Safe Foods

My desert island food has always been bread. Except when you have ARFID it’s like you’re on desert island game restrictions at all times. In other words a strict small diet only of safe foods.

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When you hear about eating disorders, most people usually think of Anorexia Nervosa or Bulimia. Where one struggles with their body image and digestion. This book is about one of the many other eating disorders you have likely never heard of: Avoidant

Restrictive Food Intake

Disorder, or ARFID. Nowadays, being given a diagnosis implies a plethora of resources, treatments, unsolicited advice, and being able to do a deep dive on the Internet. This is true for ailments easily recognized, but what about ARFID? ARFID is a new diagnosis in the Diagnostic and

Statistical Manual of the American Psychiatric Association - Fifth Edition

(DSM5) as of 2013. ARFID has gone by many names before being medically established - feeding disorder, food neophobia, sensory food aversion, and others. It is an eating disorder where a person under-eats due to a lack of interest in food or an intense distaste for how certain foods feel, look, or smell.

ARFID is characterized by extreme limitations in the

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types and amounts of foods consumed. This can cause weight loss, nutritional deficiencies, and growth deficiencies that become severe if left untreated. Due to taking in less than is necessary to When you hear about eating disorders, most people usually think of Anorexia Nervosa or Bulimia. Due to taking in less than is necessary to maintain a healthy diet.

Most people with ARFID are brushed aside as fussy eaters, especially before 2013, often resulting in blame and a stigma of being childish and difficult. Not only is this harmful but it is inaccurate. This insensitivity causes shame and discourages the affected from reaching out to professionals to get help. The difference between picky eating and ARFID is the intensity of anxiety undesired food brings on, ARFID leaves them feeling powerless often to a degree that entangles their entire life in the eating disorder and causes a consistently lower quality of life. This can be seen through the nutritional and medical deficiencies it brings on when the eating disorder goes untreated. medical deficiencies it brings on when the eating disorder goes untreated.

There is more than one type of disordered eating pattern caused by ARFID. The Three-Dimensional Model of the Neurobiology of ARFID shows how a diagnosis of ARFID can include several different types of the disorder. However, each diagnosis must involve significant distress or complications that require medical attention. DSM-5 describes three primary ARFID presentations including sensory sensitivity, lack of interest in food or eating, and fears and phobias of aversive consequences (“Avoidant Restrictive Food Intake Disorder”).

Avoidant:

Is categorized as a significant fear based experience with food. The fears usually revolved around vomiting and/or choking on food, they may also be tied to a physical traumatic experience (“ARFID”).

Lack of Appetite:

Is categorized as a group that does not want to eat but it is not based on fear or anxiety with eating, they lack an appetite or the drive to actually eat. They frequently forget to eat as well (“ARFID”).

Aversive:

Is categorized as a group with a sensory disinclination, causing the patient to be unable to eat due to certain textures, tastes, and even colors. Sensory aversions vary by case (“ARFID”).

It should also be mentioned that there is a sub category, ARFID Plus. It shows some signs of anorexia, such as wanting to lose weight but starts with avoidant or aversive, becoming comorbid. However, it is not a part of the 3D model.

Three-Dimensional model of the neurobiology

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Fear of physical consequences

(e.g., choking phobia) Sensory Sensitivity

(e.g., avoids fruits & vegetables)

Lack of Interest in eating or food

(e.g., skips meals, eats little)

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Combined presentation

i.e., Sensory sensitivity

Perception

(i.e., Lack of interest in eating Arousal/Regulatory or food) (i.e., Fear of aversive consequences Negative Valence

Combined presentation

Like all eating disorders, the causes can be genetic, psychosocial, and/ or psychological

Anxiety is a large factor in the disordered eating patterns categorized as ARFID. Most of the time if you ask me why I won’t eat certain foods, I don’t have a reason and there’s a large chance that I’ve never even tried it. I’ve never been able to explain my fear of food and why it’s so intense. I’ve had panic attacks, anxiety, and full-blown breakdowns over not wanting to try new food. It’s polarizing, and I wish so badly to “just eat it,” as I’ve been told by numerous unprofessional specialists, but that is the nature of the eating disorder. Feeling out of control even though the aversion, actions, and rules I set for myself are a form of control, which is why the idea of safe foods is prevalent in all ARFID cases.

Many people with ARFID will start from 20 to 30 foods in their diet and sometimes even less. These foods are often processed foods that are seen as unhealthy. It’s a repetitive diet where the affected exhibit an unwillingness to try anything new and truly fear trying anything new. Most people will convince themselves that they are simply. However over time there is this progressive dropping of foods from their diet. While they might have started out with 20 foods they were willing to eat, that number may slowly become 15, then 10, and then even less (“Campbell”).

Affected cases like mine will even avoid entire food groups like fruits and vegetables, often due to sensory issues. These aversions can also cause not wanting to mix different foods and ingredients like salads or salsas, as well as making sure every pile of food is separated and not touching. It can even result in a persistence to using specific flatware and utensils.

“Picky” or selective eating is normal until it isn’t. It is not a phase if the person can’t even sit through a family meal. Eating disorders become an incredible obstacle to overcome every single day. It causes so much social anxiety at gatherings, where food is involved. They will go to lengths to avoid events where unfamiliar foods are present such as parties, restaurant outings, and almost any celebration.

When eating feels like a tedious task, it is cause for concern. However, it can mean many things and falls under different eating disorders. A person with ARFID that is not accommodated or treated will essentially end up starving themselves to avoid the pain that’s brought on at the idea of consuming fear foods. This eating disorder, like all, is valid and dangerous but the intention is different. People must seek an accurate mental health diagnosis and specialized treatment for their condition. Eating disorders should not be accommodated but met with proper treatment and empathy.