V Yom Kippur is a difficult day for Jewish people at the best of times, but for anyone struggling with an eating disorder (ED) or in recovery, it can be a fraught and complex period that puts their mental and physical health at risk.

Since the strict rules surrounding the Day of Atonement’s 25-hour fast, and the meals before and after, have the potential to jeopardise eating disorder recovery, Noa Girls – a UK charity that supports girls and young women through mental health struggles – has published guides to help those affected.

One booklet, for rabbis, community leaders and parents – created under the guidance of Rabbi Yisroel Meir Greenberg and Rabbi Shloime Yitzchok Bixenspanner – sets out the challenges and triggers faced by girls with an ED and the risks. A second booklet guides professionals, ED services and GPs to support patients with more awareness and sensitivity, and the third helps girls affected to navigate the holiest day of the Jewish calendar.

Finding a way to honour Yom Kippur when fasting isn’t possible can bring up difficult emotions, says Noa Girls CEO Naomi Lerer. “Fasting on Yom Kippur is so ingrained in us; it’s literally in our DNA. We were brought up with just how essential it is. Even when there are leniencies given by rabbis, when someone struggling is given that permission, the guilt around it can be really hard.”

The booklets, Lerer says, are about trying to take away that guilt. “It’s trying to help them to see that not only do they not have to fast, but they also need to be eating and helping them to see that’s what God wants from them.”

Joint head of Noa’s ED programme and counselling, psychologist Lubna Dar has witnessed clients’ guilt over not being able to fully observe the rules. “Some people struggle because it’s seen as a time when you should be seeking forgiveness or repenting, so it can really hook onto their eating disorder and make them feel like they’re not worthy.”

Eating disorders affect 1.25 million people in the UK and are the most fatal of mental health disorders. When the charity launched its first eating disorder guides for Pesach this year, it had “incredible feedback”, both from professionals and community leaders.

While some people might be warned not to fast at this point in their illness or recovery, it is not just because the fast could make them ill; it is about the psychological impact, says Lerer.

“This is an incredibly fraught and challenging time due to the focus on food,” Lerer says. “Fasting can really trigger them. If an alcoholic is recovered, and if they just have one drink, it might then precipitate them going back to alcohol. It’s similar with an eating disorder: fasting for 25 hours can reactivate that and precipitate that downward spiral.”

Yom Kippur can be a particularly challenging time for people who have or are in recovery from an eating disorder. (Photo: Noa Girls/the jc)

It is also not only about the fast itself. The abundance of food beforehand and in the breaking of the fast can be triggering, as can conversation around food that is common in the week leading up to it.

“It can be triggering and overwhelming for some people being exposed to that amount of food or knowing how to break the fast and not feel guilty,” says Dar. “How do you navigate all of those thoughts that are very hard, while trying to stay true to yourself and wanting to observe your faith?”

Emily (not her real name), who was hospitalised with an eating disorder, says it would have been “very helpful” for her recovery to know that the professionals understood the challenges she faced at this time of year, and for community leaders to have been able to guide her better. For ten years she was unable to fast because of her illness and sought advice from a rabbi.

“He was clueless,” she says, recalling his advice to eat little and often throughout the day. “To me, it was the worst thing to eat something every half an hour. It made it very difficult.”

In the end, she ignored the advice. “I was lucky that I had the courage. I felt bad within myself that I wasn’t fasting, and I was trying to find a way that was still acceptable. It’s like someone that is diabetic and needs to have insulin throughout the day – it’s basically the same for someone with an eating disorder, because it’s such a slippery slope.”

Dar says that the information guides are about trying to “break down taboos” around eating disorders and helping families to feel heard and seen. “It’s important at this time of year to be kind to yourself, talk to your loved ones, rabbis or professionals and think: ‘What could I do that would feel meaningful, that I can engage in my faith and observe it where it’s not going to jeopardise my recovery?’,” she says. “And maybe it’s about allowing someone to guide them and say it’s okay for where we are right now.”

​For a copy of the booklets, click here or email: contact@noagirls.com

To refer someone to the Noa Girls eating disorder programme, email: Edreferrals@noagirls.com