Understanding Avoidant Restrictive Food Intake Disorder

We live in an era where food is closely linked to our personalities. We go for coffees and pastries to catch up with our girlfriends; get avocado toast brunches to snap aesthetic Instagram pics; frequently discuss which takeaway does the best spice bag, and what amazing restaurant we have yet to try.

And it makes sense, in a way. We spend a huge portion of our lives preparing food, eating it, and now photographing it – so of course it has an impact on who we are. But what happens if you don’t particularly care for food? What if you actually can’t stand it? 

What is ARFID?

Avoidant Restrictive Food Intake Disorder is an eating disorder which is exactly that – a disorder where a person has extremely little interest in food, or is extremely selective with their food, to the point where it has a detrimental affect on their life. It’s characterised by the National Eating Disorders Recovery Centre as “a person restricting their food intake by eating smaller amounts, or eliminating certain groups, to the extent whereby they do not meet their nutritional needs.”

There are many reasons why a person may live with ARFID. They may have had a traumatic experience connected to food in the post, or have a phobia of choking or vomiting. It may also develop due to sensory issues, like finding the texture, smell or taste of food unsettling. 

We caught up with Barry Murphy, Research and Policy Officer at Bodywhys (The Eating Disorders Association of Ireland), to gain more insight into the disorder. Barry explains that ARFID was formally recognised as a diagnosis in 2013, and that in recent years there’s been a lot more research done to focus on the best modes of treatment. 

Barry also explains how ARFID is different from other eating disorders you may be more familiar with, like Bulimia or Anorexia, as it has different motivations. “[With ARFID], there aren’t the same kinds of concerns about body image. There isn’t a drive for thinness or muscularity and those kinds of things. Like all eating disorders, it does have a profound impact on a person’s health and how they interact with food – and ultimately navigate the world.” 

Living with it

Bia, 23, developed the disorder around the age of four, after deciding to change her diet: “I loved animals so much, and I made the choice to go vegetarian.” Bia’s mother was worried about her cutting out meat at such a young age, so she would sneak it into her food. This gave Bia suspicions that her food wasn’t strictly veggie, and made her wary of her meals. “

That made me stop eating everything altogether. So, since I was four, I’ve mostly eaten chips, that would be the one thing I really eat. As I’ve gotten older, I’ve slowly been introducing more food, but even now I mostly just eat chips.”

Bia explains how some people misunderstand the disorder, not taking her seriously when she struggles to introduce new foods. “I think that sometimes people think that it’s easy to try foods, or that it’s just me [being picky] and not wanting to taste it. They don’t understand that it’s scary for me. Just the thought of it terrifies me. And I know it’s not a rational thought, I know there’s nothing scary about it, that it won’t harm me or anything like that. But it doesn’t feel like that right before I do it, you know?” 

Barry affirms that there is some stigma surrounding ARFID. “There can be a dismissiveness. ‘It’s just picky eating’, and so on.” And while Bia thankfully has great support from her loved ones, she does sometimes worry about how it will affect her relationships. “My friends are quite understanding, but it can get quite difficult when I’m in a relationship. I get really anxious because I don’t know food. We’re meant to be making dinner together and I don’t know what goes with what, or what to make them. I just want to eat my thing, and obviously I can’t always give them chips for dinner!” 

There’s also the health side effects that come from restricting or avoiding foods. “There’s always stuff wrong with me, I’m always sick and always tired! A lot of your serotonin is produced in your gut, and if your gut health is unbalanced, it affects your mental health too.” Bia confesses that being around food in her home can make her feel “crazy, sad, and sometimes even suicidal”. 

Getting help

Of course, there is always help available when it comes to living with an eating disorder, and ARFID is no exception. Barry tells me that if you think you may have ARFID, the first step is to visit your GP. From there, you may be referred to an eating disorder specialist, who can help set you on the right treatment path. There are different therapies for dealing with the disorder, like CBT, but Barry explains that they’ll usually take a multidisciplinary approach – using a few different treatments together, to help you safely and slowly rebuild your relationship with food.

He also stresses that organisations like Bodywhys are working toward raising awareness about ARFID, as the more people that understand the disorder, the more empathy and compassion for those who live with it.

When I ask about the future, Bia tells me that while it’s a slow burn, she feels more optimistic than ever. Having made incredible progress, she sees a light at the end of the tunnel when it comes to her experiences with food. “I’m a very hopeful person, and I always have been. I’m a lot better now that I’m older. At sixteen I was like, ‘the only thing I’ll be eating for the rest of my life is chips!’. But now I’m a lot more open to eating more foods, at my own pace.” 

If you are struggling with an eating disorder, visit Bodywhys.ie

This article first appeared in the March/April issue of STELLAR magazine 

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• health