Ramadan and Eating Disorders

What is Ramadan?

Ramadan is a holy month of significance for Muslims. It is a period of 29-30 days where Muslims are challenged to increase in all forms of worship, revive their awareness of God and in turn, achieve a deeper connection. An integral expression of this is demonstrated through spiritual fasting (sawm).

Spiritual fasting involves abstaining from eating or drinking from dawn until sunset. The intention behind spiritual fasting distinguishes the act from other forms of fasting which may be intended for weight control or influencing metabolism.

For Muslims, fasting in Ramadan is a shared experience and therefore increases community connection. It is obligatory on all those who are capable (physically, financially, mentally etc) and of mature age (passed age of puberty). There are many conditions and circumstances, however, that exempt followers from needing to fast, especially if it poses a significant threat to a person’s health and well-being.

Every year, there will be millions of Muslims around the world who are unable to or struggle to fast due to their situation (including an active eating disorder). There are concessions that exist and can be verified by local religious leaders (e.g. an Imam). Nevertheless, the nature of an eating disorder is inherently encouraging of fasting and restriction and an eating disorder gaining control can be seamlessly disguised as religious practice. This can make seeking help extremely difficult and lead to feelings of shame, dismay and isolation.

Things to consider around Ramadan and eating disorder recovery

Eating disorders exist in all community groups and Ramadan can be a challenging time for Muslims who have an active eating disorder, or a lived experience of one.

A daily cycle exists of waking up early to eat, fasting during daylight, followed by breaking the fast at sunset. For a person who is unwell with an eating disorder, this cycle can trigger eating disorder thoughts and can even be contrary to their prescribed treatment. If this is the experience for you or someone you know, it is important to consider the following:

• You are not alone

• Speak to your GP about accessing professional support if you’ve not yet done so

• It is recommended to discuss your concerns with your treatment team and religious leader (e.g. an Imam) ahead of time in order to plan for Ramadan

• You may be able to decide on an adapted fasting schedule according to your needs and progress in recovery (e.g. fasting alternate days or fasting on shorter days of the year)

• Reflect on your intention behind fasting – are you fasting to express your religious beliefs or are you intending weight loss? Are you finding it impossible to eat sufficiently before dawn? Are you feeling this urge to delay breaking fast at sunset?

• If there is a supportive person in your family or community that you can talk to, it can be helpful to do so. There can be a lot of focus and conversation around food during Ramadan which is anxiety-provoking and having someone to turn may help you navigate that.

• It may be that you are not medically safe to participate in fasting at your current stage of recovery and that’s OK. Focusing on recovery today can mean that you can observe Ramadan more fully in the future.

Even if you are currently unable to fast, you can choose to explore the many other ways of practicing your faith that are also encouraged in Ramadan.

Other ways to participate in Ramadan

• Prayer and practicing mindfulness

• Donating time/clothes/food/money to people in need

• Preparing meals for others

• Attending Friday or night prayers at the local Mosque

• Appreciating that seeking treatment, taking steps towards recovery is honourable and an act of worship itself

Eid celebrations

As with Ramadan, Eid can be wonderful celebration with family and friends for millions of people worldwide. However, for people with an eating disorder, it can be a challenging time. They may even dread the day.

Festivities like Eid, will almost always involve special food in abundance and cultural traditions which can be triggering. In the lead up to Eid, it’s important that you express any fears you have with your support network (e.g. your treatment team, partner or family member). This can help you feel prepared and provide a sense of safety.

Journaling is a great way to put words to some of the emotions we feel and a useful release in addition to voicing our concerns with others. We can also use a journal to plan ahead for the festive day which could involve setting reminders to eat regular meals and snacks, scheduling time to check-in with ourselves and rest.

If there are some aspects of Eid that are more confronting for you (e.g. menu planning/cooking), then you might like to involve yourself with other aspects instead (e.g. decorating your home or organising gifts).

We can accept that some level of anxiety is to be expected and that it’s okay to have these feelings. Remind yourself that, like any other day, the day will pass. Try your best to be kind to yourself.

Blog post written by Aneela Panhwar, Accredited Practising Dietitian at Mind Body Well.

Navigating Diet Talk and Body Image Concerns During the Holiday Season

The holiday season is a time for celebration and relaxation. It's a time to gather with people we care about, and hopefully also a time for some rest. However this can also be a time when diet culture ramps up, creating pressure in the warmer weather to focus on our ‘bikini body’, attending events which are usually centered around food and eating, and the impending wellness focus of New Year's resolutions – all of which can make the holiday period a minefield of diet talk and body image distress.

