“Muslims Get Eating Disorders Too”

By Nadia Shabir (Pen name Maha Khan), Pakistan/UK

Eating Disorders don’t get headlines in Muslim world, but they are a real crisis in many countries of the Middle East and Asia. Sadly we don’t have the statistics that can provide us with accurate figures for those who suffer from eating disorders in Muslim world. However, in the past two years eating disorders have been getting some headlines in Western media in the Holy month of Ramadan. From BBC to Guardian to Buzzfeed, all these media outlets have covered the effects of fasting on Muslims with eating disorders.

The month of Ramadan is a very busy time. Fasting is associated with eating disorder and dieting is seen as a precursor to developing an eating disorder. Many sufferers approach Ramadan with the thinking: ‘In Ramadan, I’ll be healthy, and healthy means going on a diet, cutting out food groups and feeding the needs of your eating disorder.’

As soon as the Ramadan fast opens, more people who are vulnerable to developing the illness fall into the vicious destructive cycle of eating disorder behaviours; many people binge and then purge, and others try to restrain thereby causing more harm to their body.

The blog ‘War against Eating Disorder’ has been creating awareness of Ramadan fasting since its inception in 2012. Through this blog we are gathering records that challenge the perception that most Muslim sufferers live in non-Muslim countries such as US, Australia, UK and Canada. The blog gets much traffic from UAE, Lebanon, Malaysia, Egypt, India and Indonesia. The red alert area is UAE.

The United Arab Emirates problem with this endemic is reflected in the fact that the levels of anorexia in teenage girls are almost double those in Britain. On August 20, 2013, The National UAE published the article Western ideals ‘lead to rise in anorexia’, UAE experts say. According to the publication:

“An Al Ain University study of 900 Arab girls aged between 13 and 19 found 1.8 per cent were anorexic, compared with 1 per cent of British girls aged between 16 and 18.”

Reported by http://www.thenational.ae/news/uae-news/health/western-ideals-lead-to-rise-in-anorexia-uae-experts-say) Another area of great concern is Muslim men who are suffering from this illness in complete silence. Ignoring eating disorders in Muslim world won’t make it go away. Eating disorders can be defeated because Allah says: “There’s a cure for every disease except death.”

Importance of World Eating Disorder Action Day June 2nd
On World Eating Disorders Action Day, Muslims get the opportunity to take a stand, affirm their stance and boldly say ‘Eating Disorders don’t discriminate and affect Muslims too’. This event is an opportunity for us to make ourselves heard, and make it known to the world that such a disease exists and knows no boundaries, as it affects all.
Let’s stop the spread of the illness before it starts. Let’s help the victims and put an end to silent suffering. This can be done if we stand in unison and fight this epidemic together.

June 2nd is the day which will bring change to the world, this is the day the world will stand united against all forces of eating disorders. This is the day that steps will be taken to provide cure for this illness and give hope to many people who have been struggling.

Gap in the Services
The treatment experience of those with eating disorders is extremely variable. In part, this relates to the inherent ambivalence to treatment commonly experienced by those with these conditions. It is also due to the uneven provision of effective psychiatric treatments that range from high quality age-appropriate specialist eating disorder services, to basic generic provision in areas of the country where skills and experience are scarce. Sadly, a number of those with eating disorders will receive negative attitudes from inexperienced clinical staff and they may on occasion fear being trapped in treatment rather than helped by it.

In Muslim world, the support which is available can be accessed only by narrow masses of society. Understanding of this illness is very slight among the wide-ranging population as well as the medical fraternity. Recently in Pakistan, when I visited local hospitals with another volunteer, Mansoor Ahmed, we found psychiatric units in unacceptable state. All patients with different kind of mental health problems were put under one roof.
It’s sad to see that in a country of over 190 million people, there’s only one Eating Disorder Treatment Centre, which is in Lahore, and also few people have access to.

To overcome this lack in service requires great solutions and even more efforts are needed in bringing solutions about eating disorders. We need more introduction of doctors to eating disorders, we need to create more eating disorder treatment centres and to hold more sessions in colleges, and universities and many other places.

