Fatwa ID: 01350

Answered by Mufti Mohammed Tosir Miah

Question:

I had a lap band surgery on May 11th, 2010. The lap band is a form of bariatric (weight loss) surgery meant for morbidly obese people who have other health concerns. Because I have hypothyroidism and borderline high cholesterol and other potential genetic family factors, I qualified. Hypothyroidism is when the butterfly shaped gland located in your throat does not work properly- it is either too slow or nonfunctioning. This is what regulates your metabolism, among other things.   I have to take a thyroid replacement tablet every morning for the rest of my life. It is meant to be taken at least 30 minutes before eating or drinking anything beyond water. The past few Ramadan's, this did not pose a problem as this tablet and a lot of water were what I was having for my suhoor and it sufficed quite well. Fasting has never been a problem for me before the surgery either during Ramadan or for any other reason. Obviously this was prior to the lap band surgery.   Currently, I have a very difficult time eating most foods. I can only consume about 3 or 4 bites of food that is basically pureed and that is only if my stomach pouch is empty. I can not drink at least 30 minutes before or after I eat and then I can only sip liquids slowly. In order to maintain proper hydration, I am supposed to always have a glass of water handy so I make sure to get in at least 8 to 10 cups per day- but this is a time consuming process and can not be done conventionally- I really can only drink a bit at a time. The opening between the stomach pouch and my actual stomach is a very small opening. If I eat or drink too much or too rapidly, I will vomit. It is also very painful (think heart attack like feelings) if I eat or drink too much or too rapidly. The lap band does not make me feel like I am not hungry. On the contrary, I AM hungry (all the time!) I just am not physically able to eat.   I opted for this surgery for my health and not for vanity reasons; it was not an easy decision to make and it is not easy to live with this decision now that it has been done. Currently I weigh about 235 pounds- this is approximately 50 pounds less than before surgery. I lose a few pounds every week and should for 1 to 2 years until my body stabilizes because of my inability to eat "normally". The lap band is meant to be forever but could be removed with another surgery if medically necessary.   I did attempt to fast this Ramadan, initially. Consequently, I became quite dehydrated and very ill. I was weak, jittery and faint feeling. I was nauseated and unable to concentrate and probably posed a risk as I was driving to and from work as I was not as attentive as I should be. I was ill tempered (crabby) as well and had a massive headache. I am not sure how well my thyroid medication was working either, as I was taking it with a 12 ounce protein shake in the morning in hopes to help stave off the effects of fasting. It is only meant to be taken with water or perhaps a small bit of juice- not anything with protein (like milk, etc…) because it blocks the effectiveness of the medication, unfortunately. However, if I do not get an adequate amount of protein into my body because of the lap banding, I may also become ill, perhaps becoming anemic or even having my hair fall out (among other not so pleasant things).   Finally, I did inquire with my physician in regards to fasting and he stated that as long as I am not becoming ill, dehydrated and am able to get in enough nutrients daily that I could try. He was worried about not getting enough liquids  in general as well but again left the end decision to me. Now I am asking you for your advice because things are not working well for me, unfortunately.   Here are some links in regards to hypothyroidism and the lap band:   http://www.endocrineweb.com/hypo1.html   http://en.wikipedia.org/wiki/Hypothyroidism     http://en.wikipedia.org/wiki/Lap-band   http://www.youtube.com/watch?v=r5ICI9q7nxU   Let me know if you need any more information from me and I will do my best to provide it.   Thank you for listening and considering these matters on my behalf.   Kind Regards; masalama,

Answer:

In the name of Allah, the most Beneficent, the most Merciful.

Allah in the Holy Qur’an has said “…should anyone of you be sick or on a journey, then a number from other days (i.e. do qadha on another day) (Surah Baqarah v.184)

Allah has given concession to a sick person and to a traveller in the matter of fasting. The word sick here refers to a person who cannot fast without an unbearable hardship or has strong apprehension that his illness will be aggrieved by fasting. (Maariful Qur’an p.455 v.1)

However, it should be borne in mind that the aforementioned concession does not apply for headache or fevers unless the individual has had some past experience that by having headaches he would get so ill that there is unbearable hardship or his illness increases. Generally, this is not the case for such illnesses.

With regards to your question, it is permissible for you not to fast due to the after effects of your surgery, which has lead, you to become weak. (Fatawa Darul Uloom Deoband p.474 v.6) You should try and do qadha of them at another time during the year, maybe during the shorter days.  If this is not possible then you are considered incapable of fasting and thus it will be permissible for you to forgo your fasts and pay fidyah instead.  (Maraqi Falah p.453)

The fidyah for each fast is similar to how much one gives for sadqah fitr.  This is to give 1.6 kg of wheat or 3.2 kg of barley or the equivalent of the above in cash (£2 – £3).  (Raddul Muhtar p.532 v.2)

It must be remembered if the patient somehow becomes capable of fasting again, all the missed fasts will have to be made up again, even if you have already paid fidyah for them.  (Fatawa Hindiyyah p.207 v.1)

Only Allah Knows Best

Mohammed Tosir Miah

Darul Ifta Birmingham