When we talk about ARFID, it’s definitely not a one size fits all diagnosis.
And on top of that, there a few different Types of ARFID.
From a therapy point of view, it’s really important to know what type of ARFID a person has, so we can tailor the therapy to give them the best possible outcome.
The two broad types of ARFID are Aversive ARFID and Avoidant (or Sensory) ARFID.
The first type, Aversive ARFID, is where some past food trauma created such a negative emotional or physical experience for the person, that their mind lost trust with food.
Some of things that make young children or babies frightened of food are when they get gastro or vomit, reflux and colic, choking on food, painful constipation, allergic reactions, tongue/lip tie, digestion discomfort, lots of things. And when we’re young, food is the obvious thing to blame. So the mind keeps food away to avoid a repetition of the discomfort. It makes sense.
The second type, Avoidant or Sensory ARFID, is where some people have natural heighted Sensory awareness. This acute sensory awareness often extends beyond food. Younger children may be oversensitive to tags on clothes, certain types of clothing or material, seams on socks, wet grass on feet, sand or slime on the hands, certain smells, loud noises, bright lights, that sort of thing. This heightened sensory awareness can often spill over to food, so the person becomes overly focused on food temperature, texture, colour, appearance, smell, they get brand specific,… and so food variations are something that can make them nervous and cautious.
Another pathway to ARFID is Autism. It’s estimated that around 21% of people with Autism will experience ARFID at some point in their life. Autism can often generate stronger sensory responses to food that might include altered hunger cues and uncomfortable feelings in the stomach.
Food is also unpredictable (its seasonal, has blemishes, is different across brands), and this can also be a barrier to exploring new foods. There is a higher degree of rigid thinking with Autism, and life just feels more comfortable and predictable when things don’t change, when things are the same. These feelings can often make exploring new foods difficult and a low priority.
It is also estimated that up to 26% of people diagnosed with ARFID will also have ADHD, where distraction can easily lead to disinterest in food.
And then there is Anxiety. People with high anxiety or an overly sensitive nature are more prone to generating ARFID behaviours. Over 72% of people with ARFID are also diagnosed with heightened anxiety.
Finally, sometimes people refer to a third ARFID type presenting as a lack of interest in food. This may be due to altered Interoceptive signals (i.e. low or no hunger feelings, low hydration awareness, low full or satiated feeling, etc.). But it may also be due to the onflow effects of ADHD and/or Autism.
Someone with (undiagnosed) Coeliac disease may also exhibit disinterest in food due to years of pain and discomfort with food.
Someone with Hypermobility my have poor motility in the bowel which may cause constipation, discomfort, etc., and this can transform into disinterest.
Also, if we develop an anxiety or nervousness around food for whatever reason (trauma, sensory, allergy, autoimmune challenge, etc) eventually the body/mind may turn down interest in food as a form of protection. This may also present externally as disinterest.
I have worked with many ARFID clients who experience an increase in hunger cues after participating in ARFID therapy and releasing the inner fear/nervousness/anxiety their mind is holding around food.
So let’s do a thought experiment. If we have an imaginary group of 10 young children who all experience the same food trauma (like choking or vomiting) we would expect all of them to have the same outcome and response. However, in reality, only about 5% of these children will go on to develop ARFID. Why is that?
Well, here’s the thing… Not everyone who has Autism develops ARFID.
Not everyone who has a Food Trauma develops ARFID.
Not everyone with heightened Sensory Processing develops ARFID.
Not everyone with altered Interoceptive Awareness develops ARFID.
And not everyone with high anxiety gets ARFID.
In fact, it’s often the case that people with ARFID have more than one of the above Pathways or Triggers.
It’s as if we all have our own inner discomfort thresholds.
For example, we know that people have different pain thresholds. If two people receive an injection from the doctor, one might hardly feel it, and yet the other may wince with pain.
And so it is with ARFID.
It seems that if one or a combination of the ARFID pathways pushes a person above their threshold, above their individual capacity to deal with discomfort… their mind (or more correctly, their subconscious mind) takes over and decides to keep food away in order to prevent the pain and discomfort from happening again.
This protective decision making is not a function of the conscious mind. But it is the function of the subconscious mind. It’s the subconscious mind’s fundamental need to protect and make safe. This is the strongest program in the human mind.
And once the subconscious mind makes a decision and acts, and the response seems to help… the protective program locks in and keeps running.
And so with ARFID, a program that was developed in the mind to protect the person from food discomfort when they were a baby or toddler… well, it’s still running inside of them. The person may have grown up physically and mentally, but the protective program that was generated when the discomfort first started, the feelings and actions that were generated at that young age… those young feelings and emotions are what the ARFID person feels around food. That’s why ARFID doesn’t respond to logic.
Logic is a process of the conscious mind, and ARFID is a product of the subconscious mind.
The good news is, that with the appropriate ARFID Therapy, these outdated subconscious programs and reactions can be reduced and/or eliminated.
You don’t have to live with ARFID, change is possible.
