I recently had the opportunity to listen to a rabbinical discussion about Yom Kippur and anorexia. The question being debated was: should someone who is suffering from or in recovery from anorexia be required to fast? Having known people who have struggled with this eating disorder I was immediately interested in the conversation.
According to Women's Health, anorexia nervosa is an eating disorder where a person has "an intense fear of gaining weight." People with the disorder obsess about food and limit what they eat, even if they are already dangerously thin. Anorexia isn't just about food though, it's also about "using food or starving oneself to feel more in control of life and to ease tension, anger, and anxiety." People in recovery from anorexia often follow strict eating schedules and avoid skipping meals in order to prevent a relapse.
Given these facts you can see why fasting on Yom Kippur could be problematic, so I was relieved to see how the rabbis involved in the discussion agreed that pikuach nefesh (the saving of a life) always comes first. In other words, if fasting (or observing any other halakhic commandment) will place a person's life in danger the safety of the individual must be prioritized, even if it means forgoing an aspect of observance.
On Yom Kippur fasting is used as a tool for temporarily afflicting our souls while we repent, but in the case of someone striving to overcome an eating disorder, using food in this manner is not a good idea. Unlike most people, the 25 hour fast has the potential to bring up hurtful sentiments or even trigger a relapse. Hence, the rabbis concluded that it would be better for such an individual to focus on other aspects of the holiday, such as rituals (like not wearing leather) and the liturgy. One rabbi suggested that by eating regularly and taking extra care of oneself during Yom Kippur, anorexics can perform a unique form of teshuva (repentance) by taking care of the body they once neglected.
Overall the discussion was thought provoking and I appreciated how it highlighted the way each of us experiences the High Holy Days in our own unique way.
Pikuach nefesh pertains to my condition too. I have a lung transplant and am immunocompramized as a result. I therefore forgo the fasting commandment.
Wow!! Baruch Hashem!!! I wholeheartedly agree with the discussion posted!
Add to those who should eat are people with diabetes, type 1.
Anyone under a doctor’s care for an ongoing medical condition including pregnancy should check with their doctor before Yom Kippur to see if fasting is acceptable or not. Be sure your doctor understands what is involved – total fasting (no food or drink) for approximately 25 hours. Never assume the doctor knows – some fasts allow for liquids or only apply during daylight hours. Perhaps a modified fast would be ok – liquids only or lighter meals than usual. As was pointed out, this is mostly symbolic.
For several years, my fast has included drinking water the full time. I am an asthmatic, and going without water during past fasts has always affected my health for a week or so after the fast ended. I made my peace with that long ago. This year, I am not fasting at all due to sever health issues. I will take food with me, enough for 2 meals and two snacks, and my service dog and I will duck out of the building when I need to eat. (And if anyone is wondering, I was on the bema on Rosh Hashana, with my dog by my side. It was a wonderful experience as I thought I’d never get an opportunity to go up for any honor again.)
Hi. Thank you for this post…
I assume that, even more so, the same would apply for minor fasts such as Taanit Esther (tomorrow). I was also wondering if you could give me the name of the Rabbi would led this discussion or the sources he used, just so that I would feel legitimate following this ruling.
Wow. This may have just saved me from relapse. I have wanted to fast for spiritual reasons, though I am not Jewish, and I am in recovery from EDNOS (Eating Disorder Not Otherwise Specified). Basically, this eating disorder doesn’t fit any one category so as to be classified as only Anorexia, Bulemia, or Binge Eating Disorder. I have struggled with a unique mix of all three. Whenever I try to fast, I put my recovery in jeprody, but I have never understood that it really is okay for me not to fast food. I love the comment about teshuva (repentance). I will seek to use “fasting” days to specifically focus on taking care of this God-given body that I once so neglected and abused. Thanks for this! God bless you!