Recovering Food Aversionists

"It was starting to affect his self-esteem. He couldn't eat what the other kids were eating. He said, 'I feel stupid. I don't know why I can't do it. I just can't'."
"We use chasers [candy treats] to try to minimize the not-so-pleasant taste and texture of the food or to try and mask the taste." 
"[But her son, after treatment] understands it [his aversion to foods] his self-esteem is better, he's learned strategies to deal with it in someone else's home or in a restaurant."
"He's also eating different foods and more of them. His mental health has improved because he realized there's nothing wrong with him, it's just something he struggles with and has challenges with."
Jeannine Mackson, U.S. mother of 'picky' eating son

"They're avoiding the possibility of experiencing something fearful to them. It's 'Certain foods in my mouth have felt kind of funky since I was little. There are tastes I don't like and things I can't eat because they make me feel weird'."
Dr. Ovidio Bermudez, Eating Recovery Center, Denver, Colorado

"They have less flexibility around eating, and a harder time socializing because of eating. The biggest issue is that it doesn't correct on its own."
Renee Nelson, clinical director, adolescent services, Walden Behavioral Care, Waltham, Massachusetts

A balanced diet is impossible for suffferers of ARFID. Picture: iStock.

At Walden Behavioral Care in Massachusetts, children who experience a nauseating reaction to certain foods, in a visceral antipathy to texture, look and feel in the mouth, are guided through a process to help them understand the source of their eating disorder, one called Arfid, for avoidant/restrictive food intake disorder. And this is where Jeannine Mackson took her son Brendan who from an early age experienced an antipathy to various foods.

As he grew older, after years of struggling to entice her son to eat, the family realized that Brendan appeared to be symptomatic of malnourishment, which prompted them to take him to the Walden Behavioral Care clinic. Where the boy, at age 12, was diagnosed with Arfid. He was not, as his family always believed, just being very particular about what he could and would eat; he was suffering from an eating disorder which became progressively more pronounced.

This disorder begins in childhood and goes on through the adolescent years and if not treated can lead to a lifelong problem of nutritional deficiency and social awkwardness. It was discovered that three percent of 1,444 children between the ages of 8 to 13 in a Swiss study were affected by this condition. With Arfid, children avoid particular colours, textures, tastes or food odours. They can be fearful of choking or throwing up. While other children may be completely disinterested in eating.

The condition may exist alongside other eating disorders, although those suffering from Arfid do not begin with a distorted view of their body image. Although their aversion to food is not driven by a desire to be thin, Arfid suffers will lose weight simply because of the condition leading them to fail to consume sufficient calories required for a healthy growing body. And as such, Arfid can lead to developmental delays arising from insufficient food consumed to feed a healthy mind and body.

The outpatient program at Walden exposed the boy to therapy conducted three hours daily, for three afternoons weekly, throughout an eight-week period. Parents are required to be present, to participate in family-oriented therapy. The therapy is geared toward directly exposing Arfid patients to the very foods that they avoid. Dialectical behaviour therapy is used; cognitive behavioral psychotherapy focusing on changes to behavior, while the family learns the process of techniques leading to behavior modification.

In the case of Preston Ray, 21, a diagnosis of Arfid drew him to seek help at the Eating Recovery Center in Austin, Texas. He had become aversive to such an exhaustive list of foods that he ended up eating only grilled cheese, cheese quesadillas, pasta without sauce, and a few fruits. "They used individual and group therapy to teach us tangible skills we could use throughout the day and at meal time to cope with anxiety. It also gave me a chance to slow down and work through my own thoughts alongside other young adults who were going through very similar issues", he explained.

The end result for this young man is that he has learned to cope with an anxiety centred around food that will never completely be absent from his life. But the therapy he took part in and the understanding that it imparted to him, along with the techniques he was taught to meet his anxieties and learn to deal with them, has left him in a position where his social life and overall  happiness has improved, as has his schoolwork.