How are Trauma and ARFID Connected?
Avoidant/Restrictive Food Intake Disorder (ARFID), also known as selective eating disorder, is identified by professionals at eating disorder treatment centers as an eating disorder in which individuals restrict their caloric intake to specific kinds of food, avoiding certain ingredients and dishes completely. This is a clinically identified disorder, not a simple preference for one type of food or restrictions due to cultural or religious reasons.
Individuals who have developed selective eating disorder will often focus entirely only personal “comfort foods” (often carbohydrate-heavy snacks suck as noodles, white bread or chips), resulting in nutritional deficiencies and related side effects. ARFID is a DSM-V identified eating disorder, but unlike better-known disorders requiring eating disorder recovery programs like anorexia nervosa and bulimia nervosa, ARFID is not characterized by a negative body image or obsession with body weight or losing weight.
ARFID Symptoms and Health Risks
Although people with ARFID do not generally intend to lose weight or control the number of calories taken in, experts at eating disorder treatment centers have noted that extreme weight loss can take place. Depending on the type and amounts of the selected foods being eaten, the individual may be at an acceptable or even high BMI. The most common symptom of ARFID that may require eating disorder recovery treatment is malnutrition resulting from a refusal to eat a variety of proteins and vitamins. Other symptoms and corresponding health risks can include:
- Only eating foods of a certain texture (such as crunchy, chewy, etc.)
- Nutritional deficiencies (especially iron and certain vitamins)
- Distress at shared meals
- Anxiety in the presence of the foods being avoided
- Dependence on nutritional supplements
- Bloating, constipation and other digestive problems
- Osteoporosis and other bone density issues
- Low blood sugar
- Kidney and liver issues
What Causes Selective Eating Disorder?
While ARFID which requires help from an eating disorder treatment center is similar in many of its symptoms to other eating disorders, especially anorexia nervosa, it does not normally share the preoccupation with body image and caloric intake restriction observed in those disorders. However, it does share a few root causes which are found in more common eating disorders. As with most mental health disorders, genetics play a factor in the development of ARFID. Co-occurring mental health disorders such as anxiety and obsessive-compulsive disorder have been linked with ARFID as many of the anxious behaviors observed in OCD treatment are similar in nature to the restrictive behaviors seen in ARFID.
As with many mental health and behavioral disorders, a common triggering event is past trauma. Traumatic events such as abuse, a car accident or even losing a job or going through a divorce can have very strong effects on the psyche, especially in children. Not coincidentally, ARFID’s first incidence is most commonly observed prior to the onset of adulthood.
How Trauma and PTSD Influence Selective Eating Disorder
Post-Traumatic Stress Disorder (PTSD) was once only considered to affect soldiers returning from war, but it has become more and more clear to clinicians that various kinds of stress can have a tremendous effect on people of all stripes, especially in childhood. PTSD often results in changed, disordered behavior – it has been linked clinically to the development on drug and alcohol abuse issues, panic attacks, repetitive behavior patterns like those seen in cases of OCD, and clinical depression. While in most cases these disorders have some genetic and environmental causes, traumatic events and the resultant PTSD can act as triggers, setting off the onset of ARFID.
What’s the Good News?
Quality eating disorder treatment centers are focusing more and more on combining a medical/psychiatric approach to promoting eating disorder recovery with a stress on mindfulness and talk therapy designed to address the underlying causes. When applied to treatment for ARFID, this can mean nutritional programming to help balance vitamin and protein deficiencies which may have developed, added to family therapy and techniques such as CBT (Cognitive Behavioral Therapy) which can promote emotional regulation and distress tolerance. With a multidisciplinary methodology for treating selective eating disorder, the underlying causes (especially trauma) can be addressed simultaneously with the physical and any psychiatric symptoms resulting in the disorder. This gives hope for individuals with ARFID to take the steps necessary to heal – mind, body, and spirit.