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HOW DO YOU TREAT AN EATING DISORDER SO FEW KNOW ABOUT?

There are no clear answers for ARFID. And many nationally-recognized facilities don’t have a dedicated curriculum for this disorder.

CN/TW: this essay discusses Avoidant/Restrictive Food Intake Disorder (ARFID), and eating disorders.

By Ariana Drew Torres

When I talk about my eating disorder, I always begin with the disclaimer, “You’ve probably never heard of it.”

In late 2018, I was diagnosed with ARFID: Avoidant/Restrictive Food Intake Disorder. This was not the kind of eating disorder that I learned about in middle school health classes or the kind that showed up in subplots in the young adult novels I checked out from the library. To this day, ARFID is under-treated and under-discussed; by and large, the people talking about it are those of us who live with it. 

When I was in elementary school, my relationship to food looked like anyone else’s: I looked forward to mealtimes, I liked lots of different kinds of foods, and while I ate, I felt pleasure rather than stress. These are the hallmarks of healthy, non-disordered eating.

But by my middle school years, something imperceptible began to shift. I lost my motivation to keep up with meals; I would skip breakfast, subsisting on shitty public school lunches and small-portioned dinners. And I began to feel actively repulsed by certain foods, like meat, eggs, avocados, and mushrooms.

For people with ARFID, these are common symptoms: low appetite or apathy toward food; aversions to certain foods based on taste, texture, smell, etc.; extreme restrictions around the amount and kinds of foods you’re willing to eat; and/or anxiety around choking or vomiting while eating. Without treatment, these symptoms tend to intensify over time. In my case, the kinds of foods that I was willing to eat became narrower as I got older, and the amount of food I ate each day fluctuated dangerously.

I knew there was something wrong with my eating; it was obvious that my relationship to food looked nothing like that of my friends and family. But I had no frame of reference for what I was experiencing. Everything I’d learned in school about eating disorders came down to a set of universal criteria that didn’t apply to me: I wasn’t struggling with body image issues, and I didn’t want to lose weight.

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What makes ARFID anomalous amongst the most common ED diagnoses is that it isn’t related to body image at all. But when I was a kid, the term “ARFID” hadn’t even been introduced yet; the only language I had was that I simply didn’t like eating. As far as my parents knew, that wasn’t a disorder. Their well-intentioned consensus was that I just needed to try harder.

The first time I Googled my symptoms and found myself scouring a fact sheet about ARFID, I was a sophomore in college. I had managed to keep my symptoms at bay until then, and my university’s dining hall offered enough options that I could keep myself moderately well-fed during my college years. It was the thought of what I would do when I graduated – when there would be no external structure or support around mealtimes – that scared me. 

And it was true: when I graduated from college and moved out on my own, my condition deteriorated quickly. I was so repulsed by food that I could barely eat one full meal per day. I lived off of iced coffee and protein bars, my body withering away at a rate that terrified me. 

The second time I Googled ARFID, I was living in a Brooklyn apartment with two roommates who were beginning to notice that there were barely any groceries in my third of the refrigerator. I was afraid of what my life was becoming: the fatigue, the constant headaches, the wild heart rate, and anxiety. I decided to schedule an intake appointment at an ED treatment facility in the city; at the very least, I thought, they could give me a diagnosis.

What I learned there is largely what I already knew: there are no clear answers for ARFID. Even the nationally-recognized facility I attended didn’t have a dedicated curriculum for my disorder. The counselors essentially lumped me into the treatment plan for body image-based disorders and hoped for the best. I’ve since learned that this is standard practice at ED treatment facilities; research and treatment options for ARFID are still in development, and experts aren’t sure how to help us in the meantime.

For me, getting better has looked like creating my own structures. I dropped out of the treatment program when I realized that it simply wasn’t designed for me, and I invested my energy into one-on-one sessions with a therapist trained in eating disorder treatment. Together we began to work through the underlying fears and traumas at the root of my food apathy. Then came the (ongoing) process of unlearning the dangerous eating habits that brought me to the point of crisis, and relearning how to engage food as a vehicle for love, nurture, and care. 

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Now, a year and a half later, I’m much more stable in my recovery. I’m still coping with food apathy and I still struggle to maintain my weight; the key difference is in how I approach both eating and recovery. Rather than thinking of meals as a burden, I treat each mealtime as an opportunity to nurture myself. Even if I don’t feel like eating or I don’t enjoy the experience of it, I commit to caring for myself enough to meet my body’s nutritional needs. And rather than thinking of my recovery as an obstacle to overcome, I treat it as an opportunity to give myself the love I deserve.   

I hope that one day I’ll be able to find pleasure in eating the way that most people do; given how vital food is to Black diasporic cultures, it’s easy to feel like I’m missing out on a form of communal pleasure that should have been my birthright. But I also love my body exactly as it is, and that means honoring my relationship with food for what it is: a daily practice, a care ritual, and an intentional exercise of love. Every day, I remind myself that this can be enough.  

Ariana Drew Torres is writing themselves into being as a Black non-binary person. Their work has been published in The Fem, Foglifter Journal, Kweli Journal, and Sinister Wisdom 107. You can follow them on Twitter and IG @ari4na_drew.

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