the chair of mental health at Western Sydney University’s School of Medicine, says cultural practices can be used to justify internal motivations.
Professor Hay has worked with Muslim communities and says exemptions from the fast are available for those who ask.
Often, however, Muslims with eating disorders won’t ask, “because the nature of the eating disorder is that fasting is seen as a positive thing”.
“There’s quite a tricky pathway to help the person not use Ramadan to continue or exacerbate their eating disorder,” she says.
The challenge of a nightly feast
It’s not just fasting that poses risks for those affected by eating disorders.
Nightly iftars, communal banquets at which Muslims break the fast, and the feasting celebrations of Eid al-Fitr can also be difficult situations.
“It’s conflicting because I love dinner settings and lunch settings, I like that communal energy,” Bahar says.
“I just know I will take part in it, but then the next few days I just won’t eat to balance everything that I’d ingested.”
Christine Morgan, the chief executive of the Butterfly Foundation, a national charity raising awareness around eating disorders, says people suffering or recovering from disorders often find feasts a challenge.
“Part of the support and recovery service is being able to help somebody navigate through that,” she says.
“To understand that food is something celebrated and how to navigate through times when there is a plethora of food is part of the strategy of learning to live with a disorder.”
Current data indicates that 4 per cent of Australians are experiencing eating disorders at any given time, but less than 25 per cent are receiving treatment.
Bahar admits she fits into this trend, having only sought professional counselling in the last few months.
“It’s just a bit of a struggle to unload everything, having not done it before, especially to someone who’s so far from my ethnicity and religion,” she says.
“But that also in some way makes me feel like she’s giving a more objective perspective.”
Eating disorders ‘know no boundaries’
While eating disorders may have been traditionally associated with a specific demographic, Ms Morgan explains the conditions — which can manifest as anorexia nervosa, bulimia nervosa, binge eating disorder or an atypical disorder — can affect anyone.
“People tend to think of eating disorders as predominantly affecting adolescent girls, but eating disorders know no boundaries in terms of age, sex, socio-economic groups,” Ms Morgan says.
“There seems to be some personality traits which are more common. Traits such perfectionism, high achievers and attention to detail will often accompany someone who has an eating disorder.”
Bahar says that although her eating disorder went largely undetected, “being thin” became part of her identity.
“It was something that people would always compliment,” she says. “I come from a very big family and it was always just assumed that I was always that thin.”
Self-care and a regular eating routine
For many Muslims, Ramadan is an opportunity to express self-control, and this year for Bahar that means self-care and a regular eating routine.
“Fasting, in itself, is not the only way to participate in Ramadan,” she says.
“Sadly, some of us were not created in the perfect image, but that does not mean we don’t try to partake in our understandings of Islam. I believe Allah, who we speak of as all compassionate, makes concessions for this.
“There are codes in the Koran that say if you are ill, if you are travelling, if you’re pregnant, if you’re menstruating — there are so many factors for you not to need to fast.”
“I need to come to terms with that: an eating disorder is an eating disorder, and they’ll fit me in the category of someone that’s exempt of fasting.”
Despite the difficulties and risks involved in fasting, Bahar hopes to one day participate in all aspects of Ramadan.
“I think that would not only be a testament to my relationship with my religion, but also it would for myself to prove to me that I’m doing OK and that I’m out of the battle.”