You’re exempt. Full stop.
The Orthodox Church has always taught that fasting should never harm your body. If you’re sick, if you’re pregnant, if you’re nursing, if you have diabetes or any chronic condition that requires specific nutrition, the fasting rules don’t apply to you in the same way they do to someone in perfect health. This isn’t a loophole or a compromise. It’s basic Orthodox teaching.
Here’s what people get wrong about fasting. They think it’s a law, something you either keep or break. But fasting in Orthodoxy isn’t legalistic. It’s a spiritual discipline meant to help you grow closer to God, not a test you pass or fail. If fasting makes you sick, it’s not helping you spiritually. It’s just making you sick.
The Church has always recognized this. Very young children don’t fast. Pregnant women don’t fast. The elderly often can’t keep the full fast. People with diabetes need to eat at certain times and can’t skip meals. Those with eating disorders need to avoid anything that might trigger relapse. People taking medication that requires food can’t fast strictly. And on and on. The Church isn’t asking you to damage your health for Lent.
So what do you do instead?
First, talk to your priest. This is crucial. Your priest can help you figure out what fasting looks like for your particular situation. Maybe you can’t give up all animal products, but you could cut back on sweets or fried foods. Maybe you can’t skip meals, but you could eat simpler foods. Maybe physical fasting isn’t possible at all right now, and you need to focus on other disciplines like limiting social media, being more patient with your kids, or adding extra prayer time.
I know a woman at our parish who has severe food allergies and digestive issues. She can eat about twelve things total without getting sick. The idea of her trying to navigate Orthodox fasting rules on top of her medical restrictions is absurd. Her priest told her to forget the food rules entirely and work on controlling her temper during Lent instead. That’s pastoral care. That’s how the Church actually works.
The technical term for this flexibility is “economy,” or oikonomia in Greek. It means the Church applies its rules with wisdom and mercy, taking into account real human circumstances. The fasting guidelines exist as an ideal, a standard we aim for. But they’re not rigid laws that apply identically to every single person regardless of health, age, or situation.
Think of it like physical training. If you’re training for a marathon, you follow a rigorous plan. But if you break your leg, you don’t keep running on it because the training plan says to run that day. You heal first. You adjust. You do what you can. Fasting works the same way. It’s training for the soul, but it has to be appropriate to where you actually are.
Some people worry that taking an exemption means they’re not really Orthodox, or they’re somehow less serious about their faith. That’s nonsense. St. Basil the Great wrote about this back in the fourth century. He said the rules of fasting should be applied with discernment, not rigidity. The goal is healing and growth, not performance.
If you’re coming from a Baptist or evangelical background, this might feel strange. You might be used to thinking in terms of all-or-nothing obedience. But Orthodoxy doesn’t work that way. We’re not trying to prove anything to God. We’re trying to be healed by God. And healing looks different for different people.
Your health issues aren’t a spiritual failure. They’re just part of being human in a fallen world. The Church knows this. She’s been caring for sick people for two thousand years. She’s not going to suddenly demand that you wreck your health to keep a fasting rule.
When you talk to your priest, be honest about your limitations. Tell him what your doctor has said. Explain what foods you need to eat and when. Don’t try to be heroic about it. The goal isn’t to push yourself until you collapse. The goal is to find a way to enter into the spirit of the fast within your actual circumstances.
And here’s something else: even if you can’t fast from food at all, you can still participate in Lent. Come to the extra services if you’re able. Read the Scriptures more. Pray more. Give alms. Work on patience, kindness, forgiveness. Lent is about turning toward God with your whole life, not just your diet. The food part is important, but it’s not the only thing.
Your priest might suggest small modifications rather than a complete exemption. Maybe fish twice a week instead of the usual restrictions. Maybe dairy but no meat. Maybe just cutting portion sizes. Work with him to find something that fits your health needs and still gives you some sense of discipline and participation.
Don’t let anyone make you feel guilty about this. Not other parishioners, not your Baptist mother-in-law, not that one person on the internet who thinks everyone should be doing the full monastic fast. You answer to God and to your priest, not to anyone else’s opinions about your health.
Come to church. Pray. Do what you can. That’s enough.
