Transform Your Relationship with Food: Hypnotherapy for ARFID

ARFID is not just picky or fussy eating. Hypnotherapy offers real opportunity for changing your experience with food. One that feels safe. Read more.

What the bleep is ARFID anyway?

ARFID is the acronym for Avoidant/Restrictive Food Intake Disorder. It is an eating disorder that is different to other eating disorders. It is not characterised by body image issues. Instead, it is expressed as an anxiety-based aversion or avoidance of certain foods or food groups. Sufferers are usually labelled as ‘picky’ or ‘fussy’, but it’s more than that.

ARFID appeared in the DSM for the first time in 2013. The DSM is the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association and used worldwide by clinicians in diagnosing mental disorders. But ARFID is not new.

And it is still not widely understood.

For a sufferer, often, the foods selected are beige/white and processed foods, and whole food groups (like green ones) can seem like poison to the sufferer. Processed foods are particularly appealing because they can be relied on to look, smell and taste the same every time. This is important. It’s important because food needs to be identifiable as safe.

This need for safety comes from a number of aspects. Sensory sensitivities, physical discomfort or dissociation, fear of consequences, trauma response and a need for control. It is not one thing.

ARFID often develops in early childhood. Signals can emerge as young as infancy when a child is first being introduced to solids. This element of sensory input in infancy affects a child’s neurological development and creates the anxiety loop that fuels further aversion as the child grows. By the time their child is 3 or 4 years old, a parent may be feeling desperate, helpless, and misunderstood.

And they are misunderstood. Because in their own homes, they and their children are experiencing stress, anxiety, trauma and pain with every meal. Their children may be nutritionally deficient already, may have medical complications which either contributed to or were caused by the onset of ARFID. They may be underweight, overweight or of normal weight. Does it sound complex yet?

Because it is.

Why can’t they just eat normal food?

ARFID, in essence, is a food phobia. A person who experiences ARFID cannot be bribed or cajoled to eat foods that don’t seem safe to them. They can be forced, however. Have you ever been forced to face your greatest fear? The point at which an ARFID sufferer is forced to eat, will almost always involve yelling and screaming. Because bribing and cajoling don’t work. So the force experience is one that is, in nature, emotional and traumatic.

We now not only have a phobic engagement with food, we have a traumatic one. That feels good doesn’t it? For parents and children alike, it most certainly does not feel good.

The other way trauma can contribute to ARFID is through experiences of choking or vomiting. These kinds of experiences can, in older children, be the trigger for rapid onset of ARFID. A traumatic experience like that triggers an ongoing, irrational anxiety around food and eating.

The sensory elements that may contribute to ARFID, which include a lack of interest, are often dismissed as phases in a young person’s life. But they are anything but just a phase. And the loop of anxiety, fear, trauma and stress around food and eating are reinforced over and over. Because we need to eat every day.

The stress on the individual as well as their family, is intense and unrelenting. The impact on families often leads to social isolation around food and eating. Financial costs associated with parents trying to find answers to help their children also add to family stress. Judgment and criticism from well-meaning family and friends adds to family stress. These stresses impact each member of the family.

Parents are stressed about their child’s mental health, nutritional needs, medical needs, social engagement, learning and development. They may even approach their child’s expressions of ARFID from very different perspectives, causing conflict in their relationship. Siblings can become resentful. All of this will reflect back on an anxious child and grow their anxious thoughts and feelings within themselves.

What’s the big deal?

Research to date has identified that approximately 50% of ARFID sufferers have comorbidies with other psychiatric, neurodevelopmental and medical conditions. There are correlations with generalised anxiety disorder (GAD), social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD).

The statistics are really quite alarming in the larger context of ongoing mental and physical health into adulthood. The following graph provides a snapshot of the percentage of comorbid diagnoses amongst ARFID sufferers.

The World Health Organisation (WHO) and Australian statistical data relating to our children, youth and adult mental health don’t paint a good picture. I’ll leave that to another blog, but for now, suffice to say, the reality is, we have children as young as 8 being diagnosed with anxiety disorders.
It is well know in the field that 7-10 years of anxiety leads to depression. What will their mental health be like when they are 18 after 10 years of anxiety?

What is their physical health and wellbeing outlook after years of malnutrition from eating chicken nuggets, chips and Nutella sandwiches? When nutrient deficiencies contribute to mental health, you can see how the cycle isn’t just as simple as fussy or picky eating.

So, I realise all this sounds rather dire. Eating disorders are serious mental and physical health conditions. ARFID is no less so. But it is not like other eating disorders and its treatment should therefore be different to that of other eating disorders. Particularly, in my experience, when you add neurodivergence into the mix.

Knowing the roots anxiety has in ARFID, working from a strategic psychotherapeutic perspective to dismantle the way someone responds to their thoughts and feelings, offers so much in the way of creating a new relationship with food and eating.

By introducing a different perspective, there is an opportunity to recreate a curiosity and sense of exploration of food. This allows for a journey to begin to find what foods, across a much broader range of foods, can be enjoyed, experienced and shared.

Read more deeply by visiting our Hypnotherapy for Avoidant/Restrictive Food Intake Disorder (ARFID) page.

 

 

Data source: Kennedy, H.L., Dinkler, L., Kennedy, M.A., Bulik, C.M. and Jordan, J.  2022.  How genetic analysis may contribute to the understanding of avoidant/restrictive food intake disorder (ARFID). Journal of Eating Disorders.  10:53.