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.

About Mindful Eating

January is World Mindful Eating Month. So what’s ‘Mindful Eating’ all about?

What is mindfulness?

Mindfulness is the practice of paying attention to the present moment in a non-judgemental, accepting and self-compassionate way. Mindfulness is not just about our thoughts, it also includes embodied awareness – experiencing our body from the inside out. We can do this by focusing on the information the body sends to the mind through the senses – what we see, hear, feel, smell and taste. In the context of eating, this can mean being aware of how we’re feeling before, during and after a meal. This includes how our body feels physically, as well as the thoughts and feelings we’re experiencing about eating.

Why eat mindfully?

Mindful eating is an approach which is often recommended to help us be more engaged in the process of eating. It’s also a way to pay more attention to our bodies signals of hunger and fullness, and to assist with appetite regulation – the ability to know what the body is telling us about the need for food, or when it’s had enough.

It is important to note however that it’s not inherently ‘better’ to eat mindfully - it’s perfectly natural to also have times when we eat with less mindfulness – like while watching television or at the computer. This less mindful eating though is more likely to cause a sense of disconnection from the experience of eating, and to confuse our hunger and fullness signals, also resulting in less pleasure or satisfaction from our food – which may cause us to keep seeking more.

Mindful eating and Diet Culture

Unfortunately Mindful Eating is yet another of the potentially helpful strategies which has been co-opted by the diet industry as a method of food restriction and impulse control. It is important to keep in mind the central premises of self-compassion and non-judgement which mindfulness is based on – and not to let this become yet another way to moralise and punish ourselves for what and how we’re eating.

When we can bring that spirit of self-compassion to mindful eating, it can be a way to enhance our connection with our body and our relationship with food, to build intuitive eating skills, and to allow ourselves more joy and freedom with eating.

How do I eat mindfully?

If you’ve never practiced mindfulness before, try starting with a general introduction – i.e. learn mindfulness skills in other (less ‘loaded’) areas first, then practice transferring those skills to eating. You can gradually learn to be more mindful by regularly bringing awareness to your breath, to the sensations in your body or the things happening around you. If you’re in therapy, you could ask your therapist for strategies, or experiment with some of the great app’s which teach mindfulness practices (we like Calm, Smiling Mind, and Headpsace).

Once you’ve become familiar with the practice of mindfulness, you can begin to transfer this awareness to eating - try sitting down to eat with no distractions, and bring non-judemtnal awareness to the experience of eating. Pay attention to the sight and aroma of the food. As you eat, pay attention to taste and texture. Chew slowly and notice how these change over time, notice how the taste changes as you eat. Notice if you feel a change in your hunger and fullness cues as you eat. Keep coming back to self-compassion and non-judement as you do this, and start slowly – maybe just for the first few bites of your meal, and begin with foods that feel more comfortable and less threatening for you.

When Mindful Eating is difficult

If you’re experiencing an eating disorder, working on mindful eating might not be appropriate for you right now. Sometimes paying too much attention to the experience of eating can be unhelpful – especially for those who may already be obsessing about eating, and feeling really uncomfortable in their bodies when they eat. In this case you may need to rely on some deliberate distraction rather than mindfulness – use strategies such as reading, music, games or conversation to enable you to eat without increasing anxiety may be more appropriate for now. Like all strategies, mindful eating isn’t a panacea, and isn’t the only tool in the eating disorder recovery toolkit. If you’re not sure whether mindful eating is appropriate for you, discuss this with your therapist, and ask them for alternatives, or practice working toward mindful eating over time.

Would you like to learn more? Enrol in our upcoming Mindful Embodiment online program.

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

'Wellness' Program or Diet in Disguise?

Intuitive eating and non-diet approaches to weight and nutrition have been gaining popularity as many people elect to step off the dieting treadmill and change their relationship with their body, and their eating attitudes and behaviours. As these approaches have gained momentum however, many diet programs, companies and influencers have begun to co-opt the language of ‘non-dieting’ to mislead people back into the diet cycle. A number of established weight loss companies have re-branded, and new ‘wellness’ programs have emerged, with strong marketing messages about supporting people to make ‘sustainable lifestyle changes’ rather than focusing on weight loss.

However, when you really look at many of these programs it’s clear that they have not really changed their focus, but have instead become traditional diets in disguise – the new breed of diet industry companies. These so called ‘wellness’ programs continue to promote restrictive eating behaviours, encourage people to monitor their weight, and hold at their core the false idea that thinness equates to health - only now with an added side-serve of ‘wellbeing’.

So how can you tell the difference between an actual non-diet approach and a wolf in sheep’s clothing? One of the main differences between dieting and intuitive eating is the focus on weight loss and changes to body shape which are integral to dieting programs. Intuitive eating however is weight neutral, and focused on healing your relationship with food and your body. Intuitive eating is not about weight loss, it won’t ask you to eliminate any foods from your diet, or to label foods as ‘good’ or ‘bad’. Intuitive eating is a not a hunger-and-fullness diet but rather is about unconditional permission to eat all foods, building body trust and eating foods which feel satisfying and enjoyable. Another main difference between intuitive eating and dieting is that intuitive eating has a strong evidence base supporting its effectiveness, compared to traditional diets which are shown to be ineffective for 95% of people (especially in the medium to long term).

This re-branding of weight loss dieting to ‘wellness’ is dangerous and confusing for so many people. This new generation of diets aims to differentiate themselves from traditional diets by claiming that they are not ‘fad diets,’ that they value ‘wellness over weight loss,’ and some even use the language of eating disorder recovery as part of their marketing campaigns. Yet most of these programs continue to focus on food restriction, monitoring or logging what you eat, and weight monitoring. These programs now commonly offer self-care activities ‘on the side’, and may market themselves with health buzzwords or topics such as gut heath or inflammation. They offer a simplistic view of health and wellness, and a narrow assumption that weight loss equals health.

Studies show that weight loss dieting is one of the biggest risk factors for the development of eating disorders and disordered eating. Yo-yo dieting which is characterised by the cyclic nature of losing and re-gaining weight has been shown to have negative effects on physical health and how you feel about your body. Dieting also promotes the development of maladaptive eating behaviours. When our food intake is restricted, food often becomes our focus, which can cause obsessive thinking about food, and can result in either further food restriction, or episodes of reactive binge eating – where the body tries to gain back some of the energy which has become depleted from restrictive eating.

So how can you tell the difference – how can you differentiate a diet in disguise from an approach which is truly focused on enhancing health and wellbeing?

An approach may be a ‘diet in disguise’ if it:

• Encourages you to disconnect from your body by ignoring body signals (including hunger and fullness)

• Is focused on changing your body - weight loss or body shape/size

• Asks you to count points, macros, or uses approaches like a traffic light system

• Uses negative language around ‘good’ and ‘bad’ foods, classifying certain foods as inflammatory, detoxifying, guilt-free, or clean

• Recommends that you restrict or eliminate certain foods or food groups

• Acknowledges that diets don’t work followed by a BUT… (insert dieting behaviour here)

• Causes you to feel preoccupied with food and weight loss

• Recommends you buy expensive supplements or unusual foods

As an alternative to diet industry programs we recommend an individualised and therapeutic approach to understanding your nutritional needs, and changing your relationship with your body. If you’re ready to make this change, the team of Psychologists and Dietitians at Mind Body Well can assist.

Other relevant Blog posts:

• What is Intuitive Eating?

• Let’s set some perspective on ‘Food Addiction’

• What does it mean to be a Non-Diet Dietitian?

• Breaking up with weight loss