Severe Eating Disorder Denominated as ARFID Distinct from Common Health Concerns
Article
Mara, a woman in her mid-30s, grapples with Avoidant-Restrictive Food Intake Disorder (ARFID), a condition that makes eating a challenge. Fruits, vegetables, and cold cooked meat are among the few foods she struggles to consume. Despite the hurdles, she is gradually expanding her diet, working towards alleviating the burden of her eating habits on her daughter.
"Not even strawberries," Mara often finds herself explaining her food limitations, referring to her aversion to various solid fruits, vegetables, and cold cooked meats. The anticipation often escalates before social gatherings, such as the company's Christmas dinner, where her anxiety can be palpable. For over three decades, she believed her food struggles were due to her own idiosyncrasies, much like a toddler's fussiness.
It wasn't until she came across a child with similar eating habits on Instagram that she recognized her condition - ARFID. This disorder has been known for several years, but it's more than just picky eating. ARFID involves a strong aversion to certain foods, unlike personal preferences that may stem from disliking specific tastes or textures.
"It's a relief to finally know what I have," says Mara, who is of normal weight but has sought medical attention. She is considering consulting a psychotherapist or a speech therapist, who specializes in helping individuals overcome aversions to specific solid foods.
Both adults and children can be affected by ARFID. It may stem from rejection of food due to its smell, taste, consistency, or appearance. Many affected individuals express a lack of hunger, fear of eating, or a reduced appetite. Eating becomes a burden rather than a source of enjoyment for them.
In severe cases, children may develop malnutrition or lose weight due to their restricted diets. These limitations can lead to physical and psychosocial disadvantages, as they may restrict their participation in social activities that involve food, such as children's birthdays or school trips.
While ARFID has been recognized as a separate disorder in a diagnostic manual in the USA since 2013, it has not yet been fully recognized in Germany. Diagnoses are typically coded under other eating disorders. The prevalence of ARFID is unknown, but there is a self-help association based in Münster for those affected.
On a positive note, ARFID cases have seemingly increased since the COVID-19 pandemic, with healthcare professionals now more likely to consider ARFID in the diagnoses of sick teenagers. ARFID differs from other eating disorders like anorexia, as those affected do not seek to lose weight but may unintentionally do so due to their restricted diets.
While the causes of ARFID are not well-understood, a genetic predisposition could play a role in those sensitive to smells, textures, or tastes, or who have a strong aversion to many foods. Early traumatic experiences, such as severe choking incidents or allergy reactions, may also contribute to the development of ARFID symptoms.
While more research is needed, initial studies suggest therapeutic approaches such as family-based therapy, cognitive-behavioral therapy, and in some cases, the use of psychotropic drugs. However, therapy should be tailored to the individual and their unique needs and severity.
Parents should be vigilant, particularly during early childhood, when abnormalities in eating may first become apparent, such as during breastfeeding or the introduction of solid foods. Such concerns should be addressed with a pediatrician to assess potential physical consequences and rule out other issues, such as stomach problems or food allergies.
Creating a relaxed, joyful atmosphere at mealtimes is crucial, even if it proves difficult. Offering refused foods in bowls on the table and trying new foods repeatedly can help individuals acclimate to them. It's essential not to pressure individuals to eat, as this can exacerbate their aversion.
Multidisciplinary teams, including psychotherapists, psychiatrists, and nutritional therapists, often provide comprehensive care for eating disorders. Individualized treatment plans are vital, focusing on psychoeducation and family therapy sessions. Parental support and involvement in managing food intake and eating disorder symptoms are crucial in the recovery process.
With time, patience, and the right approach, individuals with ARFID can improve their diets and overcome their limitations. Mara, for example, has expanded her menu over time, now able to eat dried tomatoes and olives. She ensures she does not pass her ARFID on to her child, encouraging her to explore various foods through the popular method known as baby-led weaning.
Source: ntv.de, Simone Humml, dpa
- Health
- Disease
- Germany
- Studies
- Recognizing the rise in ARFID cases since the COVID-19 pandemic, health authorities in Germany are contemplating incorporating Community policy to better understand and address this disorder, such as funding research on its causes and effective treatments.
- In her quest to address her health issues and improve her mental well-being, Mara is considering seeking vocational training in the health-and-wellness sector, specifically mental-health services, to help others who face similar challenges as her in expanding their diet and overcoming food aversions.
