Contents lists available at ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres Holy anorexia: Eating disorders symptomatology and religiosity among Muslim women in the United Arab Emirates Justin Thomas a, ⁎ , Lily O’Hara b , Sabrina Tahboub-Schulte c , Ian Grey a , Nayeefa Chowdhury a a Zayed University, Abu Dhabi, UAE b Abu Dhabi University, Abu Dhabi, UAE c American University of Sharjah, Sharjah, UAE ARTICLE INFO Keywords: Religion Eating disorder United Arab Emirates Muslim ABSTRACT There is a substantial body of literature reporting a negative association between religiosity and psychiatric symptoms. In the context of eating disorders, however, this relationship appears to be reversed. The few studies exploring the relationship between religiosity and eating disorders have mostly focused on the Judeo-Christian religious traditions in Western nations. The present study examines this relationship among Muslim college women from the United Arab Emirates (UAE). All participants (N = 1069) independently completed the re- ligious commitment inventory (RCI-10) and the eating attitudes test (EAT-26). As hypothesised, there was a positive association between religiosity and eating disorders symptoms. Furthermore, those scoring above the EAT-26 cut-off reported significantly greater levels of religiosity. These findings suggest that heightened re- ligiosity among young Emirati women may represent a vulnerability factor for eating disorders. Preventative initiatives in the UAE should consider focusing on religiosity. 1. Introduction All of the world's major religions advocate eating in moderation and promulgate some form of dietary restrictions. Fasting, for instance, is a religious practice in Islam, Judaism and several Christian denomina- tions (Gerber et al., 2015). Early case reports of psychogenic self-star- vation tend to implicate excessive religiosity as a central feature of the phenomenon. Morton (2004) alludes to a form of anorexia nervosa in the medical literature dating back to 300 A.D., when ascetics reportedly starved themselves to death engaging in religiously motivated acts of renunciation. Within Roman Catholicism, drawing on the writings of the desert fathers, gluttony was considered one of the seven cardinal sins. Gluttony's corresponding heavenly virtue was abstinence (Lyman, 1989). Extreme abstinence (e.g. prolonged celibacy and fasting) is characteristic of a number of case studies that have, retrospectively, been described as anorexia mirabilis or holy anorexia (Bell, 1985). These cases, centring on pious women from the European medieval period, depict individuals who ostensibly renounce the world and en- gage in religious self-starvation. As one commentator describes it, “overcoming the flesh to achieve a triumph of the soul” (Nasser, 1997). Perhaps the best known of these holy anorexics is Catherine of Sienna, who is described as adopting an unusually extreme regime of ab- stinence/self-starvation and is also reported to have engaged in frequent bouts of self-induced vomiting (Bell, 1985). Catherine's regular self-starvation resulted in emaciation and arguably contributed to her death at the relatively young age of thirty-three (Pittock, 2014). A significant difference, however, between the anorexic presenta- tions of late antiquity and the European medieval period, is the absence of any discourse concerning an obsessive fear of weight gain (Huline- Dickens, 2000). Brumberg eloquently argues that: “…in the earlier era (13th to 16th centuries) control of appetite was linked to piety and belief;…the modern anorectic strives for perfection in terms of society's ideal of physical rather than spiritual beauty.” (Brumberg, 1988 p.7) Anorexia's apparent shifting symptomatology has been explained with reference to the idea of pathoplasticity. This is the argument that anorexia's content and prevalence are profoundly influenced by pre- vailing sociocultural pressures (Russell, 1985). Much research has ex- plored the centrality of weight phobia (see Habermas, 1996) and body image disturbance to the contemporary condition (see Legenbauer et al., 2014 for review). Far less attention, however, has been paid to examining the extent that religiosity may or may not continue to play a role. There is a fairly broad consensus that religiosity is a multi- dimensional construct. Concerning the specific content of the multiple dimensions, however, there is far less agreement (Pargament, 1997). https://doi.org/10.1016/j.psychres.2017.11.082 Received 31 March 2017; Received in revised form 16 October 2017; Accepted 27 November 2017 ⁎ Correspondence to: Zayed University, Department of Psychology, Abu Dhabi PO BOX 144534, UAE. Psychiatry Research 260 (2018) 495–499 Available online 05 December 2017 0165-1781/ © 2017 Elsevier B.V. All rights reserved. T