I want to write today about a lesser-discussed eating disorder. Food Avoidance Emotional Disorder is no longer a stand-alone diagnosis, as far as I can tell, but has been incorporated under the general ARFID umbrella, as discussed here. It seems to be a very large component of my own issues with food, so maybe I might be able to provide insight into what it’s like.
Imagine you have a major exam coming up. You wake up that morning, very anxious, your stomach in knots. You just can’t face your breakfast. I’m sure you’ve all experienced something like this. It is natural to experience this with any anxiety-inducing event. I remember clearly teasing a groom-to-be when he couldn’t face breakfast on his wedding day. We all had a good laugh, and nobody took it seriously. Sure enough, I later saw him tucking into a large steak during the reception meal.
A more extreme case can be when somebody is experiencing grief, perhaps after the death of a loved one. They are overcome with sadness, and eating is the last thing on their minds. Again, after a day, a week or maybe even a month, and maybe some coaxing with friends, they regain their appetites and things go back to a form of normality.
The above examples are obviously normal human reactions to anxiety or depression. They are temporary and certainly not classified as eating disorders. The disorder occurs when the avoidance of food, the lack of appetite, becomes long term. You lose weight, and in extreme cases you may be hospitalised. Like all the other eating disorders in the ARFID camp, you have absolutely no desire to lose weight, you are not afraid of becoming fat. You are simply too anxious or too depressed to eat. Usually the anxiety or depression are too subtle to gain a diagnosis in their own right. They are there in the background though, effecting your appetite and desire to eat.
This type of eating disorder seems to run in my family. As a young adult, my mother experienced an episode of extreme trauma. As a result, her weight plummeted. She describes it simply as her “stomach closing up”. And when my daughter was being bullied in school, she claimed she was simply “too sad to eat”. In both these cases, their appetites returned when the underlying conditions eased. Which took several long months. But both are still “trigger happy” when it comes to losing their appetites. For example, I’ve seen my mother not being able to continue eating simply because my father said the wrong thing to her during the meal.
Similarly, I find it impossible to eat when stressed. The worst example is when I am travelling, especially if I have to take a flight. I have often gone the whole journey unable to eat, which can be a problem if the journey takes a whole day. These days I pack milkshakes and smoothies as liquids seem to go down better. But I also suffer a more subtle form of this nearly every day, as I’m stressed and anxious at some point every day. It’s like having “butterflies in my stomach” for hours on end. This has been going on for my whole life, as far back as I can remember.
And so, FAED, while not being the sole cause of my problems with eating, plays a big role. And another reason I really need to work on the stress and anxiety in my everyday life.
[image shows a hand holding a fork, in the foreground. The hand itself is blurry so that the fork, which is in focus, stands out by contrast. In the background is a blurry image of what looks like a very fancy meal.]