(RNS) — As a Muslim, I have an obvious personal interest in Ramadan, which this year is expected to begin Tuesday (May 15). The holiest month of the Islamic calendar, Ramadan is a time when millions of Muslims abstain from all food and drink (yes, even water) from sunrise to sunset. It’s a time for spiritual reflection, introspection and community building.
It’s also no small feat, especially in the Northern hemisphere where the monthlong fast at the heart of Ramadan can last as long as 17 hours each day.
As a medical student, I’ve come to look at Ramadan in a different light: how fasting in Ramadan might affect individuals’ bodies.
As I began my hospital rotations with primary care patients, I saw that many chronic conditions that physicians manage are related to obesity, such as diabetes, heart disease and high cholesterol. I wondered if they might improve during Ramadan since people were eating less.
To be clear, there is a wide array of exemptions for Ramadan fasting, including traveling, pregnancy, breastfeeding, menstruation — and serious medical illness. (Individuals who experience intractable health challenges on any given day are also exempt from the fast.)
But I was curious how fasting even in healthy people might improve their chances of avoiding weight-related problems.
It turns out that weight loss during Ramadan is minimal at best, because individuals often consume high-calorie foods during the night hours after breaking their fast. I can personally attest to this, as my consumption of samosas — Indian fried pastries — as well as chocolate, curries and soda usually increases exponentially during Ramadan.
Another reason for the minimal weight loss is that individuals often decrease their exercise during Ramadan.
Similarly, studies have shown that fluid loss from Ramadan fasting is minor, and that Muslims can simply drink extra fluids during the night to make up the deficit, as they manage to do with their calorie count. This is true even for athletes, many of whom will be fasting during sporting tournaments around the world. In fact, Ramadan fasting appeared to have few adverse effects even among patients with well-controlled chronic kidney disease.
While Ramadan fasting may not directly cause weight loss, however, it might be a catalyst for a healthier lifestyle in general.
The scientific literature agrees that a prolonged commitment is needed to not just lose weight, but keep the pounds off. Short courses of dieting or fasting are considered ineffective for weight loss. The Quran seems to anticipate this. Says Chapter 2, Verse 183: “Oh you who believe! Fasting has been prescribed for you … so you might learn self-restraint.”
Self-discipline is a key virtue in Islam, and Ramadan is the time to practice or strengthen one’s own willpower. Abstaining from food and drink is the most obvious manifestation of Ramadan, but observant Muslims are encouraged to give up bad habits such as smoking, gossip and cursing during the month as well.
Indeed, many Muslims view Ramadan as a time to make personal resolutions, similar to what many people do before the new year. My personal “Ramadan resolution” is to continue my exercise routine during Ramadan whenever possible, and to gradually increase it after the month ends.
This is not to say that fasting during Ramadan has no health benefits. Reduced “bad” cholesterol and improved glucose control may result from the physiological response to fasting: Normally, the body burns food we’ve recently consumed for energy. However, if no food has been consumed for several hours, the body switches to burning glycogen, a stored form of sugar. Fasting for upwards of 16 hours causes the body to start burning stored fats instead.
But since reliance on these fuel sources comes with trade-offs such as “hunger headaches” and being “hangry” (irritability caused by low blood sugar), the beneficial effect also demands spiritual discipline.
In the same way, fasting at Ramadan often involves overcoming food and drink addictions.
If you don’t drink coffee during the day for 30 days, there is a good chance that by the end of the month, you will have overcome that addiction. The first few days might be difficult as you suffer withdrawal headaches, but at the end, you are no longer dependent on coffee. This is clearly more difficult for more addictive substances, such as nicotine, but Ramadan might also serve as an impetus to start treatment to quit these other substances.
Many Muslims say staying spiritually connected while managing their “hangriness” and their caffeine withdrawal might be the toughest challenge of Ramadan.
Interestingly, becoming aware of the health implications of Ramadan has also made me a better medical student. After completing my primary care rotation, I switched to dermatology, the field in which I plan to specialize. I found surprising intersections between observance of Ramadan and effective skin care.
For example, when the attending physician and I took care of a woman with severe acne, we were puzzled that she had experienced a huge outbreak given that her condition had been previously well-controlled on medication. After further questioning, we learned that she was an observant Muslim and had stopped taking her acne medication during Ramadan since it had to be taken multiple times a day with food. We switched her to a longer-acting medicine that could be taken during the night hours, and as a result, her acne improved considerably over the next several weeks.
As time went on, I learned about other potential challenges for Muslim dermatology patients.
Many dermatologists prescribe creams, oils or lotions to be applied to the skin. While most Muslim scholars disagree, some Muslim communities hold a misconception that smearing a medication on the skin invalidates the fast. One survey found that nearly one in three British Muslims held this belief.
It’s a good lesson for physicians in the value of understanding Muslim patients’ cultural practices, in and out of Ramadan. Some Muslim women, for instance, are less likely to request screening for some cancers because they were hesitant to visit male health providers.
In an editorial I wrote for the Journal of the American Academy of Dermatology, I suggested that when patients are hesitant to reveal their religious beliefs, health care providers can break the ice by asking open-ended questions. A doctor might say, “I think it is helpful to have a supportive community. When you need help, whom do you turn to?”
Some patients might comment on their religious community, while others might mention strong family ties, friends or work colleagues. These answers open additional conversation options, and provide increased opportunities for providers to connect with their patients. Of course, knowing a bit about diverse religious and cultural practices can also help guide these conversations.
(Aamir Hussain is a medical student at the University of Chicago Pritzker School of Medicine and Harris School of Public Policy. The views expressed in this commentary do not necessarily reflect those of Religion News Service.)