Kristen Carter (3:34)
We're going to talk about the eating disorder arfid. Let's talk about first what happens when you eat a limited variety of foods. Let's talk about what happens when you become more careful about eating after a negative experience with food. Hey, what's up? This is Kristen Carter and you've tuned in to the I have ADHD podcast. I am medicated, caffeinated, regulated, and ready to roll. Get in here. We're gonna have a great time today. How are you? Welcome. Welcome to the show. I'm so glad you pressed play on this podcast. I say it a lot, but I really do mean it. I know you have a lot of choices out there. When I first started this podcast, there were like two other ADHD podcasts on the planet. This is back in 2018, 2019, and now there are so many great podcasts for people with adhd. I'm really glad you pressed play on this one. Thank you for being here. I have a confession to make. I'm gonna really, like, pull back the curtain and say that I am so not prepared to record today's podcast. I have my editing deadline on Tuesday, which is in just a couple days. And that means that my book that I've been writing since May, I wrote all of the chapters, then editors gave me tons of feedback. And then for the last six weeks, it's been my job to go back and, like, implement all of the feedback that they've given me and edit the entire book. Hundreds and hundreds of pages of my writing. And that has been an incredible hurdle. It has been my Everest and I have been working on it. And I don't know about you, I do think this is very common for people with adhd. When you have something huge that you're working on, everything else just doesn't take priority. And so, like, literally, my book is the only thing that I can think about. I do show up and do my job to the best of my ability to. But other than that, I. I'm just, like, all consumed with this huge project, is probably hyper focus. And that's fine. I embrace it, I welcome it. But also, oh, my goodness, has it made just like living the rest of my life very, very difficult? So that's what I'm working on right now. We are. We are planning a publishing date for October 2026. So we're pretty close to publishing. And do you know that I am freaking out? Do you know that my rejection sensitivity is already on overdrive where I'm like, people are going to read. Like, it's not. It's not just that I'm writing the book, which is hard, but now I'm grappling with. People are going to read this. Like, I am putting my heart, my soul, a lot of personal stories, a lot of my childhood stories, which are complicated and messy, that's in the book. And, you know, while I've been writing it, it's been kind of activating, but I've been getting through it. But now the idea of people actually reading it, I'm like, oh, my gosh. That is like, next level emotional regulation work that I've been doing. So I am here. I am recording. I drove to Manayunk this morning. I am happy to be here. The weather is horrible. It's freezing and windy and, like, we're here. But I do want you to know that, like, if you ever show up to work and you're just like, I am so unprepared, and I'm just gonna fake it till I make it today. That's where I'm at. Okay. And I think that's okay. You're good at your job, I'm good at my job. And sometimes we just show up and we just do the work, feeling like I. I'm not sure how this is gonna go. Let's find out. So the beauty here is that we're finding out together how this is going to go. Today's podcast is actually very near and dear to my heart because we're going through something. We, meaning me and the people that I love that is complicated and new. And I'm going to share it with you because I actually think that this is a conversation that we don't have in the ADHD community very often. And we're going to talk about the eating disorder arfid, which stands for avoidant restrictive food intake Disorder. I, over the years, have followed on social media, a couple people with ARFID But I had a very limited. And I just followed because I was interested. I thought they were interesting people, but I had a very limited idea of what it meant to have arfid. Recently, somebody that I love has been diagnosed with this disorder, and I'm going to share everything that I'm learning about it with you today because I suspect that many of you and maybe your kids are struggling with this without realizing that it's an actual disorder that can be treated. So that's where we're going today. Before we get there, I do wanna let you know if you have adh, if you've been diagnosed with adhd, or if you're learning about ADHD and nobody's really told you what it means to have adhd. If you were diagnosed and you were handed a prescription like me, this was my diagnosis experience. I was diagnosed at around age 20, 21. I can't exactly remember. And when I was diagnosed, they said, yep, you have adhd. Here's a prescription. Have a great life. And while the prescription was helpful, I didn't learn much about what it meant to have ADHD until 15 years later. I don't want you to have that same experience. Because of that, I developed a resource for you called 10 Things I Wish My Doctor Had Told Me About ADHD. You can find it if you go to ihaveadhd.com 10things. It is comprehensive, and in it, you're gonna find all of the things that I wish that I knew right away when I was diagnosed instead of my doctor being