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Do religion and religious fasting contribute to the development of eating disorders?
December 5, 2010
††††††††††† Fasting is an important part of many religious ceremonies or holidays dating back to the earliest parts of the Old Testament where fasting was used in response to calamities and to demonstrate humility and repentance.† In Christianity today fasting is seen as a way that one can grow spiritually and become closer to God.† Beliefs of Hinduism surrounding fasting state that fasting not only increases oneís spirituality but also teaches self-discipline that can be applied to become a better person.† Fasting was originally developed in an effort for one to forget about their personal needs and to instead focus on God or another higher being.† Every religion that has fasting as a component of its worship agrees that fasting is not intended to punish the body; the main goal in most of these religions is to focus on God. †Another common belief among religions is that fasting should not be considered a "dieting method.Ē (http://www.allaboutgod.com/christian-fasting.htm)
††††††††††† Fasting in different societies and religions has been occurring for a very long period of time.† In todayís Western society many people have eating disorders and are sent to treatment facilities or are encouraged to participate in programs like Overeaters Anonymous (OA) (http://www.oa.org/).† But in some of these programs people are encouraged to find God or develop their spiritual self, which could create some problems due to the commonality of fasting in many religions.† If fasting is an important part of spirituality in religious practice, could developing spiritually at a treatment facility actually hinder oneís ability to recover from an eating disorder or even lead to a later relapse in an eating disorder?† Does fasting for religious and spiritual reasons contribute to the development of eating disorders?† These questions along with related queries will be addressed in this paper through the use of literature reviews that have examined these same issues.
Impact of Religious Fasting on Human Health:
††††††††††† One study conducted by Trepanowski et al. looked at how different types of religious fasting affect human health.† The different religious fasts used in this experiment were: Islamic Ramadan, three fast periods of Greek Orthodox Christianity, and the biblical based David Fast.† These religious fasts were used in the study due to an increased knowledge about the dietary intake and health-related outcomes found during these fasting periods. †The researchers examined the effects of these fasts on numerous health risks including, energy and nutrient intake, anthropometry, hematometry, and blood pressure.† (Trepanowski et al., 2010)
††††††††††† Ramadan is a holy month that lasts between twenty-eight and thirty-one days.† During this month Muslim people refrain from eating from sunrise to sunset.† The findings in this part of the study were not definitive.† Studies found that the level of vitamins consumed stayed stable during Ramadan but intake of sodium and fiber decreased during the fasting period.† Anthropometry, hematometry, and blood pressure remained the same throughout the fasting month.†
††††††††††† Greek Orthodox Christians have three major fast periods:† The nativity fast, lent, and the assumption.† It was discovered that during these fasting periods total fat and protein content decreased and total carbohydrate intake stayed the same.† The average BMI of Greek Orthodox Christians during the fasting periods decreased by a small amount.†
††††††††††† The last fasting period studied in this experiment was the Daniel Fast.† This fast is very well known among Christians and involves consuming nothing but water and vegetables for ten days.† The results of this fast showed that body weight and body fat were reduced slightly but not to a significant amount.† Also, total cholesterol and insulin dropped by a largely in the Daniel fast in this experiment.†
††††††††††† After testing these religious fasts it can be seen that quality dietary intake is more favorable to a low intake or high intake of food.† Mostly negative effects on the body were seen from the studies.† Some results of the fasts were a decreased BMI, reduction in total cholesterol and insulin, and a decrease in a personís intake of sodium and fiber. †In the Daniel fast and multiple Greek Orthodox Christian fasting periods, people lost weight from fasting.†† (Trepanowski et al., 2010)
Religious Affiliation, Angst, and Disordered Eating:
††††††††††† Disordered eating is very prevalent in society today.† This study took into account two factors that may contribute to disordered eating and tested to see if there really was a connection to disordered eating, and also looked for a connection between the two factors.† The two factors used were religious affiliation and religious angst.† Over 80% of people in the United States state that they belong to a religion, making these examined factors relevant to American society.† Another purpose for utilizing these factors was that while religion is usually seen as a positive experience that improves oneís health and sense of well-being, recent studies have shown that not all religious experiences are positive.† Having a negative experience with a religion can lead to many problems including physical and mental health issues.† Previous research has also found that Catholic and Jewish women were more likely to develop eating disorders because they experience a higher level of guilt in their religion than women of other religious affiliation.† The women in the study felt the need to compensate for their sins by not eating or by reducing their food intake.†
††††††††††† This study included 330 undergraduates at a large state school.† The measurement used to determine the disordered eating behaviors was the Eating Disorders Inventory (EDI).† Religious affiliation was determined with a questionnaire.† Participants put themselves into one of five categories:† Christian, Catholic, Latter Day Saints (LDS), other religious affiliation, and no religious affiliation.† Religious angst was measured using the Multidimensional Quest Orientation Scale (MQOS).†
††††††††††† The results of this experiment showed that a high level of religious angst was directly associated with a drive for thinness, and bulimia.† On the other hand there was no significant correlation between religious angst and body dissatisfaction.† Christians were found to have a higher drive for thinness than students who were LDS or of no religious affiliation.† Similarly, Catholic students had the highest drive for thinness and level of body dissatisfaction out of the five groups.† This study established that both male and female Catholic students have the highest risk for developing an eating disorder as opposed to male and female school children of a different religious affiliation.† Students with a high level of religious angst were also more susceptible to developing disordered eating.† Therefore this study concluded that it would be beneficial for a therapist working with a patient who suffers from an eating disorder to find out the patients religious history and consider how religious belief could be affecting his or her problem.† (Gates et al., 2009)
Anorexia Nervosa among Female Secondary School Students in Ghana:
††††††††††† Another case dealt with the definition of anorexia.† Anorexia is normally defined with one of the core elements being a fear of gaining weight.† This study conducted by Bennet et al. tests out this theory of anorexia responding to a history of self-starvation in cultures where thinness is not necessarily a positive attribute.† The study predicted that anorexia would take a different form in people not from Western culture.†
††††††††††† This study went to two different schools in Ghana: a small technical day school with about 200 students and a girlsí boarding school with about 600 students.† All the females in the school who agreed to help with the study had their weight and height measured in order to calculate their BMI.† The girls with a BMI of 19 or lower were then assessed. These girls were also told to elect a friend of normal BMI to compare the two groups.† The assessment of the girls consisted of both physical and mental examinations, and a survey of eating attitude and behavior.† Out of 668 girls 100 of them had a BMI of less than 19, and 29 had a BMI lower than 17.5 which is the cutoff for anorexia based on BMI.† Of the 29 girls, 19 had some sort of contributing physical illness that contributed to their low weight.† The remaining 10 girls did not have any physical illnesses and when questioned about their weight they all attributed it to religious fasting.† The participants who admitted to religious fasting were either of Christian or Islamic faith.† Many of the girls who were interviewed shared a belief that through their fasting they could atone for their sins and God would forgive them and help them with their schoolwork and family.† Other girls reported claimed that by restricting their food intake they could better concentrate on prayer.
††††††††††† In conclusion, this study demonstrates that a Western idea of anorexia is not necessarily true for all cultures.† Self-starvation is a core part of anorexia nervosa, while other contributing parts of anorexia differ between cultures.† This study also shows that fasting can be used in excess, and practiced in an extremely unhealthy way that can lead to eating disorders.† (Bennet et al., 2004)
Spirituality and Clinical Care in Eating Disorders:
††††††††††† Historical research has shown that eating disorders and religion have a direct correlation.† Many European women during the renaissance era punished their bodies by fasting in an effort to reach a higher plane of spirituality and closeness to God (http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=11747&cn=46).† Not as much contemporary research has been conducted to analyze the link between eating disorders and religious asceticism.† This study helps in the effort to discern how spirituality and religion can help and hinder people in overcoming their eating disorders.
