July 3rd 2024.
When Hannah was seven years old, she sat down with her parents and mustered up the courage to tell them something very important. She didn't want to be afraid of food anymore. It was causing her a lot of anxiety and making her avoid certain activities, like going to Girl Scouts, birthday parties, restaurants, and even family celebrations. Food seemed to be everywhere, and it was starting to take a toll on her. Her mom, Michelle, who wanted to protect her daughter's privacy, shared that Hannah had first shown signs of this fear when they tried switching her from formula to milk and solids. She just refused to eat them, often pursing her lips shut or spitting out whatever was given to her.
As Hannah grew older, her food preferences became even more specific. Michelle revealed that her daughter would only eat about five different foods, and they had to be a certain way. For example, she loved the green sour cream and onion Pringles, but only the small ones, not the big container. Now, at eight years old, Hannah has been diagnosed with Avoidant/Restrictive Food Intake Disorder, or ARFID. Unlike other eating disorders that focus on body shape or size, ARFID is more concerned with the types of foods that a person feels comfortable eating.
According to Kate Dansie, the clinical director of the Eating Disorder Center in Rockville, Maryland, people with ARFID have a very limited range of foods that they consider safe to eat. It's not just pickiness, as some may assume, but a debilitating disorder that can lead to long-term health problems. ARFID was only recently added to the Diagnostic and Statistical Manual of Mental Disorders in 2013, and studies suggest that it affects somewhere between 0.5 to 5 percent of the population.
Dr. Stuart Murray, an associate professor of psychiatry and behavioral sciences, and director of the Translational Research in Eating Disorders Laboratory, calls ARFID the "silent eating disorder." He explains that it is not as well-known or studied as other eating disorders, and lacks federal research funding. But it is a serious condition that can have a significant impact on a person's life.
So, what exactly is ARFID? Unlike anorexia or bulimia, which are characterized by restricting calories or nutritional content, people with ARFID tend to limit their food choices based on sensory or textural preferences. For instance, they may avoid certain textures, smells, or flavors, or even specific brands of food. In some cases, a traumatic experience with food, such as choking, can trigger this condition. Other times, a low drive to eat and high anxiety around food may contribute to ARFID. Personality traits, such as rigidity and fear of change, can also play a role.
But how is ARFID different from picky eating? According to Dansie, many children can be picky eaters and try to avoid certain foods, but that is not the same as ARFID. The main difference lies in the level of impairment and anxiety that comes with facing a new food. For someone with ARFID, the mere presence of an unacceptable food on their plate can be debilitating. They may have a list of only five or ten foods that they feel comfortable eating, and may even be able to taste subtle differences, like a change in brand of pasta sauce.
As you can imagine, living with ARFID can be incredibly challenging for both the person affected and their loved ones. It's important for people to understand this disorder and be aware of its signs and symptoms, in order to provide support and seek appropriate treatment. ARFID may be a lesser-known eating disorder, but it is just as serious and deserves attention and understanding.
When Hannah was seven years old, she bravely shared with her parents that she no longer wanted to live in fear of food. It had become a major source of anxiety for her, causing her to avoid activities like going to Girl Scouts, attending birthday parties, or even sitting at the dinner table with her family. Hannah's mother, Michelle, whose last name is being withheld for their safety, described how food was everywhere, triggering her daughter's unease.
This aversion to food first became apparent when Hannah was a baby and her mother attempted to switch her from formula to solid food. However, Hannah refused to eat and would often close her lips tightly or spit out whatever was given to her. As she grew older, her diet consisted of only five specific foods, such as small packs of green sour cream and onion Pringles, but not the larger containers.
Now eight years old, Hannah has been diagnosed with Avoidant/Restrictive Food Intake Disorder, or ARFID for short. Unlike other eating disorders that focus on body shape or size, ARFID is characterized by a limited and restrictive diet due to safety and comfort concerns. According to Kate Dansie, the clinical director of the Eating Disorder Center in Rockville, Maryland, this disorder is not just being picky, as it can be debilitating and lead to long-term health issues.
ARFID was only recently recognized as a disorder and was added to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013. While an estimated nine percent of the US population will experience an eating disorder at some point, studies suggest that only 0.5 to 5 percent of the population has ARFID, according to the National Eating Disorders Association. Dr. Stuart Murray, an associate professor of psychiatry and behavioral sciences at the University of Southern California and director of the Translational Research in Eating Disorders Laboratory, calls this the "silent eating disorder" because it is prevalent but under-researched and under-discussed.
Experts want to raise awareness about ARFID and provide more information about the condition. Murray explains that rather than restricting calories or nutrients, people with ARFID often limit their food intake based on sensory or textural preferences. This means they may avoid foods with certain smells, textures, or flavors, or even specific brands. In some cases, a traumatic experience with food, such as choking, can also contribute to ARFID. Additionally, personality traits like rigidity and fear of change may play a role in the development of this disorder.
It's important to note that ARFID is not the same as picky eating. While many children may be selective about their food choices, the impairment and anxiety associated with trying new foods are much more severe for those with ARFID. Murray explains that a picky eater may be able to eat around a food they don't like, but someone with ARFID may not be able to eat anything on their plate if an unacceptable food is present. Furthermore, it's not just a few foods that people with ARFID will avoid, but rather a very short list of safe options. They may also be hypersensitive to slight differences in taste, which can be distressing for both the individual and their loved ones.
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