In this article, we'll explore strategies to help you navigate the challenges of diet talk and body image concerns during the holidays. Different factors such as your environment, relationships, personal history, and comfort levels can influence which strategies are most effective for you – so think about how you can personalise this information for your own circumstances.

Setting Boundaries

Where possible it can be helpful to set some boundaries prior to an event. Depending on your relationship with the people involved and your comfort level, it might be possible to let people know how they can support you – maybe you could communicate these boundaries in person or via text. Some examples could include:

• ‘I'd appreciate it if we don't talk about 'good' vs. 'bad' foods’

• ‘It would be really helpful if we could avoid any discussions of weight during the holidays’

• ‘I really want to have fun with you over New Years, which will be a lot easier for me if we don’t talk about diets’

• ‘It’s important for my recovery that we don’t talk about ‘working off’ Christmas dinner’

Responding to Body or Diet Talk

Despite setting boundaries, it’s possible that instances of unhelpful diet or body talk could still arise. In these situations, it can be helpful to have some practiced strategies for responding. Here are some ideas:

• Remove yourself: Remember it's okay to leave the conversation or the situation. Excuse yourself for a bathroom break or step outside for some fresh air

• Redirect the conversation: Change the topic to something more neutral or comfortable to steer the conversation away from diet talk

• Express discomfort: Be honest about your feelings, eg. ‘I'm not comfortable with this conversation’

• Question the body talk: Gently question the person engaging in body talk, eg. ‘I've noticed you make a lot of comments about good and bad foods. For me, this contributed to a really unhealthy relationship with food’

• Plant Seeds: eg. ‘I've found it helpful to learn more about my relationship with my body, if you're interested, I can send you some podcast or book recommendations’

• Direct Response: In some cases, you may need to be more direct and assertive, eg. ‘I'm not engaging in diet talk’

Focus on What You Can Control

Despite our best attempts, we have limited control over other people’s body and diet talk, and we may not always feel comfortable or have the capacity to challenge them. In these situations, focus on what you can control:

• Remind yourself of your personal journey: Tell yourself that you’re on the path to recovery and that it's important to prioritise your wellbeing

• Practice empathy: If it feels safe, try to empathise with those around you who might be caught up in diet culture, and be dealing with their own food and body image concerns

• Focus on positives: Concentrate on positive aspects of yourself, list three things you're proud of accomplishing

• Consider the source: Reflect on the source of comments and ask yourself whether it's helpful to place much value on their perspective

• Use mindfulness techniques: To let go of unhelpful thoughts, such as mentally saying, ‘I'm having the thought that...’

• Practice self-compassion: Engage in self-compassionate thoughts and soothing activities after challenging interactions

Ultimately, prioritise your wellbeing, and before you know it the holidays will have passed – hopefully without too much stress or challenge along the way. Be sure to schedule in some of your favourite activities, and spend time with the people who you know are good for your spirits.

Challenging Stereotypes: Masculinity and Eating Disorders

For far too long, eating disorders have been stereotypically associated with women, most commonly young women. However, the truth is that eating disorders do not discriminate based on gender, size, sexual orientation, cultural background, age, or ability. Men, too, grapple with these complex mental health conditions, and it's time to break the stigma surrounding men and eating disorders. In this article, we shed light on the prevalence of eating disorders among men, the unique challenges they face, and how we can challenge societal norms to support those in need.

Eating Disorders in Men: The Numbers Speak

Recent statistics from Australia's Butterfly Foundation revealed a significant presence of eating disorders among men. It is estimated that over one-third of eating disorder presentations are seen among men, with 360,131 Australian men living with an eating disorder (Butterfly, 2019).

According to the National Eating Disorders Collaboration, it is estimated that men account for:

• 20% of people in Australia who experience Anorexia Nervosa

• 30% of people in Australia who experience Bulimia Nervosa

• 43% of people in Australia who experience Binge Eating Disorder

• 55-77% of people in Australia who experience Other Specified Feeding or Eating Disorder (OSFED)

• 67% of people in Australia who experience Avoidant Restrictive Food Intake Disorder (ARFID)

Heightened Risk Among Certain Groups

Certain groups of men face a higher risk of developing eating disorders. This includes queer men, transmen, gender diverse groups, and men involved in fields that promote specific body ideals or physiques, such as athletes, bodybuilders, and actors.

