Expert: Close monitoring needed for Muslim Anorexia patients
Published on: Monday, April 18, 2022
By: Bernama
Kuala Lumpur: Close attention should be given to Muslims diagnosed with Anorexia illness, an emotional disorder characterised by an obsessive desire to lose weight by refusing to eat, during Ramadan as they may “struggle” to break their fast.Psychiatrist Dr Hijaz Ridzwan said that the experience of Iftar can be very challenging for Anorexia patients as they often feel uncomfortable, both physically and psychologically.
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“People who are diagnosed with Anorexia are usually terrified to eat or gain weight. So, during Iftar they will either under-eat or over-eat themselves. If they eat too much, they will tend to puke or vomit and later become trapped with feelings of guilt.
“They might also relapse and doubt whether they are going to recover from the illness. It is not an easy experience for them to deal with Anorexia, and fasting at the same time,” said Dr Hijaz in an interview with Bernama, recently.
Dr Hijaz, who also lectures at the International Islamic University Malaysia (IIUM), said that one percent of the Malaysian population have been diagnosed with this illness, which is commonly found among young women and children, as early as 10 years old.
According to him, factors such as personality issues, underlining mental illness, past traumas and surrounding environment could lead a person to suffer from Anorexia Nervosa.
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“For the past decades, we have seen super models are portrayed as successful, happy, and beautiful people. This thought of persona, where anybody who is thin is considered beautiful and healthy, while the slightly chubby one are is considered lazy, or unhealthy, that has been taught in the West, including in Asia, is what our children and growing adolescent see as they grow up,” he said.
Dr Hijaz said Anorexia patients should be attentively monitored not just by their doctors, but together by the people around them.
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“Encourage them to go for a group Iftar with family or friends, because we want them (patients) to eat in public so that they won’t undereat or overeat and build good relationships with their food,” he added.
Dr Hijaz said fasting for 30 days can be a problem for Anorexia patients, whereby adjustments had to be made for them.
“I will advise them to take one step at a time. We let them try to fast till Zohor (noon prayer) and the next day, they can try till Maghrib (night prayer) and if they can’t continue then it is okay,” he said.
Meanwhile, Child and Adolescent Psychiatric Consultant at Universiti Kebangsaan Malaysia (UKM) Dr Fairuz Nazri Abdul Rahman said parents should avoid commenting negatively on their children’s appearance and body weights as it will lead them to go for an unhealthy diet.
“(Instead) Parents should motivate their children to exercise and adopt a healthy eating pattern at home,” she said.
Tuanku Muhriz Chancellor’s Hospital (HCTM) Dietetic Officer Dr Muhammad Azif Azizi Md Noh said specific calories should be given to patients with low Body Mass Index (BMI) if they still wanted to fast, even though it was not recommended.
“This prescription depends on the individual because the weight of each individual is different, therefore patients need to follow a diet and must eat three times a day during sahur, breaking fast and moreh.
“Apart from periodical monitoring, I also ask patients to make a diary of their diet once a week and from there we will monitor their weight changes and make changes to their diet,” he said.
According to Dr Azif, he also introduced the ‘Family Based Therapy’ for his patients which involves discussion between patients and family members.
“In this therapy session, we will ask for the cooperation of parents to prepare food and monitor the patients during and after meals to ensure that they do not go to the toilet to vomit or throw the food away,” he said, adding that Anorexia patients are more likely to suffer from brittle bones, malnutrition and hormonal imbalances if they fast for a long time during Ramadan.
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