This post was written and submitted by Kailey Adkins. Connect with Kailey on Instagram and Facebook @thedisordereddietitan or online at https://thedisordereddietitian.weebly.com/
Hello All! This post will provide some background on, as well as my personal experience with avoidant restrictive food intake disorder.
“Let’s start at the beginning, a very good place to start” The Sound of Music
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder recognized by the diagnostic and statistical manual (DSM-5) put out by the American Psychological Association). Below is a snip from the National Eating Disorder Association’s webpage on ARFID discussing the DSM-5 criteria.
According to the DSM-5, ARFID is diagnosed when:
- “An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
- Significant weight loss (or failure to achieve expected weight gain or faltering growth in children)
- Significant nutritional deficiency
- Dependence on enteral feeding or oral nutritional supplements
- Marked interference with psychosocial functioning
- The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
- The eating disturbance does not occur exclusively during anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.
- The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.”
I also want to link to Dr. Katja Rowell’s page “the feeding doctor”, as she is a current researcher on this topic.
Now to my story:
That has been the understated title of my life.
Today I want to discuss the rationale behind my decision to become “The ‘Disordered’ Dietitian.”
As I have mentioned, my passion in life is to help people with their relationships with food. Now, this can come from many angles from body image issues to full blown clinical eating disorders. I have a complicated history with some eating/feeding disorders myself. My history was a painful guiding light that led me to study nutrition and dietetics (and soon psychology) on a professional level.
Being born in the early 90’s, there was limited research on eating disorders outside the realm of anorexia nervosa and bulimia nervosa that were being put into practice. So, picky eaters were just that: finicky children that make life difficult for any adult that must deal with them.
***On top of/in conjunction with my eating issues, I have always been a very petite person. I am currently only 4’ 10” and I still wore toddler and baby clothes when beginning elementary school. I have been told different things over the years regarding my size, but when it comes down to it, I am quite positive that my diet pattern played a significant role.
As soon as I began eating solid food, I began giving the world (and my parents, bless their hearts) hell. I would spit out/throw up/or refuse more types of foods than I would eat. As I got a bit older this aversion morphed as I was introduced to more food and gained more control over the things I could and could not eat. I am assuming that my continued aversion was fueled by traumatic/negative food and feeding experiences. The best way I could describe my weirdness was to tell unknowing, and uncaring, strangers that I was a vegetarian.
Most of my eating aversions were around protein foods – meat, dairy, eggs, beans. I am still not sure why, but texture is the largest player in my eating problems. On top of it, I had polar-opposite parents. My Mom is nearly as particular as I am about food, and my Dad will eat anything that doesn’t eat him first (if there is no vinegar involved).
As a kid, I was really freaking weird about food and with little explanation. I developed social fears. I hated eating in new or unfamiliar places – restaurants, friend’s houses, school. This fear is something I have carried with me into adulthood, and sometimes even now.
Each new experience was like speed dating with every new person I happened to eat with. People who thought playing 20-questions with me about what I will and won’t eat would be a fun and interesting dinner conversation.
“What about *insert local favorite meat item here*?”
“Are your parents vegetarian?”
“Do they make you eat that way?”
“OMG, I couldn’t live without eating *insert meat item, normally steak, fried chicken, or bacon here*.”
“Is that why you are so short?”
On and on and on: the insulting, well intended, ignorance would never end.
Even after 27 years on this planet and coping with my eating issues, I still get people who question my eating behaviors. I don’t hate it as much as I did as a socially insecure child and teenager. Being in the field I am entering – people mainly find me interesting. So, in a confident, circus-freak sort of way, I’m cool.
I have had some pretty cool people come into my life that have helped me heal.
My parents, after many years of food battles, are supportive and helpful.
Past significant others have helped.
My husband is incredibly supportive and at this point I tend to be more adventurous than he is.
I have had some really understanding friends over the years. Growing up I always managed to find friends that would trade food with me at lunch and didn’t ask questions when I pulled foods apart because I couldn’t eat them together.
In college, I found a friend who has been the most pivotal individual in helping me come out of my eating closet. Sara, one of my dearest friends, is a food connoisseur. She will eat anything! She is awesome about helping me be adventurous and comfortable doing so. We have a “no pressure” eating policy and that has been one of the most helpful things in my recovery/coping of this.
As an adult, I have made the most progress exploring foods on my own and have made grand strides in having a more balanced diet, as well as mended my negative relationship with food. While I finally have a name for it, this eating disorder has mainly been researched in children. While I did not get a name for what was wrong with me until I was 26 years old, that did not change how it affected every aspect of my life.
I am in remission, as I have overcome many of the clinical manifestations of this disorder. I eat infinitely more foods than I used to, and I have developed coping skills for dealing with the food neophobia. I thoroughly enjoy trying new things now. However, I still do not eat around 97% of meats due to the concern of aversion portion of the diagnostic criteria. At this point in my life that is something I am at peace with.
I hope to help further research and treatment techniques on this topic, but until then I aim to spread awareness of how it can affect people – even adults.
I have a pretty strong philosophy when it comes to well-intended people telling each other what to eat: just don’t.
If you are not a professional in the field of nutrition and dietetics or trained to treat those with eating disorders in some manner, kindly stay in your own lane and mind your own plate. You never know a person’s personal, nutritional, psychological past and why they chose that food and they do not owe you an explanation.
Enjoy food to the best of your personal abilities because damn, there are some good eats out there!
My wish for my career and my life is to be the person I needed most and I know I am on the right path.
Hungry for more learning on ARFID? Don’t miss EDRDpro’s November 2019 Webinar with guest expert Katja Rowell, MD, titled Considering ARFID: Diagnosis, Etiology, and Treatment!