like, yes, you have adhd, here's a prescription. I. I wish they had given me more information. Okay, what does it mean to have adhd? What should I expect? What parts of my life are connected to adhd? What's the difference between my own character flaws and the symptoms of ADHD? So go to I have ADHD.com 10 things if you're interested in that resource. Also, we're going to pop it in the show notes, if you're a show notes kind of person. But I also know that you can multitask right now while you're listening to this podcast, if you want to go to I have ADHD.com 10 things, you can find that resource for you there. It is like a labor of love that I created because I really want us to be more equipped with information about adhd. What does it mean to have adhd? What does it matter? What does it even matter that I have adhd? What are the implications? That's what this resource is all about. So I hope that you will grab it if it sounds like it would be useful to you. Okay, so I'm gonna tell you the story of how all of this came to about. Came about with this eating disorder discovery. And one of the lines that I have to walk with having this podcast is I wanna share information with you. I also wanna share my story and be vulnerable with you. And also, sometimes I want to really protect the identity of the people that are involved in the story. So I'm not. I'm gonna try to be really protective of who I'm talking about and just make sure that I'm not sharing someone else's story that's not mine to share. But as a person involved, it's very complicated. I wonder if you can, like, relate to this where it's like, I don't wanna disclose anything too much, but also, if I don't say anything, I'm not gonna help anybody. That's where I'm at. If I don't say anything, I'm not gonna help anybody. And my job, my job is to show up here and help you. So I'm going to. You're gonna hear me try to, like, dance around some things. This is why I really wanna protect people's identity and I wanna help you at the same time. So there's someone in my life that I love very much that has been wanting to gain weight but has been struggling to do it. And we've had conversations with this person and said, hey, you know, if you want to gain weight, here are the ways that you do it. We're going to eat more food, we're going to eat more calorie, dense foods. And none of the traditional advice was helpful. That's key here. So I want you to, like, keep that in your mind. None of the traditional advice for this person was helpful. As a matter of fact, it was activating, it was frustrating, it was triggering. And that makes things really complicated, right? Because when someone has a goal to increase their weight, but they're activated by just like, traditional advice of like, well, eat more food and you'll gain more weight, then there's kind of an issue here. So this person went to a doctor's appointment and relayed this to a doctor. Now, how many of you have been to a doctor and you've kind of, like, exposed yourself and you've been vulnerable and you've asked for help and they've responded to you in a way that really makes you feel dismissed, unheard, and like, they just do not get it. And that Was this person's exact experience. They came out of the doctor's appointment being so activated, so like on fire with just like this person did not understand. And again, the traditional advice didn't resonate. The traditional advice of like, eat more foods, let's look into calorie tracking, let's look into, you know, more calorie, dense foods. Not helpful. So what we discovered. What we discovered and like, now looking back, it just makes so much sense. And so I really hope this resonates with you. What we discovered is that this person was actually struggling with an eating disorder. Now, I would have never clocked them as having an eating disorder because I grew up in the 90s and my perception of what an eating disorder looks like is anorexia or bulimia. Someone who is extremely obsessed with their body. Somebody who is wanting, you know, all day long thinking about their body. And obviously I don't know much about anorexia or bulimia, but this was my perception that it was body. Like eating disorders are body focused. Eating disorders are, you know, you want to lose weight. Eating disorders are. You're obsessed with how you look and you're trying to change it. And that's not at all what this person was struggling with. And so I never ever would have thought that they would be diagnosed with an eating disorder, but they were. We're gonna talk all about it. I'm gonna go into it in depth and I hope that it's so helpful for you. So they were diagnosed with arfid, which stands for avoidant restrictive food intake disorder. Now, people with ARFID have an eating disorder, but it is not a body based eating disorder in that they're not trying to like change the way their body looks. Okay, but let me describe it to you a little bit. People with ARFID eat a very limited variety or amount of food and it causes problems in their lives. These problems may be health related, like losing too much weight or not getting enough nutrients. And these problems also may be social, like not being able to eat meals with others. ARFID is different from other eating disorders. This is so important. And this is what, like, completely shocked me. ARFID is different from other eating disorders like