Invisible Illnesses In Ramadan
Trigger warning: this article discusses eating disorders and polycystic ovary syndrome (PCOS).
Stereotypes of any kind are harmful but they can be especially harmful during Ramadan. People who suffer from invisible illnesses are often subjected to comments charged with stereotypical notions about their illness. During Ramadan we sometimes hear one Muslim ask another why he or she is not fasting. This is a problem in of itself. Ramadan is about individuals building their relationship with God and fasting is someone’s personal worship of God. It isn’t someone else’s place to encroach on this personal matter. Upon being asked this question women who are on their menstrual cycle are often uncomfortable revealing the reason why they cannot fast because it is personal to them or they feel shame due to cultural stigmas.
People with invisible illnesses are often afraid to respond to this question due to a fear of being judged, that their reason for not fasting wouldn’t be “good enough” and that they are just making “excuses” to not fast, that they don’t “look sick”. Asking someone why they aren’t fasting can bring up feelings of embarrassment, shame and be quite triggering. We should not put them in this uncomfortable position.
For a lot of people Ramadan means preparing food during the day and becoming excited to break your fast with friends and family. However, for some Muslims Ramadan is a really difficult time.
AJ+ news interviewed Maha Khan, a Pakistani woman who has been living with anorexia nervosa since she was 15. Sadly people like Maha are often forgotten about during Ramadan. Iftar is often a way to bond with loved ones but when someone has a difficult relationship with food the thought of iftar can be daunting. Instead of iftar being a time of togetherness, it was a period of isolation for Maha. While everyone was enjoying their food, Maha would not join her family to eat at iftar or suhoor. She would eat very little.
“Am I fasting for God or to lose weight?” she would ask herself. The guilt that came from her internal battle with her intentions swallowed her. This can lead Muslims going through similar experiences feeling conflicted about their identity and feeling like a “bad Muslim”. Her eating disorder was affecting her physically because she was drastically losing weight. She would wear layers of clothes to hide her weight loss. At the same time it was affecting her mentally. The feeling of wanting to lose weight really overwhelmed Maha and after iftar she would go running for hours. Topics surrounding mental health illnesses can be taboo in Pakistani culture and so Maha was battling this fear of how she would be perceived in her community although her parents were supportive.
Maha set up a blog in 2012 called Islam and Eating Disorders to help other Muslims who are experiencing similar struggles. When we think of eating disorders we generally think of a thin white woman because most of the research surrounding this disorder has been conducted by white health professionals on white participants. However, an eating disorder can affect anyone no matter their sex, religion, ethnicity or weight. There is also a widespread lack of awareness and understanding about this illness in Muslim communities which makes it difficult for people like Maha to converse about her eating disorder and how she feels with other Muslims. “In my experience, many people in our community have no conception of what an eating disorder is, leading most to conclude ‘eating disorders are a phase, diet gone too far’. There is a significant level of stigma attached to the illness” she wrote on Dazed Beauty.
Like Maha, Rayyan, a Lebanese Instagram influencer, struggles during Ramadan but for a different reason. During Ramadan this year, Rayyan, made an Instagram story explaining what fasting is like for her with polycystic ovary syndrome (PCOS), a condition that affects how the ovaries work. There's no cure for PCOS, but the symptoms can be treated. This is the first Ramadan in which she has to take medication. It is recommended that if you are overweight, losing weight and eating a healthy, balanced diet can make some symptoms better. However, some people during Ramadan find it really difficult to control their diet because they are eating what has been cooked perhaps by someone else during the day and eat at the same time as everyone else in their family at night. It is especially hard to control weight when you have a condition and have to take medication. Depending on the medication, it could lead to weight gain.
Rayyan revealed that she is used to drinking water throughout the day to keep her hydrated after the diuretics she takes for PCOS flushes the fluid out of her body. However, during Ramadan she cannot drink water and so it leaves her extremely thirsty during the day. “I feel swollen. With my PCOS I was controlling it by not eating after 8:00pm but now I am eating 8:00pm and after, and at suhoor so my body is completely freaking out.”
Maha’s and Rayyan’s experiences of their illnesses and how they struggle during Ramadan remind us that we have no idea what people are going through, and just because we can’t see their illness, doesn’t mean it is not there. c. God knows of our intentions and struggles and “Allah does not burden a soul beyond that it can bear” (2:286).
There are exemptions for not fasting during Ramadan such as menstrual and postnatal bleeding, being elderly or travelling, as fasting in these circumstances could put someone’s health at risk. However, it is often forgotten that people with physical illnesses, whether temporary or permanent and mental illnesses are also exempt from fasting for this very reason. The Qur’an reads: “Allah intends for you ease and does not intend for you hardship.” (Qur’an, 2:185).
We all have our own struggles during Ramadan and in life in general. It is so important that Muslims support one another and are mindful of what we say.