Positive  Actions to effect change
One positive action taken in Pakistan that worked absolutely well, and we hope soon it will be used in other countries as well, was holding small level seminars, awareness events and talks on every local level. We encouraged our local ambassadors to spread the word in their neighbourhood areas.

This positive action was accomplished via inviting neighbours around and telling mothers about eating disorders and then holding a session with young people. This pilot action was tested for its results in February 2016 in Islamabad. Overall, five seminars were held. One seminar was held in partnership with Rising Youth in Islamabad. This organisation has great influence in bringing people to their sessions and we were part of it. We realised our aim was to get the word across and out in open. If media co-operation is not forthcoming then we do what we can to make our voice heard.

Another optimistic action has involved going into hospitals and telling the Doctors about National Eating Disorder Awareness Week in USA and World Eating Disorder Day and speaking to staff about assessments.
Assessment encompasses making a diagnosis and eliciting the necessary information to prepare a care plan, including the assessment of severity and risk. As eating disorders are commonly characterised by ambivalence, assessment should not be seen in isolation from treatment, as the patient’s first impressions of services may have a powerful impact on their willingness to consider referral to secondary care and subsequently accept treatment. Specialist eating disorder services are increasingly adopting a motivational approach to assessment and induction into treatment

We also visited Lahore in January 2016 where, with the help of Shiraz Mirza, first Asian Mayor of Royal Borough of Kingston, a small conference was held to discuss and promote World Eating Disorder Day, where we spoke to the media and mental health professionals about eating disorders, suffering and treatment.

Additional and most progressive action has included going out onto the streets and interacting with men in Pakistan.
We took our information banners and educated men about eating disorders on the streets of Pakistan in 2015. We went to a sports field, had discussions with athletes on this issue and getting college professors to help was a very helpful action. This action in Pakistan was completed by our volunteer Ali, a young engineering student from one of the most turbulent areas of Pakistan, Khyber Pakhtunawa. He spoke to men on the streets, at mosques, in madrasahs about eating disorders. Another student completed a similar action in Oujda Morocco, in September 2015. These events fulfilled the purpose of getting the word out and telling people not to ignore the illness, be mindful of signs and symptoms of eating disorders and to seek help. All our actions are covered in this blog http://waragainsteatingdisorder.com under Eating Disorder Awareness Category.

One improvement we would like to see
Ultimately we want our governments and local health associations to get up to reality on the problem of global epidemic. We want our governments to look at access standards for mental health, acknowledging that people with eating disorders are not getting any essential mental health treatments. We want our governments to acknowledge that there are few or no specialist treatment in country and that this needs to change. Finally it’s time that Muslim countries step up, create awareness and recognize this illness for its destructiveness and offer treatment options that are available to all, including men.

About Nadia (pen name Maha Khan)
For more than fifteen years of my life I’ve suffered an eating disorder. My disorder was insidious, gradual and inexorable. My work on raising awareness started from home in Surrey, UK in 2012. I wanted to understand eating disorders, why is it on the rise, and what does Islam say about it? In order to break the silence in Muslim culture, I went on Islam Channel on 16th September 2013 and spoke about my struggles and my journey. Since 2013, I’ve dedicated myself to changing the way our society perceives eating disorders. Eating disorders are uncomfortable, but Muslims can’t ignore the reality of this mental illness. Through my blog I’ve come to know sufferers who have embarked on a journey of grandiosity, paranoia, delusions, and nearly fatal suicide attempts. These victims give me motivation to keep going forward, to keep writing and to keep engaging in the war till eating disorders are defeated. This is my mission in life: to keep engaging in this war against eating disorders, and to help create effective accessible solutions to this destructive illness.

• War against Eating Disorder, Http://waragainsteatingdisorder.com founded in 2012, is run by volunteers and self-funded by Nadia Shabir under the pen name Maha Khan. The blog creates awareness of eating disorders in the Muslim world, offers information and support for sufferers and their loved ones.
• Website: Http://waragainsteatingdisorder.com
• Twitter: @Islam_ED

Join Nadia in supporting World Eating Disorders Action Day. Be sure to follow along on Twitter @WorldEDDay and hashtag #WeDoAct, #WorldEDActionDay, @WorldEatingDisordersAction on Instagram and World Eating Disorders Action Day on Facebook.