anorexia, because people with ARFID don't worry much about how they look or about how they weigh. Instead, people with ARFID might have one or two or two or three of these important concerns. And we're going to go through them. Number one, some people with ARFID find that novel foods have a strange or Intense taste, like a texture or a smell, and they feel safer eating foods that they know very well. I just wonder like, who of you relates to this? Or how many of you can look at your kids and say, oh yeah, okay, they find novel foods have a stranger intense taste, texture or smell, and they feel safer eating foods that they know very well. Number two, and this is interesting, and I think this is the type of ARFID that I have seen portrayed on social media. Another aspect of ARFID is that people have had a scary experience with food like choking or throwing up or an allergic reaction. So they might avoid the food that made them sick that one time or stop eating it all together. And then lastly, and this is primarily what the person that I love struggles with, still others don't feel hungry very often or they think that eating is a chore or they get full very quickly, which can also be a sensory issue. So you get full quickly and you don't like the feeling of being full. It feels, feels bad in your body. And so you try to avoid the feeling of being very full. One of the conversations that we had with this person, you know, back before we had all of this information, they would say, I'm full. And we would say, that's totally fine if you want to gain weight. Part of gaining weight is eating a little bit past that feeling of being full. And, and that was really difficult for them to receive and it made them really upset because the experience in their body of being really full was so uncomfortable, they couldn't even imagine having to eat past that feeling of being full. So I just, I just want to pause here and ask you, does this feel like you or anyone you love? Because the more that I have like pulled this apart, learned about it, I can see this in myself a hundred percent. A hundred percent. This is something. I can see this in me as a kiddo. I can see this in my kids as they were kiddos. Like maybe not to a diagnosable extent, but definitely tendencies of it. Here's the part that is so important for everyone to understand about arfid. And sorry, I'm like struggling to speak because I really want to say this gently. A lot of clinicians don't know about arfid, A lot of doctors don't know about arfid. And so they will label people or children as being picky or being stubborn or needing boundaries. And that's not at all what it is. It's not about being picky, it's not about being stiff, stubborn. On the contrary, people With ARFID have underlying biological traits that initially made their eating habits illogical choice. And then once established those logical choices that they were making, develop a pattern. A pattern of avoidance becomes this long standing, you know, habit and then they're highly resistant to change. Huge, huge, huge, huge. How many of you are parenting kids that are really, really picky eaters? One of the struggles in my own family is, you know, my husband was raised in a family where you just eat what's on the table, nobody complains about it, and he never had a problem just eating what was put in front of him. God bless. That's amazing. I come from a family where we all had kind of like sensory things we all struggled to eat. My mom would say like, you eat like a bird, you hardly eat anything. And looking back I can see like, yeah, it was a texture issue for me. It was a safety issue for me. It was a, like a resistant to new for me. And to hear like this is an underlying biological trait, it's like, that is so, so helpful. Okay. The good news is that these patterns can be interrupted and ARFID can be worked with. And there are, there are things that we're going to talk about later that will help. But let's talk about first, what happens when you eat a limited variety of foods. Okay. So what's interesting and what I've learned is that flavor preferences are partially genetic. Which is fascinating because if you've ever blamed your kids, like what is wrong with you? You're like, why can't you just try something new? Like understanding. Oh, it's, it's actually genetic. Flavor preferences are actually partially genetic. That's really, really, really important. And also, people with ARFID are often super tasters, meaning that they could have been born with high concentration of taste buds on their tongue and dislike things like bitter foods, vegetables, like, is this why I can't eat a vegetable? I said this to my husband the other day. Is arfid. Now, to be clear, I have not been diagnosed. I believe that I am accommodating myself well, and I have good nutrition intake, blah, blah, blah. But is this why I can't eat a vegetable? Is this why? Like the thought of cooking like broccoli and then actually eating it or a green bean. Get out of here. I'm sorry, I can't do it. I can't do it. And I'm a 44 year old educated grown ass woman. Why can't I eat a vegetable? Why can't I do it? Is it perhaps because I'm a super taster that the bitter foods are just explosively disgusting in my mouth. Maybe. Maybe. Okay, so what's so interesting is that once someone with ARFID develops this pattern of limited food intake so there's