Help for the Heavy at Ramadan
A Diet Doctor in Iran Guides Obese Patients Through the Annual Fasting and Feasting

By Thomas Erdbrink
Washington Post Foreign Service
Sunday, September 28, 2008

TEHRAN -- Millions of faithful Muslims worldwide do not eat or drink between dawn and sunset during Ramadan, a month of sacrifice and humility punctuated by joyous family gatherings -- and vast quantities of food.

But until the Saadati family consulted a Tehran diet doctor, Ramadan was a time of frustration and anger. Their obese son, Mehdi, struggled to contain his appetite at a time of year when it becomes normal to consume the equivalent of several meals at one sitting.

Every evening, the Saadatis would gather around a plastic tablecloth on a red Persian carpet in the living room of their basement apartment to break the day's fast. There would be a huge bowl of soup, chunks of Turkish goat cheese, dates, and fresh, long loaves of bread.

The Saadatis would eat and eat to satisfy their hunger. But Mehdi was famished even after the meal. He would eat five more servings of soup, five more loaves of bread and just as many chunks of cheese.

"After all that food, Mehdi would go out for a sandwich," said his father, Ali Asghar, a big man who loves to talk. "We had so many arguments with him. He didn't move the whole day, he just waited to eat."

Mehdi was moody as he craved food during the day, his father said. "To be honest, we never had much fun during Ramadan because of his appetite."

Last year, just before Ramadan, Mehdi, who weighed nearly 350 pounds, consulted Mohammad Sadegh Kermani, a physician and diet guru who has developed a seminar to help patients ride the Ramadan roller coaster.

Mehdi has since lost 180 pounds. He had to change his passport after customs officers said the photo was no longer a valid likeness. Now when he breaks the fast with his mother, father, sister, brother-in-law and infant nephew, he eats only modest portions, carefully weighing pieces of bread on a scale.

"It's all part of the special diet made for me by Dr. Kermani's people," said Mehdi, 24, moments after state television aired images of dreamy colors and a verse from the Koran to announce the end of the day's fast. His face hollow from the sudden weight loss, Mehdi took small pieces of cheese and bread and ate slowly. "This is the right way to eat during Ramadan," he said. "Not bolting down lots of food in the shortest possible time."

In a northwest Tehran apartment building one day this month, dozens of people, some obese and some extremely thin, filled one of Kermani's clinics. Some sought advice on dieting; others wanted to enroll in a program to lose or gain weight.

Jafar Hosseinzadeh, a young tailor from downtown Tehran, had come with his wife and mother, who also were trying to shed pounds. Hosseinzadeh said he knew he was overweight when he kept needing to alter his clothes.

"Iranians are extremely polite," he observed. "But they would just say to my face that I am fat. Now that my overweight uncle has gotten diabetes, I decided to go on a diet."

Ramadan was on everyone's mind. Unlike most Sunni Muslims in Arab countries, some Shiite Iranians aren't very committed fasters and often will use one of numerous religiously permitted excuses to avoid participating in the Ramadan rituals. Those who travel more than 14 miles outside the city limits are exempted, as are menstruating women and those who physically are unable to go without food during the day.

But eating or drinking in public during Ramadan is considered a state offense, and violators can be fined and even jailed. So people on diets sometimes worry that they won't be able to maintain them.

Hosseinzadeh's mother proposed skipping her diet this month, but one of the clinic's doctors brushed aside her concerns.

"That is nonsense," said Faranak Zekri. "Haven't you visited our special Ramadan diet seminar?

"After sunset, drink a glass of warm milk, eat three dates and maybe some walnuts," Zekri said, looking strict and serious in a white lab coat. An hour and a half later, she advised, eat a normal meal. "Don't eat all your food at once; control yourself and wait. Losing weight is all about willpower."

At the Saadati home, Mehdi's mother showed her pride in her son, who has received several weight-loss awards from the clinic. "Mehdi, bring out your old suit for weddings," she told him. He returned with a voluminous black garment and matching belt, eight feet long.

As a special Ramadan television comedy series started and the family gathered around to watch, Mehdi, in a whisper, told a visitor why he decided to lose weight: "A girl promised she would marry me if I became thin."

But the marriage never came to pass. "Who cares about the girl?" his father said. "Think of us -- finally we are having a normal Ramadan, thank God."

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