Unique Presentations in Men

Eating disorder presentations among men may differ from those commonly associated with women, or they may also be very similar. Men may focus on low body fat and high muscularity as well as weight. They might also be more concerned with high protein foods and counting macros, as well as engaging in excessive or compulsive exercise with an emphasis on muscle appearance. Concepts like ‘bulking’ and ‘shredding’ and the use of supplements and performance-enhancing drugs can also be prevalent.

The Impact of Stigma

Unfortunately, eating disorders among men are often underreported due to the stigma surrounding these conditions. The stigma can lead to a lack of awareness of symptoms, misdiagnosis, delayed diagnosis, difficulty accessing appropriate treatments, and a feeling of exclusion from available treatments.

Cultural Expectations and Norms

Cultural expectations and ideals surrounding body size and appearance can play a significant role in the development of eating disorders among all genders, including men. Society's narrow definition of masculinity, characterised by being muscular, strong, stoic, and independent, contributes to the pressure men face to conform to unrealistic body ideals. ‘Diet culture’ preys on this by promoting fasting, high protein products, and ‘biohacking’ – all of which contribute to the normalisation of disordered eating behaviours and a focus on gaining muscle.

Challenging Stereotypes: Redefining Masculinity

To address the stigma and promote a healthier understanding of masculinity, it’s important that we challenge existing stereotypes and societal norms. Here are some prompts to think differently:

1. Question the origins of the narrow definition of masculinity, and how this impacts the lives of men and masc folk

2. Develop media literacy skills to recognise how masculinity is portrayed

3. Notice how diet culture products are marketed toward men and women

4. Learn about the gendered and socialised nature of emotions

5. Explore and redefine masculinities, encouraging a broader and more inclusive sense of identity

Seeking Help: An Act of Courage

Remember that all people are worthy of support, and seeking treatment is a brave and essential step for anyone struggling with an eating disorder, regardless of gender. At Mind Body Well, our team of Psychologists and Dietitians is here to support you on your journey to a healthier relationship with food, exercise, your body, and identity. We welcome people of all genders, ages, sexual orientations, and cultural backgrounds.

Getting Away for the Holidays?

Many people have mixed feelings about the holiday season - while it can be a time of joy there can also be significant challenges for people with eating disorders or body image concerns.

These challenges can be even more intense when you’re planning to go away for holidays, or to visit family. Time away from home can bring changes to routine and daily activities; spending time with different or more people than usual; different food availability or access; increased social eating; and reduced access to usual coping strategies or activities. We’ve put together some suggestions to help prepare for the holiday season.

Food and eating suggestions

• Discuss your holiday with your treatment team, and problem solve to make a plan together

• Where possible, plan at least some of your meals, and think about when you might eat out or do your food shopping

• Have some easy options available while travelling, pack snacks or foods you’re more comfortable and familiar with and use these as a back-up when needed

• Work with your Dietitian to consider what a balance of safe and challenging foods might be like for you during the trip

• Pack clothing you feel most comfortable in

Support suggestions

• Have a trusted person you can debrief with - a friend or family member. It’s ok if the person isn’t with you on the trip, plan some phone check-ins with them if needed

• If you know you need plenty of alone or quiet time, let the people around you know and plan it in advance

• Think about different types of supports outside your immediate network, e.g. helpful social media accounts, helplines or online chats (see below)

• When you’re in social eating situations, trying to focus your attention on being present with the people around you and use this as a distraction to help you avoid over-thinking about food

Coping suggestions

• Think about distractions or activities you find helpful at home which you could take with you, e.g. journalling, knitting, reading, puzzles

• Write yourself a list of helpful coping strategies which you can use as a reminder when things get difficult, e.g. distraction, urge surfing, challenging thoughts, mindfulness or self-compassion practices

• Prepare some resources to keep you motivated while you’re away, e.g. podcasts, books, social media accounts. Check out our inspiring links

• Where possible, try to pay attention to things you enjoy or feel grateful for while you’re away, e.g. being able to travel, basking in the sunshine, spending time with people you care about

• Remember this is a temporary situation and you will soon be back in your familiar comfort zone

Useful Services

• Eating Disorders Victoria Hub

• Butterfly Foundation Helpline