Content warning: discussion of eating disorders
The story starts when I get gastroenteritis at about three years old. A fairly common occurrence for young children, I seemed to recover quite quickly, except the experience fundamentally changed my relationship with food for the rest of my life. Ever since, I have struggled with extreme anxiety around food, which I eventually learnt was Avoidant Restrictive Food Intake Disorder (ARFID). It has become a constant source of embarrassment in my life, but I’m aiming to change that and raise awareness as we move through National Eating Disorder Awareness week.
ARFID is described by BEAT, as being “a condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of overall amount eaten, or both”. However, those who suffer from ARFID are diverse and have a multitude of reasons for their restricted diet, but it is distinctly different from the likes of anorexia and bulimia in that the restriction is not based on issues with body image or wanting to lose weight. For some, they may be very sensitive to certain tastes, textures, smells or the appearance of certain types of food, a more sensory-based restriction. For others, they may be worried about the consequences of eating, usually fearing vomiting, choking or severe abdominal pain as a result of a past traumatic experience. There are also those who just experience very low interest in eating and, as a result, they may not necessarily recognise they’re hungry in the same way others would.
For me, my ARFID seems to be a combination of all three of these common causes. Since falling ill as a toddler, I have developed ‘safe’ foods – something which is very common for those with ARFID – that for whatever reason, I feel comfortable eating. Personally, but I have noticed it as common between others experiencing this eating disorder, these are often very plain foods with no offending smells, textures, tastes or appearances. I guess this is where a lot of the embarrassment I have about my eating disorder comes from: my palate is on par with that of a toddler.
In my lunchbox at school, I’d have plain bread – it wasn’t until Year 11 that I felt confident enough to include ham into the equation. I was in sixth form when I tried tomato sauce for the first time because I have a severe aversion to sauces. How do you explain this to someone when they suggest going for a meal together or, ask why don’t you just try it? This is where the anxiety that I have around food transcends simply eating the actual food itself, but it begins to permeate the practices surrounding food like eating in restaurants or with people I don’t know very well. Every time I plan on going to a new restaurant, I meticulously comb the menu online so I know that there will be a ‘safe’ option for me there, a habit my friends and family have now fallen into. And with that, I can’t help but feel guilty – I limit the options of others, nevermind myself.
For the first fifteen years of my life, this behaviour was simply attributed to being a ‘picky eater’. Every time my concerned mam would take me to the doctors, they would simply pop me on the scales and measure my height before assuring her there was nothing wrong with me, and it was something I’d ‘grow out of’.
Except, I never did. I was eventually referred to the Children and Adolescent Mental Health Services (CAMHS). I can hear all the knowing sighs from here. Like many, my experience was pretty terrible. My counsellor clearly had no experience working with someone like me, and would get me to practice mindfulness, track my emotions trying new foods and once told me “cabbage is not a sexy vegetable” – all of which had no impact on how I felt. And to be honest, I can’t blame her. Until very recently, ARFID wasn’t recognised by UK health services, and was only a recent addition into the DMS-5, used to diagnose mental disorders. It was only when my mam consulted with Felix Economakis, a leading psychologist in the field of ARFID therapy, that I was given a name for what I had been experiencing for the past fifteen years of my life.
Ultimately, this is what leads sufferers of ARFID to feel alone. For our whole lives, we are made to feel alien. We feel not only personal frustration, but the frustration of those around us. We are keenly aware that our inability to move beyond our own restrictions inadvertently restricts those around us so the food we do enjoy is often tinged with feelings of guilt. And yet, the people around me have always been very accommodating. My parents have never forced me to eat or created further irreversible trauma as many misguided and ill-informed individuals on the internet often suggest when a child is displaying signs of ARFID. My friends have always opted for ‘Livia-friendly’ restaurants. And, despite me being told that no one would want to go on a date with me the way I am, my partner personally vets any family plans or date nights to make sure I will be comfortable.
That is what happens when people are educated about ARFID, instead of making assumptions or handing out misguided advice. And that makes a huge impact on our recovery. Whilst I will probably never ‘recover’ from ARFID, I have made substantial progress simply by being around people who love and accept me, and don’t make my fears surrounding food a big deal. The problem that once plagued my life has dulled to a quiet thought in the background.
Of course, my experience is just one of many and, as I say, the experiences of those who suffer from ARFID are diverse. But I hope by bringing your attention to one of the world’s lesser known eating disorders, you may be better prepared to help those around you.
If you or anyone you know is suffering from ARFID, please visit BEAT for further information and support.