For the millions of people in the U.S. observing Ramadan this year, the holy month is a time of fasting, prayer, and spiritual reflection. From dawn to sunset, we abstain from food, drink (yes, including water), sex and even negative thoughts as much as possible, all in the name of discipline and gratitude to Allah.

But for Muslims with eating disorders, fasting during Ramadan isn’t just a spiritual challenge — it can be a mental minefield. Instead of strengthening the connection to faith, it can trigger harmful behaviors, amplify anxieties around food, and spark an exhausting tug-of-war between religious devotion and personal well-being.

According to the Quran, those who are sick, menstruating, pregnant or facing undue “hardship” are exempt from fasting and can compensate by fasting later or practicing altruism by feeding someone in need. While this is the known rule, cultural stigmas surrounding mental illnesses such as eating disorders don’t always inspire compassion and understanding from the community.

The result? Muslims with eating disorders are often left to navigate this deeply personal battle alone, with little support and even less awareness. Many Muslims with eating disorders are faced with difficult questions: Should they fast during Ramadan, even if it harms their recovery? Can they honor their faith while also prioritizing their health? And how do they navigate a month so centered around food (or the absence of it) when their relationship with eating is already so fraught?

Mosammat “Mo” Alam, an Atlanta-based Muslim mental health counselor who primarily works with adolescents struggling with eating disorders, tells me that she worries about the consequences of a community that prescribes prayer as the solution to all struggles. “Fasting can be a slippery slope back into a full-blown eating disorder if the person hasn’t reached a point of full acceptance with their body,” Alam says. “In my professional opinion, the best way to support someone struggling with an eating disorder during Ramadan is to support them in not fasting.”

But while the solution may seem simple, the reality is much more complicated. Tanjeela, 25, recalls that her relationship with food was shaped by binge eating disorder long before she even understood it was a problem (Editor’s note: Some sources in this piece preferred to go by their first names only for privacy.) “I didn’t recognize it as a disorder at the time ... people around me saw it as a personal failing or a lack of discipline,” she says. “And I always believed that about myself.”

As Tanjeela grew older, she realized her eating habits were tied to deeper struggles with depression and anxiety. Therapy became a crucial turning point — not just in addressing her eating patterns, but in healing the mental health challenges that fueled them. But each year when Ramadan rolled around, it presented a unique set of difficulties.

“Growing up, the pressure to fast made managing my relationship with food even more difficult,” she says. And this shame around not fasting like her peers led her to hide the truth. “I would lie about fasting, pretending I had made it through the day just to avoid judgment. I’d even go as far as to say I got my period when I really hadn’t.”

Suha, 26, also understands the mental gymnastics that come coupled with observing Ramadan as someone with a complicated relationship with food. Her disordered eating patterns fluctuated between extreme restriction, bingeing and long periods of starvation. “While fasting, I would think to myself, ‘Hey, I starve myself anyway, at least this time I am getting good deeds for it,’” she tells me. “Looking back, I realize that validating restrictive eating patterns through something as spiritual as fasting was not healthy.”

Alam emphasizes how important it is for people with disordered eating patterns to challenge their beliefs when it comes to why they restrict their eating. “When such thoughts are arising ... you want to make sure this is your logical voice and not the voice of your eating disorder in the driver’s seat,” she says.

Fasting, in our spirituality, is often seen as a means of practicing self-control. But for Suha, embodying this “strength of will” meant pushing herself past the limits of what fasting required. She found herself skipping iftar (the evening meal that breaks the fast) and extending her fasts well beyond sunset. “I think a part of me wanted to assert control over at least one thing in my life, which manifested in unhealthy cycles of restriction and bingeing,” she says. It wasn’t until she became more self-aware of these harmful cycles that she sought a path toward balance.

This theme of control is one that’s common in those with disordered eating, Alam explains. “The person struggling with the eating disorder has this notion that because they are able to eat less, restrict food groups, or completely just not eat, they’re in control,” she says. But this often leads to spiraling — which is the exact opposite of feeling in control.

