This Is What It's Like To Recover From An Eating Disorder During Ramadan
For those recovering from eating disorders, the Islamic holy month can be a difficult period.
Sofia always used to look forward to Ramadan.
It wasn't the religious rituals or the spirituality of the holy Islamic month that was most appealing. Rather, she says, "it was because my family would praise me for not eating".
But early last year, Sofia, who's currently a university student in Manchester (she didn't want to give her full name because she feared it could affect her relationship with her family), was diagnosed with anorexia nervosa after being found unconscious on her kitchen floor by a former flatmate.
She has been dealing with the condition since she began deliberately stopping herself from eating at the age of 12. "It was quite tricky managing that," she says. "My family are very traditional Pakistani Muslims, so food was very important in my house."
Nevertheless, Sofia says she was able to avoid eating, usually by telling her family she needed to do homework, or deliberately tiring herself out by cooking, and telling her family she would eat later.
"To be honest, my parents – my community – really didn't know much about any type of eating disorder," she says. "Actually, they would see being thin as being beautiful … You know, like a [woman] who would be desirable in marriage. So even when I was really thin, no one in my family said much, and I could get away with eating next to nothing."
Ramadan – the holiest month of the Islamic calendar, during which Muslims usually fast for up to 18 hours a day – took on a different level of significance for Sofia.
"A lot of Muslims use Ramadan as a way to become closer to God, and I tried my best to do that too…but it also meant that I would actually be encouraged not to eat," she says. "I'd look forward to losing lots of weight, and [get] really scared that by the time I broke my fast I'd gain it all back again – so I'd make sure, sometimes, that I wouldn't even eat more than just a date or two after breaking time."
Sofia felt that when her parents had questioned why she didn't eat more, she could deflect it using Islamic texts relating to the actions of the Prophet Muhammad, known as hadith: "I used to say to them that said the Prophet would never eat until he was full – that he'd always make sure he had only filled a quarter, or half his stomach – and it actually made me feel like what I was doing was a religious duty. That I wasn't eating because I wanted to become closer to Allah."
Eating disorders are still an underreported issue in the UK. According to the most recent figures published by the NHS, the number of people admitted to hospital for eating disorders has nearly doubled since 2012. Meanwhile, despite eating disorders becoming increasingly common among black and minority ethnic groups, particularly young women, some charities have criticised the government for its lack of investment into treatment.
The lack of specialist treatment is also evident among many south Asian Muslim communities, according to Akeela Ahmed, a former executive director of the Muslim Youth Helpline, who also campaigns on youth and gender issues.
"It's becoming an issue that's growing among young girls from south Asian communities, including Muslim girls," Ahmed tells BuzzFeed News. "One thing I noticed while I was researching this was that social services didn't have a clue about ethnic minority girls dealing with eating disorders."
According to Ahmed, some eating disorder units are also "ill-equipped to deal with young South Asian girls with eating disorders", often because it was "less likely these cases would be picked up" as statistically, they would be less likely to be reported, and because of "ingrained stereotypes about south Asian culture" in some hospital wards.
"The lack of understanding about their culture and background and the role food plays in south Asian culture means that this is also a very underreported issue," she adds.
Yet for some Muslims recovering from eating disorders, it's not just the lack of public resources that makes managing their illness difficult, but also that there is little knowledge about eating disorders in some Muslim communities. Such issues are not exclusive to British Muslims, but with Ramadan's emphasis on food, those who are in the midst of recovery face a unique set of challenges – often lying in personal conflicts between their faith, and their own recoveries.
"Food is obviously a big part of the holy month," Sofia says. "Usually after breaking fasts, my family have bigger meals than usual, my mum cooks a lot of extravagant Pakistani dishes for iftar. It's also a time when my extended family tend to visit more, or we go to the mosque and eat there.
"It's really difficult to eat in public, especially because I'm still uncomfortable around a lot of foods. And what people usually don't understand is how seeing all that food can make you feel so pressured. Last Ramadan I remember having to force myself to eat because everyone kept telling me to – and I couldn't say no to them. When we came back from the mosque, I spent most of the night crying, because I felt I had no control."
