If you have been called a picky eater throughout your life, I have an important question for you. Are you a picky eater, or could you actually have one of the lesser-known eating disorders, ARFID?
Firstly, let’s discuss what ARFID isn’t.
ARFID is not;
Having simple food likes and dislikes. Everyone has certain foods they like and dislike, and that is absolutely okay! I adore veggies, but I’m not the biggest fan of celery… I love fish, but I find white fish pretty bland. Simple food preferences are absolutely okay, and everyone has them!
It is not eating less or restricting your food intake because you are concerned about your weight or body shape. This is disordered eating, but would fit into a different category. People suffering from ARFID actually do not engage in disordered eating for this reason.
It is not temporarily avoiding food because for example, you’ve had a stomach bug, or you’re fasting for religious reasons. People struggling with ARFID consistently avoid certain foods or whole food groups.
So let’s discuss what ARFID actually is, and why is develops.
ARFID is an Eating Disorder which has three different subtypes;
First is Sensory Avoidance. This is when the person may struggle to eat foods of a certain texture or temperature, and this can quickly result in restrictive eating and weight loss. For some of my patients, this can go as far as struggling to use the same kitchen space as others if it hasn’t been cleaned first.
The second sub-type concerns a low interest in eating. This is when the person finds cooking and eating to be a chore and struggles to find joy in eating. This can result in people forgetting to eat or simply not eating enough.
The third is is around the consequences of eating, the fear of what could happen if they do. This could be due to a fear of vomiting, choking, or IBS symptoms which can lead to significant health anxiety. I have also seen cases where patients had previously contracted significant poisoning or parasites from eating foods on holiday which has resulted in the development of ARFID.
Or, it can be a combination of all three.
ARFID generally on the surface can appear as “picky eating” and anxiety, but symptoms can also include having a very restricted pallet of food, or regularly eating the same foods, sensory challenges with food, finding it hard to listen to hunger cues, weight loss, nutritional deficiencies, and struggling to eat out with the home with family or friends, in cafes or restaurants.
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Interestingly our research is continuing to show strong links between Eating Disorders and Neurodivergence, and this is particularly prominent for ARFID and Autism.
This is for two reasons. Firstly Eating Disorders are often trauma-based coping mechanisms, and many who identify as Neurodivergent struggle with bullying and social isolation throughout their lives. This can often result in an Eating Disorder developing as a means of coping.
However, with ARFID and Autism, we also see an additional layer. Many Autistic traits can lead to symptoms of ARFID. For example many Autistic people have hightened sensory awareness, which can lead to sensory overstimulation with food. Similarly, Autistic people often enjoy structured routine, this could in turn lead to becoming too rigid and routined with food, leading to a lack of diversity and potential nutritional deficiencies.
The current statistics show that up to 23% of those who experience Eating Disorders are neurodivergent, but I suspect that the percentage is much higher from my own professional experience. In fact, I now pre-screen all of my patients in their initial assessment for Autism, ADHD, and ADD.
Have you experienced ARFID? If you have recovered from ARFID, what helped you on your recovery journey?
As always if you are struggling with an Eating Disorder, please reach out for support to a professional like myself, your GP or family Doctor. Support is available, and recovery IS possible!
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