ARFID & rumination syndrome

What are feeding disorders?

When someone has a feeding disorder, it means they struggle to eat enough or enough of the “right” foods. They may avoid certain foods or even entire categories of foods. This may be due to physical issues, such as difficulties with chewing or swallowing, or emotional distress, such as anxiety, OCD, fear of throwing up, fear of choking, etc.

Feeding disorders (FED) differ from eating disorders (ED) in that avoidance or restriction of food is NOT linked with body image concerns. If the reason behind the disordered behaviors is due to negative feelings about their body, this may be an eating disorder. It is possible to have both an ED and feeding disorder.

What is ARFID?

ARFID (Avoidant Restrictive Food Intake Disorder), also known as “extreme picky eating”. People with ARFID avoid or restrict foods for reasons other than weight loss or body image concerns. These include: texture/sensory issues with food, fear of choking or throwing up, fear of new/unfamiliar foods, or low appetite that is not explained by a medical condition.

ARFID often results in nutrition and energy deficiencies, and for some people, inability to maintain an appropriate weight. But just to be clear, malnutrition can occur at any weight; it is not the same thing as being underweight.

Common challenges for people with ARFID include: difficulty chewing or digesting food, very slow pacing, general lack of appetite, and/or avoiding specific types of food textures, colors, or smells.

In my experience working with clients with ARFID, the most common “safe” foods are: grilled cheese, chicken nuggets, french fries, butter noodles, bread, mac n’ cheese, etc. “Fear” foods are typically: vegetables, fruits, protein, mixed foods, sauces, spices. Many people say they feel more comfortable ordering off the kids menu at restaurants though they feel embarrassed for eating in a childlike way or fear that people will think they are “unhealthy”.

The 4 sub-types of ARFID include:

Sensory Sensitivity: People with this type usually have sensory issues from early childhood that make them sensitive to certain textures or strong tastes. They find that unfamiliar foods have strange or intense smells, textures, or tastes, and they feel safer eating familiar food.
Fear of Aversive Consequences: People with this variation develop fear of choking, swallowing, or vomiting usually in response to a traumatic situation they experienced themselves or witnessed. They may stop eating foods that they believe will cause these outcomes. This type usually has a more sudden onset and can develop at any age.
Neophobia: Fear of new or unfamiliar foods. These people have typically been picky eaters since childhood and have a very difficult time consuming new or unfamiliar foods due to anxiety or just because they have never tried it before.
Low Interest: People with this presentation tend to have lower levels of hunger and not find food as rewarding. They may find that they don’t get hungry often, get full quickly, or find eating to be a chore. This subtype is diagnosed when other causes of low interest/poor appetite have been ruled out.

What is Rumination Syndrome (RS)?

Rumination Syndrome, also known as Rumination Disorder, is when food is regurgitated during or after eating. The food is either rechewed, reswallowed, or spit out. Regurgitation can happen spontaneously or voluntarily (often linked to anxiety/stress). Many people can feel the sensation that food is stuck in their throat or about to come up and can regurgitate intentionally, partially relieving the discomfort. At times, regurgitation can be a form of self-soothing, used to reduce anxiety even though it may cause feelings of guilt, shame, or hopelessness afterwards.

Rumination Syndrome is often misdiagnosed, most commonly as gastroesophageal reflux disease (GERD) or if significant weight loss has occurred, anorexia nervosa. Due to misdiagnosis and the fact that RS is not widely known, the disorder often progresses and health may suffer as a consequence.

Shame is also a key component of rumination syndrome. Many people hide this behavior from their friends and family for fear of people thinking they are “gross” or that there is something “wrong” with them. I want to reassure you –

There is nothing wrong with you.

For whatever reason, your body learned to regurgitate food but that doesn’t mean you are broken. Every “disorder” has a purpose, the reason why it came into being. Disordered behaviors arise from the body attempting to cope with difficult life experiences. While the behavior may not be productive or healthy, it was the best you could do at the time with the resources you had.

Think you might have an eating or feeding disorder?

supporting:

Ages 13+
Feeding Disorders
- ARFID (Avoidant Restrictive Food Intake Disorder)
- Rumination Syndrome/Disorder
Co-occurring eating disorders
Providing trauma sensitive care to all cultures, ethnicities, religions, countries of origin, gender identities, abilities, & sexual orientations.

What to expect in a session?

Compassionate treatment
Meal planning support
Grocery shopping assistance
Nutrition education
Debunking diet myths
Exposure therapy to introduce new foods (if/when you’re ready)
Individualized digestive healing protocols

Are you ready to learn new techniques to heal your digestive system and recover from your disorder?

Reach out to start your recovery.

Naia taught me to take risks with food, even when it was scary. She taught me to challenge my intrusive thoughts and I learned that taking risks just means challenging something. You don't have to like it or necessarily do it again, but taking the risk is what matters. I learned to sit with the discomfort and nourish myself through it anyway.

-24 year old ARFID & Anorexia Nervosa