like just a small amount of foods that they're willing and able to eat, then that limited diet does keep ARFID going. So it's kind of like this loop of like, I start with a limited diet that feels. Feels safe and good to me, but because I only have a limited diet, it keeps this avoidant, restrictive diet in play. Okay. Because eating the same foods all the time makes new foods taste even more different. And certain nutrition deficiencies can change the way that food tastes, making new foods even less appealing. And eating a particular food over and over, over might also make you tired of that food. So how many of you are like, eating eggs every day? I'm gonna eat eggs every day. And then all of a sudden the eggs start tasting very eggy. Has anyone experienced this? Like, all of the sudden the eggs are just like, this is tasting very eggy, and you just like, never eat it again. Anyone? Just me. Maybe it's just me. So, like, you get tired of that food and you stop eating it, and then your diet becomes even more limited because one of your safe foods is no longer eating. A very limited diet can also cause serious health problems because eating preferred foods in, like, higher sugar and fat is associated obviously with diabetes and heart disease. Like, we know this because we're educated. And that's part of the problem is like, for me, I know that vegetables are good for me. I understand that. Like, no, duh, I already know that. But why can't I get myself to eat them? So avoiding non preferred foods like fruits and vegetables is obviously gonna be associated with health risks, with cancers, with diabetes, like, those kinds of things. That's not good. That's not good for us. It may be hard to eat. This is so interesting, like, the social component. And one of my kids expressed this just kind of randomly a couple weeks ago. They said, they said, when I get a girlfriend, my biggest fear is that I'll go to their house and the family will serve something that I literally can't eat. And at the time, this was before I had done research on arfid, I was kind of like. I kind of just like laughed it off. I was like, oh, that's so cute. Like, you'll. You'll be fine. Hello, Dismiss, dismissive mother. Like, what if this child is actually struggling with arfid? What if this is actually a very real valid anxiety that they have. Like, what if this child actually needs some therapy to be able to eat outside of, like, chicken nuggets, Mac and cheese, hamburgers, you know what I'm saying? Do you know what I'm saying? Somebody recently told me that their fiance had to go to therapy in order to, like, work up the ability to eat the meal that they served at their wedding. Like, this is not nothing, y'. All. And it's not just kids that struggle with it. It's adults as well. Imagine being like, okay, we're having this wedding, we're having this fancy dinner. Obviously, like, a hot dog is not going to be served. I'm the groom. It's my responsibility to, like, obviously I'm going to be hungry. I have to eat in front of all of these people at the head table. But I don't want to eat this stuff. I don't want to eat what's on the plate. It's disgusting to me. There's anxiety there. I can't even imagine. When they shared that with me, I was like, you should look into arfid because, of course, I've been going down the rabbit hole. So additionally, what happens? Let's talk about what happens when you become more careful about eating after a negative experience with food. So remember, part of the ARFID experience for some is that they've had a negative experience with the food. Maybe they choked on it, maybe they threw up afterwards, maybe they got sick afterwards. And now they've restricted their diet from that food because of that negative experience experience. So let's talk about that. Negative experiences with food, such as choking, vomiting, an allergic reaction, or pain after eating, obviously that can be traumatic, right? And those experience might cause you to limit your diet to prevent further trauma. So you might even avoid any food that reminds you of that traumatic experience or stop eating altogether. How does avoiding foods or eating altogether keep ARFID going? You may be using safe behaviors to try to prevent another traumatic experience from happening. Like taking really, really small bites, chewing food for much longer than needing needed, only eating at familiar restaurants, or not eating at all. Safety behaviors prevent you from testing negative predictions about eating. What's so fascinating? And you can see how this is just a perpetuated cycle. Because safety behaviors, those safet behaviors of like not eating or only eating at familiar restaurants, or chewing much longer, et cetera, I just listed them. Those safety behaviors prevent you from testing your negative predictions about the food. So it's like, this food makes me sick. That's what we've decided because it made me sick that one time, I'm never gonna try it again. So I never get to test that prediction and prove it untrue. I never get to disprove that right. And the more you avoid eating, the scarier it becomes. Becomes. I just wonder, like who are you thinking about right now? Are you thinking about you? Are you thinking about your partner? Are you thinking about your cousin? Are you thinking about your kids? I know who I'm thinking about right now. This episode is sponsored by AG1.