Farah, 22, grew up in a household where fasting during Ramadan was non-negotiable. “My family saw fasting as something you just did, no questions asked,” she says. “It didn’t matter if I was struggling with my mental health or my relationship with food. Not fasting wasn’t an option.”

This expectation prevented Farah from openly discussing her struggles with bulimia — so much so that she didn’t realize until this Ramadan that she even had an eating disorder. “I never told my family or religious leaders about [my struggles]. It didn’t feel safe. The response would have been judgment, not support,” she says.

But a recent health scare shook things into perspective for Farah. While she couldn’t turn to her family, she knew that something definitely had to change — and that began with acknowledging that she had a problem and seeking out help where she might be able to get it. “I have a weak immune system, and a big part of the issue was that I wasn’t nourishing my body with what it needed to support my health,” she tells me.

For many Muslims with eating disorders, the tension between religious obligation and personal well-being can feel isolating. “Balancing my personal health needs with religious and community expectations around fasting has been a journey,” Tanjeela says. “But I’ve grown a lot in the process. I’ve learned to set boundaries and, more importantly, to not feel ashamed for having them.”

But Islam is ultimately rooted in mercy, not punishment, Tanjeela says, adding that “fasting isn’t meant to harm us. If someone is struggling, they deserve compassion, not judgment.” Recovery, for her, means shifting focus to what she believes is the true essence of the month: engaging in prayer, reading and light movement like walks that help her reset her mind. “I remind myself that the discomfort is temporary, but the sense of accomplishment and connection to my faith lasts far beyond the fasting hours,” she says.

Suha, who has learned to approach food with more mindfulness through research, is on a journey to adopt a plant-based lifestyle. While she used to rely on societal norms to dictate her food choices, learning more about where food comes from, how it’s made, and how it affects her body has slowly shifted her thinking into one of creativity and abundance rather than restriction. She finds herself actually excited to try new recipes. “Now, I focus on properly fueling my body. Fasting isn’t about deprivation — it’s about intention and reflection. I’m working on making sure my eating habits reflect that.”

And to her surprise, her family’s been understanding of her journey since she’s opened up about her change in lifestyle. “I was expecting ridicule and confusion, but instead, they’ve been kind and accommodating … definitely not what I anticipated, but I’ll take it,” she says.

Farah’s is more of an uphill battle as she comes to terms with her eating disorder for the first time. She’s leaning on a support system outside of her family. “While I may not be able to change my family’s mindset, I’ve found that surrounding myself with supportive friends who accept and encourage me is crucial,” she says. Having an Islam-informed therapist has also been a game-changer for her. “It creates a safe space where I can navigate my challenges while staying true to my identity.”

One of the biggest lessons Farah is learning in therapy right now is how to speak up for herself — and it’s has been one of the key factors behind her struggle with food. “The experiences I’ve been through made me believe I wasn’t deserving, and without realizing it, restricting my eating became a form of unconscious self-punishment,” she says.

Alam explains, when I talk to her about how eating disorders form, that disordered eating is often a form of self-harm. Low self-esteem, feelings of unworthiness, the need for control and perfectionism can all feed into the emergence of a strenuous relationship with food, she says. These issues can become even further established when cultural norms, religious expectations, and familial pressure clash with healthy boundaries. This is why Alam says that when treating eating disorders, it’s important to pinpoint the underlying issues behind these conditions and work to treat them.

This Ramadan, both Tanjeela and Suha are finding an approach that prioritizes both well-being and religious observance is possible, whether through setting personal boundaries, seeking professional guidance or adapting their participation in a way that supports their health.

As Farah navigates this new terrain, she’s proceeding by giving herself grace. “I remind myself that if I need to break my fast or choose not to fast for any reason, it’s OK,” she says. “I am valid. My worth isn’t determined by my ability to fast — it’s about how I take care of myself in the process.”

If you’re struggling with an eating disorder, call or text 988 or chat 988lifeline.org for support.