Eating “Mostly Soft and Bland Things”
Life with ARFID, a rare anxiety disorder.
By Kevin Jiang
Credit: Zootghost
There are picky eaters, and then there are people with ARFID.
Known by the medical community as Avoidant/Restrictive Food Intake Disorder, ARFID — as it is more commonly called — is a rare anxiety disorder where sufferers can only eat an extremely narrow range of foods.
This isn’t just extremely selective eating; it’s a legitimate eating disorder that sees people suffering so much anxiety over eating unfamiliar foods that they would rather risk serious health conditions than take a bite of said-item. In extreme cases, people with ARFID have gone blind or contracted scurvy from the nutritional deficiencies of their limited diets.
The disorder manifests itself in at least one of three ways: sufferers grow disinterested in eating; sufferers are unable to tolerate the sensory feel of certain foods; or sufferers become fearful of the consequences of eating anything unfamiliar, such as choking, being poisoned, or dying.
Because of these nutritional anxieties and fears, people with ARFID stick to the foods they know, and recovery is usually only possible through intensive therapy.
For music journalist Ben Boddez, ARFID has cut his meal options down to a tiny number.
I first met Boddez through a mutual friend while we were both students at the University of British Columbia. As we settled into a conversation, he recommended we stop by this nearby fast-food place, because he could “only eat chicken strips.”
“Sure…Wait, what?” I asked.
That was when I first learned of Boddez’s condition, and how, after developing ARFID at the age of 5, he hasn’t added anything new to his palette since then. He is now 23.
Boddez’s history with ARFID resembles a supervillain’s origin story. While genetics may have played a role in its development, Boddez describes two central events that led to the disorder’s manifestation.
Back when he was a fetus, his umbilical cord got tangled around his neck, which he believes led to his phobia of choking. And when he was a toddler, doctors discovered he was deathly allergic to peanuts. Unfortunately, they learned this not through tests, but after he suffered an enormous allergic reaction from eating them.
“I can still remember pretty vividly looking up in the ambulance and going to the hospital,” Boddez said. “Then I woke up and there were cameras in my face, because they put me on the morning news. They had cured me, apparently. I still don't really know how that worked.”
Somehow, through the power of science, Boddez had been cured of his peanut allergy. Immediately after waking, in an ethically questionable move by reporters, the young boy was then forced to eat a bunch of peanut butter cups on live television, to prove he really was cured.
“My 5-year-old brain was like, ‘Why are you feeding me this thing that nearly killed me yesterday?’ ” Boddez recalled. “So I thought, logically, I'm not going to eat anything unfamiliar anymore. Because it might kill me.”
His history with food is a familiar one. While ARFID doesn’t have a single root cause, a great deal of patient cases stem from trauma, mixed with a genetic or biological predisposition to the condition.
Boddez shrugged sheepishly when I asked if he ever got tired of eating the same foods day after day.
“No,” he answered.
Just as how a life-long vegetarian doesn’t miss meat, Boddez explained that he doesn’t crave other foods because he’s never tried anything different. He has nothing to crave or yearn for because he’s simply never tried anything else.
The serious side of ARFID
Perhaps one of the most severe cases of ARFID involves an anonymous teenager who suffered irreversible eyesight damage after years of eating only white bread, chips, and processed snacks and meats. He couldn’t tolerate the texture of fruits and vegetables. When doctors later screened him, they discovered he was severely malnourished and deficient in vitamin B12, along with several other essential vitamins and minerals.
ARFID is especially prevalent in kids aged eight to 13, and more so in children on the autism spectrum. It’s not unheard of for these kids to develop scurvy or pellagra, a potentially fatal disease caused by vitamin B13 deficiency.
Experiencing ARFID in the flesh
I would later ask Boddez to lunch, in hopes that he could tell me more. He brought his own meal to our meeting: an apple juice, chocolate chip cookie, and plain toasted bagel with nothing on it.
According to Boddez, a day in his life starts with a breakfast of either cereal or pancakes. For lunch, he almost always has a plain bagel, juice, and sometimes a cookie. For dinner, it’s plain pasta or chicken strips. Sometimes he switches up the brand of cereal from Quaker Oats’ Oatmeal Squares to General Mills’ Cinnamon Toast Crunch, but mostly it’s the same selection day-in, day-out.
Overall, he can eat maybe 20 to 30 different foods — and most of them are snacks.
“Meal-wise, I don't have very many options at all,” he said. “A lot of people with ARFID have a pretty similar list of safe foods. A lot of the time it's foods that are soft and foods that are bland, stuff that’s not surprising texture-wise or taste-wise”
Despite his limited diet, Boddez and his doctors don't believe he’s lacking any important nutrients that they know of. He can still eat carrots and certain fruits and has no issues taking vitamin supplements.
Still, he worries sometimes.
“I’m obviously not getting everything I need,” he said. “I'm sure that bad stuff will start happening eventually.”
ARFID is “more than just picky eating”
It’s a common misconception that people with ARFID choose to eat the way they do, Boddez added. In fact, if he could, he would love to change — he just doesn’t know how. Because even when he tries, even when he thinks about eating something unfamiliar, this can cause him to panic, gag, feel nauseated, or just “mentally shut down.”
“It's more than picky eating, it's a physical reaction. Your body literally rejects the food,” he said, between bites of bagel.
For Boddez, one of the worst things about ARFID isn’t the lack of nutritional variety, but the stigma and shame his limited diet carries. Sometimes people will get mad at him or blame him for not eating healthier. He’s had chefs at Japanese restaurants confront him for not eating with friends when they order sushi.
“I was a lot more ashamed of it [when I was young], because I didn't know how to explain it to people. And they didn't really understand it. So I made up excuses,” he said.
The road to recovery
Since earlier in 2019, when the aforementioned anonymous teenager with ARFID went blind, Boddez believes the disorder has begun seeping into mainstream knowledge. Because of this, he’s grown more comfortable discussing ARFID publicly, and he’s even begun reaching out to others with the same condition on the subreddit /r/ARFID.
“It was super interesting to talk to other people [with ARFID] because we have the same, very specific experiences. Like the thing I said with the sushi,” he said. “It just helps. I have so much more information now.”
Partly because of society’s greater acceptance of ARFID and recognition of extremely picky eating as a disorder and not just a learned behavior, Boddez was emboldened to visit a psychiatrist for the first time ever last year. The doctor employed a technique called “exposure therapy,” which is often used to treat ARFID nowadays. It involves slowly introducing the patient to a food that causes them anxiety in the hopes that over time, the patient will become immune to those negative associative feelings.
According to Boddez, through exposure therapy, people with ARFID would have to eat an unfamiliar food roughly 50 times in order to become comfortable eating it. That’s just one specific food item, mind you —if he wants to eat something else, he’ll have to eat that 50 times, too.
“[In therapy,] I ate things that I hadn't eaten for years and years and years. I had a tiny, tiny, little bite of a pizza,” he said. “That was insane. I felt sick for the rest of the day.”
Treatments were awful for Boddez. The appointments were easily the worst parts of his week, he said. But, miraculously, they were working.
That is, until life got in the way. He started a Masters in Journalism program last September, and his newfound busyness soon pushed therapy out of his life and he stopped going.
“I literally hated [therapy] so much that it just vanished from my mind when I started being busy on something else. I just forgot to go,” Boddez said. “But I think I was getting somewhere.”
He laughed nervously and stared at his plain bagel. Maybe he’ll return to it someday, he said, if he forced himself. But for now, he’ll stick with the soft and bland things.
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