And while Sofia isn't fasting this Ramadan, so as to keep on top of her dietary meal plan – and indeed, she is exempted from fasting due to her medical condition – she still admits that "not being able to fast, like the rest of my family, is really difficult".
She adds: "I know in my head that I need to stick to the diet and do what my doctor says. But it's still uncomfortable preparing food while my family aren't allowed to eat or drink." At times she "feels guilty while she's eating", she says, and there are moments when she's tempted to go back to fasting again.
Such situations are not uncommon among Muslims recovering from eating disorders, Habiba Khanom, a London-based journalist recovering from anorexia nervosa, tells BuzzFeed News.
"The biggest challenge I face during Ramadan is the food during iftar," she says. "Ramadan is the only time of the year my family and I actually sit down and eat together.
"The food is usually triggering because every meal is different. Nothing seems safe for me. Also, I do not feel comfortable eating together, [as] there are always comments made by certain individuals that make me feel more triggered."
In some Muslim communities, she says, there is a misunderstanding of what an eating disorder is, and many dismiss it as a "diet": "They think eating disorders is just about wanting to be skinny – they see it as a choice.
"In fact, I would never do this if it was a choice. I would never have hurt my family and friends the way I have if this was a choice. It is a mental illness. The cause is deep-rooted and it cannot just be 'fixed' just by praying to God. You need treatment, such as therapy and a dietician to help you. You need a support network of family and friends. Because of the lack of understanding in the Muslim community, I've had very little support from my family."
Sofia believes there ia a lack of visible support groups geared toward British Muslim women dealing with eating disorders, although online communities, particularly on platforms like Tumblr, have helped in the process of her recovery.
"Last Ramadan I used to spend a lot of time on Tumblr going through blogs of other people recovering," Sofia says. "Usually they would post pictures of good healthy foods, like fruits or salads. People on there would usually be really positive and encouraging too, so it was a good way to encourage myself to keep up with the diet plan."
However, while Sofia says support groups online can also be an isolating experience for women who come from minority communities. "There are times when I was on there, and I'd see threads where people would talk about how much support they'd got from their families, or how they became closer to their mums during the process," she says. "It's great that it happens, but I know a lot of Muslim women who just wouldn't be able to speak to their families about this. It's a completely different experience for them."
As a result, there are some groups emerging in the UK aiming to specifically help Muslim women who are recovering from eating disorders.
Maha Khan, a British Muslim woman who works in charities, started the Islam and Eating Disorders blog in 2012 while she was recovering from anorexia, which she had covered up for 10 years.
According to Khan, her mother had known she was "dieting" to lose weight, but was unaware of the "wider, psychosocial issues that surround eating disorders" until doctors told her family she only had five weeks to live. "No one really understands the illness, so usually it prevails in secrecy," Khan says.
"You'll only see the issue affecting families when its too late – it's a very tedious and time-consuming process to understand the illness, and sometimes even the psychiatrists often give up, because it takes time to understand why people go through these conditions."
Khan's blog started as a way to document her own recovery, but she started receiving emails of support from all over the world, especially from Urdu-speaking families expressing concerns about their young daughters. As a result, Khan says, she was able to "build trust with these families" using her experiences.
"The girls really hide it, and those that do know often don't do anything to do it until it's too late," Khan says, adding that even when their child has been diagnosed, many families express concerns about how the illness will be perceived in their own communities.
"The last thing you want to do is expose your daughter to the community when she's suffering from the eating disorder," she says. "So many won't talk about it until their child has recovered."
Since starting the blog, Khan has provided a space for Muslims to talk about their experiences of recovering from eating disorders, as well as tips on how to maintain a healthy eating plan during Ramadan. "People going through this need to know they should fast responsibly," Khan says. "They need to know their calorie intake, consult dieticians, and also make sure they have someone supporting them, whether that's friends, families, or the imam at the mosque."
As for Sofia, she says that while her recovery is going well, there are times she's "worried it will come back", especially on days when she doesn't feel good about herself: "So much about this illness – any type of illness really – is that so much of it's psychological.
"I tell myself every morning that I'm doing well, and I thank Allah for helping me overcome it. But there are days I look in the mirror and thinking bad things about myself. And that's really how it all starts."