††††††††††† This study was performed at St. Georgeís Eating Disorder Unit in the hospital Roehampton.† Ten inpatients at the hospital, all female, were interviewed.† These patients were asked questions dealing with the relationship between eating disorders and religion.† All of the interviews lasted about 80 minutes and were audio recorded so that they could be analyzed later.† After the interviews it was found that there were five main stages that the women went through: locus of control, sacrifice, self-image, salvation, and maturation.† The women experienced locus of control and had used the rules of the church to structure their life.† God was seen as a disciplinarian in this group.† Negative self-image was common to all of the women in the study.† The patients struggled to control their sensations of a negative body because they perceived their emotions as sinful.† These women would attempt to change their views and when they failed and were unable to live up to Godís standards, they would experience a sense of guilt and shame that often led to self-punishment or sacrifice.† Many of the patients felt a need to make up for their wrongdoings and this was most easily done through self-denial or fasting.† Many patients found that their fasting served as a self-imposed penance that pleased God.† Almost all of the patients found that God offered them a recovery from their eating disorders.† This salvation was seen in the form of the medical treatment they were receiving.† Lastly the maturation stage showed that many of the patients initially thought that self-starvation was what God wanted but later came to the realization that their eating disorder was actually displeasing to God.†
††††††††††† The results of this study demonstrate that spirituality can be an effective method of treatment in eating disorders for some people.† The therapist and people working with the patient have a responsibility to determine whether the spiritual element of eating disorders is relevant to their patient. (Marsden et al., 2007)
††††††††††† Through interpretation and analysis of the previous four studies it can be concluded that religion and religious fasting do affect some people with eating disorders.† Most of the data reveals that certain religions and religious fasting contribute to some peopleís eating disorders.† But there were also some cases that showed religion as a helpful way for patients in a treatment facility or program to change their eating disorders by finding their true spirituality and reconceptualizing what God wants from them.†
††††††††††† The first study discussed how certain fasting customs in various religions had a negative effect on a personís BMI, total cholesterol and insulin, and intake of sodium and fiber.† Therefore, not only does fasting make a person lose weight regardless of if weight loss is appropriate or not, but it also depletes a personís body of the nutrients it needs to function.† This shows that it would be relatively easy to use fasting as a method for losing weight which could lead to an eating disorder.
††††††††††† Another study attempted to determine if religion and religious angst affected a personís development of an eating disorder.† The results of this experiment determined that a high level of religious angst was directly associated with a drive for thinness, and bulimia.† Also it was determined that Christians and more specifically Catholics had a higher drive for thinness and body dissatisfaction than students of different faiths.† Students with a high level of religious angst were also more susceptible to developing disordered eating which helps to prove that fasting and other difficult parts of religion could influence a person in their development of an eating disorder.†
††††††††††† A third experiment found that Catholic and Islamic girls at a school in Ghana had anorexic behaviors but were not classified as anorexic because they did not experience a fear of weight gain. †Instead these girls used lost weight as a consequence of fasting to become closer to God.† The interviewed subjects claimed that by fasting they could atone for their sins and God would forgive them; some girls claimed that by restricting their food intake they could better concentrate on prayer.† Through this study it was observed that fasting can be taken to an extreme in some cultures in an effort to be closer to God.† (Bennet et al., 2004)
††††††††††† The final study was performed in St. Georgeís eating disorder unit.† The patients who were interviewed talked both about their religious views prior to being admitted to the unit in the hospital and how their views were changed based on how they were being supported and taught to modify their spiritual ways.† Initially the women in the study believed that fasting with excessive weight loss was what God wanted them to do.† While going through the recovery process that emphasized religion many of the patients came to realize that fasting to an extreme is not what God wanted and that they should keep their bodies healthy instead.††
††††††††††† Many aspects of these studies helped to show that in some cases religion and religious fasting can contribute to eating disorders.† But it should also be noted that religion can also play an important role in the process of recovering from an eating disorder.† Therefore it is important for a therapist, doctor, or other person attempting to help someone with an eating disorder to know if the person suffering from the eating disorder has a religious background and if that influenced their development of their eating disorder or if their religion could help them in recovery.†
Dinah, et al. "Anorexia Nervosa among Female Secondary School Students
in Ghana." he British Journal of Psychiatry 185 (2004): 312-317.
K., and M. Pritchard. "The Relationships among Religious Affiliation,
Religious Angst, and Disordered Eating." Eating Weight Disorders 14 (2009):
Patricia, Efthalia Karagianni, and John F. Morgan. "Spirituality and
Clinical Care in Eating Disorders: A Qualitative Study." International
Journal of Eating Disorders 40.1 (2007): 7-12.
John, and Richard J Bloomer. "The Impact of Religious Fasting on
Human Health." Nutrition Journal 9.57 (2010).
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