The COVID-19 pandemic has created stress on our internal infrastructure, disrupting our food systems. Every time I go to the grocery store now, and see the empty and picked through shelves, I cannot help but think about my patients and other individuals struggling with or in recovery from an eating disorder. I think about the strain this may be causing in their day to day life. More so, I cannot help but think, “What are my patients with ARFID doing for food?”.
Many people are still unfamiliar with the diagnosis of ARFID – Avoidant/Restrictive Food Intake Disorder. Patients with ARFID have far more than picky eating, although this is what it may appear to be to untrained professionals and non-professionals alike. Instead, individuals with ARFID have trouble meeting their nutritional needs because they have concerns about the aversive consequences of eating or they avoid food based on sensory characteristics.
So, what does this look like in daily life? These are individuals who do not outgrow their selective eating habits in adolescence. They are often underweight and may be off track for growth compared to their genetic potential. For many of these patients, a disgust response to food starts early in childhood, even infancy or toddlerhood. Also, many individuals with ARFID seem to have a lack of interest in food or eating. This can present as rarely expressing hunger or getting full easily. Sometimes these patients will “drink” their calories, by sipping on sports drinks all day.
Because of these sensory issues, fears, and disgust – many of these patients will only have a few foods they will consume. Not only that, but those few foods can be very brand specific. For example, chicken nuggets may be one of the three foods they will regularly eat. But more than that, for these individuals it will be a specific brand. They must eat the exact same food, the same brands, day after day and meal after meal. When individuals with ARFID do not get enough to eat – they risk short-term and long-term medical issues including acute malnutrition and issues with growth and bone development.
Due to the COVID-19 pandemic, we are all seeing some disruptions in the way food is available throughout the United States. We also are aware that for some families, financial assistance may be needed to maintain adequate nourishment.
Here are some general tips for anyone dealing with tight budgets and limited purchasing options:
For families with a child or loved one with ARFID – here are some additional ideas from our team to manage this crisis:
Anna B. Tanner, MD, FAAP, FSAHM, CEDS is the Vice President of Medical Services for Veritas Collaborative. She is a Board-Certified Pediatrician who has spent the last 20 years of her career working with complicated adolescent patients with a special emphasis on treating patients with eating disorders. Throughout the COVID-19 pandemic and beyond, Veritas Collaborative remains committed to their mission and vision – providing access to care for all individuals, their families, and communities of support. We are in this together – and together we are stronger. Contact Veritas at 855-875-5812. Please visit their website at www.veritascollaborative.com.