Signs, Symptoms, and Effects

ARFID eating habits are not formed by concerns of weight. However over time the lack of weight gain can take a toll on the person, physically and mentally.

As someone who did not receive a diagnosis for something I had my entire life until I was 20, I want to caution looking down on people who self diagnosis. Not only is that judgmental classicism, but it’s also ignorant.

Doctors misdiagnose patients all the time, even when a patient presents them with the correct illness. This is not to say I didn’t receive a diagnosis or that I don’t trust doctors, but to always be mindful that some doctors have biases towards marginalized people, eating disorders, or they just get it plain wrong. You know your body best and when it comes to an eating disorder with minimal support, it can be beneficial to do what you can to research your symptoms if you feel like you are suffering from ARFID and consult a holistic team of specialists. It took me 20 years to get answers, be mindful but also trust your gut!

When Identifying ARFID, refer to the Three-Dimensional Model of the Neurobiology of ARFID.

Model on pg. 13

Some people may fall under more than one group in the model. Once the categories of ARFID are established in the affected person, they must also fall under at least one of the following criteria to be considered for a diagnosis: weight loss or stunted growth, nutritional deficiency, dependence on feed tubes or oral supplements, and significant interference with psychosocial functioning. Two common signs between all three groups in the model are that they may consistently eat very slowly or be unable to finish what is served as well as difficulty eating meals with family or friends.

According to the DSM, “malnutrition and gastrointestinal problems are common, as are developmental delays and stunted growth in children and weight loss in adults. Younger children may not lose weight, but they also do not gain the weight they need to grow and thrive. Lower than normal body weight for height puts children at risk for further medical problems” “ARFID”).

“The health effects of ARFID, which are also signs of the condition, are similar to those of anorexia, and include sleeping problems, thinning hair, dry skin, muscle weakness, dizziness, feeling cold, menstrual irregularities in females, poor wound healing, slowed heart rate, anemia, and impaired immunity.” (“ARFID”).

Long term effects show a decrease in gastrointestinal health and increase in symptoms that fall under IBS and other chronic medical issues such as chronic nausea, vomiting, diarrhea, constipation, constant bloating ultimately leading to worsening

not hungry

I fall under group aversive and no appetite, my appetite often comes in waves. But whenever I actually had an appetite I was always nauseous and it made it that much more difficult to eat. Even when I wasn’t nauseous, many foods made me nauseous and it was a continuous vicious cycle of not being able to eat because of my mind or my body.

When I got my diagnosis at 20 years old, I realized I have essentially been starving myself my entire life. The medical effects of starving yourself for even a short amount of time can be catastrophic. For reference, The Minnesota Starvation Experiment. In November 1944, physiologist, Ancel Keys, and psychologist, Josef Brozek, conducted a study at the University of Minnesota to identify the best type of rehabilitation diet for individuals who had experienced starvation.

hungry but too nauseous to eat

Minnesota Starvation Experiment

The Minnesota Starvation Experiment was a study conducted in 1945. The study was meant to acquire an understanding of the physical and psychological effects of semi-starvation as well as how those who were starved during World War II could be re-fed.

In order to participate in the study, 36 young men had to meet standards of good physical and mental health as well as an interest in relief and rehabilitation. The procedure consisted of: 12-weeks of a control period, followed by 24 weeks of semi-starvation, and then 12-weeks of controlled rehabilitation. As well as an additional 8 weeks of unrestricted rehabilitation for some participants. According to the University of Minnesota, “During the experiment, the participants most lost >25% of their weight, and many experienced anemia, fatigue, apathy, extreme weakness, irritability, neurological deficits, and lower extremity edema”. Despite starting the experiment in perfect physical and mental health and not being predisposed to these traits, after only six months of the experiment their physical and mental health plummeted.

One of the participants stated “After you’ve not had food for a while your state of being is just numb. I didn’t have any pain. I was just very weak”. As these young men became socially withdrawn and isolated, similarly in the way an eating disorder can make an impact. Participants also mentioned, ”they felt like their concentration and judgment were impaired”. Sounds pretty familiar, right?

Within six months the well-being and demeanor of these young men completely shifted. Now put this into the context of someone with a lifelong eating disorder who has minimal resources and awareness that they even have an eating disorder to begin with (which is the case of most ARFID adults,) and the implications are shattering. To this day, the Minnesota Starvation Study is considered one of the most critical pieces of psycho education to share in the treatment of eating disorders. (“Duke Health”).