Today I have something I always dread: a social occasion where food will be provided. Those who know and, worse still, live with me know how awkward and embarrassing this can be. To describe me as a ‘fussy eater’ would be a massive understatement. I approach some meals as if they were an unexploded bomb. And as I have grown older, my pickiness has become more and more extreme. I have always known that my eating habits are not ‘normal’, not least because I actively avoid social occasions where food will be available, and to that extent I wondered if there might be a reason. Now, following my ADHD diagnosis, I may have found one: ARFID.
ARFID, or Avoidant/restrictive food intake disorder as it is properly known to some folk, but until this morning not to me, was until 2013 known as Selective Eating Disorder. I don’t want to go into the technical stuff here, not least because I don’t understand most of it, but this condition has, apparently, always existed but it was just lumped into the category Other Infant And Early Childhood Feeding Disorders. What’s more, it’s highly prevalent in people who have ADHD and Autism. Now, I definitely have the former and, now I am an expert on the subject (not really) I’ve done on-line tests which indicate I have aspects of the latter condition. The last on-line test I did said this: ‘Based on your responses, you may benefit from seeing a mental health professional for an evaluation, particularly if any of the items on the list impact your ability to be successful in your work or personal life.’ The ‘score’ I got was broadly similar to my on-line ADHD test and we know how that ended. It seems that I have all manner of conditions, seemingly including an eating disorder, and I’ve done nothing about it. So, how does ARFID, if I have it, manifest itself and when did it start?
I know that as a child my diet was severely limited to what my mum brought home. Vegetables would always be tinned peas, fruit came in tins. I didn’t know the difference between different types of meat – they were basically all ‘meat’ – and fish was fish. Once in a while we might have Cod and Chips from Templars, a legendary chippie in Briz (Brislington) in Bristol. Cod was great because by and large it didn’t taste like most fish smelled. Then, one day at my grandparents’ house, we had a meal with lamb and mint sauce. I didn’t mind it at all, but I had an almighty tummy upset within minutes of finishing the meal and I’ve never touched lamb since. I seemed to get by for school dinners, when my mum could afford them, but variety wasn’t the spice of our life. The first real battle I had was sometime in the mid to late 1960s when my dad came to visit from Canada and took me to meet an old friend of his who sailed on a ship that was docked at Avonmouth. His friend kindly got the ship’s cook to knock up a fish and chip meal for me, but it wasn’t cod. It was plaice. And it was covered in weird breadcrumbs. And it really smelled of fish, which shouldn’t have seemed odd since it was fish. But I took one bite, retched a few times, burst into tears and told my dad, who was understandably livid with me, that I couldn’t eat it. Whether this was the start of my lifelong aversion to all fish, except cod from a chip shop, I don’t know, but despite limited efforts to engage with sea food things have got worse rather than better.
Years later, when I was 18, I visited my father in Canada and the meal he served up on the first night was lobster and before he put it in the pressure cooker it wasn’t dead. It looked such a repulsive creature I could not imagine how, once upon a time, someone, somewhere had looked at it and thought, “Mmm. That’ll taste nice once you’ve smashed up the shell and claws” but someone obviously did. As it sat on the plate, I couldn’t touch it. If looks could kill, my father had killed me.
But on it went and still goes on today. Cheese? When it’s from a cow, oh yes. Sheep or goats milk? Ugh. I don’t care what it takes like. I just can’t eat it. Birds Eye Cod Fish Fingers? Fantastic but not any other Birds Eye fish fingers and certainly not fish fingers by any other company. Baked beans? Only Heinz. Beef, Pork, Chicken? Bring it on. Lamb? No chance. I was nearly ill from it once.
The kind family members who invited us round today had made the sensible step of asking my partner what I like. It would have taken far too long to tell them what I don’t. We had a lovely meal, although it was followed by a type of French soft cheese and I just kept quiet because it wasn’t something like cheddar.
I’ve been to an excellent website to check the symptoms of ARFID and they include:
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Avoidance of whole food groups or textures (e.g. fruit. meat, vegetables; slimy and mixed textures).
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Sensitivity to aspects of some foods e.g. temperature.
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Gagging or retching at the smell or sight of a particular food(s).
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Difficulty being in the presence of another person eating a non-preferred food.
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Having a diet that is limited to (usually less than 10) ‘preferred foods’ (‘safe foods’).
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Lack of interest in eating or missing meals completely (not feeling hungry).
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Attempting to avoid social events where food would be present.
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Struggling to stay and/or eat at a table during family mealtimes; eats only with distraction e.g. television.
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Needing to take supplements to meet their nutritional needs and where energy intake is impaired.
One brief glance and I realised that this was my life. Most of these are true, as well as preferring to eat the various parts of my dinner on different plates. That’s an autistic trait. My mum indulged me in that but my partner offers me tough love. It’s only when she is out and I am eating alone that I can use two or three plates instead of one.
My behaviour goes into extremes. I am wary of eating chicken when I go out in case it isn’t breast meat or thigh (with the bone left on). If I suspect I am being served the fatty crap from underneath the bird, I won’t eat it. The same applies to certain brands of sausages. Honestly, being me eating out, or sometimes eating in, is a nightmare. I would love to walk into a restaurant or someone’s house and eat what’s put in front of me, but it’s never like that. My throat will close up and I won’t eat anything more.
When it comes to the crunch and I am served something about which I have any doubts or suspicions, I won’t eat it. I’d rather eat nothing, as I did when my dad served my fish an chips and when my dad served me lobster (actually, on the later occasion, I ate the starter, a corn on the cob, but I wouldn’t have anything else if it had been offered to me (it hasn’t been)). Is there anything I can do about it?
I waited a lifetime for my ADHD assessment and when I got the diagnosis it changed nothing. There’s no therapy and doctors have said I can’t have meds. There’s no meaningful therapy available for my depression and I’m being told now I have to cut back on my mental health medication because it is somehow making the physical side worse. So is it really worth ploughing on to confirm I’ve got other conditions like autism, ARFID and even PTSD when there’s probably nothing that can be done about them if I have? Or is it just worth knowing for my own peace of mind? Not for the first time, there are more questions than answers. In fact, it feels like there are no answers at all.
I fear all that remains is for me to carry on muddling on with this picky eating, embarrassing people, including me, along the way and just eat the things I can and not the things I might like if I wasn’t like this.
Today’s lunch went well thanks to the compromises of others. Not everyone is prepared to put up with my idiosyncrasies and I don’t blame them. I wonder what other conditions I will find tomorrow?
