A recent article in the Independent told the story of a teen who was “left blind and deaf after living off a diet of crisps and sausages.” Other news outlets have picked up the story, emphasizing the “dire” effects of a “junk food” diet. Most of the news coverage is ignoring or minimizing important facts about the unnamed teen: He has an eating disorder, and he was not diagnosed because he didn’t fit eating disorder stereotypes.
Avoidant-Restrictive Food Intake Disorder (ARFID)
Avoidant-restrictive food intake disorder (ARFID) is a relatively new diagnosis. It was included in DSM-5, which was published in 2013. People diagnosed with ARFID avoid or severely limit food due to the food’s taste, texture, appearance, or other sensory issues. ARFID is more than picky eating; it’s restricting to the point that it is impacting one’s health and social interactions.
The DSM-5 offers the following diagnostic criteria for ARFID:
- An eating disturbance that manifests in not meeting nutritional and/or energy needs and that is associated with the following:
- Weight loss or failure to gain weight in proportion to expected growth.
- Significant nutritional deficiency.
- Dependence on nutritional supplements.
- Interference with psychosocial functioning.
- The eating disturbance isn’t better explained by other factors, like cultural practices or a lack of available food.
- There is no disturbance in their view of their weight or shape.
- The eating disturbance isn’t attributable to a medical condition or mental health disorder.
ARFID is a serious eating disorder, and like better-known eating disorders such as binge eating disorder, bulimia, and anorexia, people diagnosed with ARFID need professional assistance to recover. The teen wasn’t eating chips and sausages because he wanted to eat those foods. He was eating them because they were the only foods he could eat.
The nutritional deficiencies he experienced led to dramatic consequences: hearing loss and vision loss. This is a tragedy, but it’s not a tale about the dangers of “junk food.” It’s a tale about eating disorder stereotypes, what happens to people who don’t fit those stereotypes, and how weight stigma hurts everyone.
Why Eating Disorder Stereotypes Are Harmful
News coverage and entertainment media perpetuate eating disorder stereotypes. These stereotypes include ideas like:
- Only girls and women get eating disorders.
- You can tell if someone has an eating disorder by looking at them
- If someone has a “healthy” BMI, they don’t have an eating disorder.
Let’s tackle these ideas one at a time.
Boys and Men Can Develop Eating Disorders
Anyone of any gender can develop an eating disorder. Although more women develop eating disorders than men, men can and do develop eating disorders. According to the National Eating Disorder Association, the number of hospitalizations involving eating disorders for male patients increased by 53% from 1999 to 2009.
Although some may associate body image issues, and the eating disorders that can develop out of those issues, with gay and bisexual men, heterosexual men make up the majority of men with eating disorders. In the case of the teen with ARFID, body image doesn’t come into play, as ARFID is more about sensory challenges with food rather than a fear of becoming fat.
Photo by kylie De Guia on Unsplash
You Can’t Tell Anything about a Person’s Health by Looking at Them Size and health aren’t as related as people think. The teen’s mom is quoted in the Independent as saying, “He has always been skinny so we had no weight concerns. You hear about junk food and obesity all the time—but he was as thin as a rake.” Given the emphasis the media puts on the “obesity epidemic,” it’s understandable that the mom wouldn’t be alarmed.
Size has much less to do with health than what’s portrayed in the media. You can’t judge a person’s health by their size or how they look. People in higher-weight bodies can be fit and healthy, and people in smaller bodies can be unfit and unhealthy. Metabolic markers such as blood pressure, cholesterol, and blood sugar are better indicators of health than size. Nutritional deficiencies, which can occur in people of any size, are also important indicators of health.
This teen’s family wasn’t alarmed about his limited diet because he wasn’t gaining weight. Similarly, the teen’s doctor didn’t dig deeper into his eating patterns until he presented with vision and hearing loss, and by that point, those conditions were irreversible. A simple conversation about the teen’s eating habits could have avoided the pain and loss this family is now experiencing.
BMI Is Flawed
BMI is a simple measure of weight compared to height. It was invented in the 1830s, and the formula hasn’t changed in the almost 200 years since its invention. BMI doesn’t take into account factors like age, muscle mass, or activity levels. The teen presented with a “normal” BMI, and that is one of the reasons his eating disorder was overlooked. People with eating disorders can fall into any point on the BMI scale, and that scale isn’t all that useful to begin with.
Moving Forward with ARFID
The teen is being cared for and is taking supplements to improve his health. A doctor is quoted in the Independent article as saying, “The processed food was not the problem per se. It was he was only eating that type of food and nothing else.” The damage that’s been done to the teen’s vision and hearing is irreversible.
Children and teens who are limiting their food intake to the point that they are feeling lethargic, as this teen did, need help. Parents and health professionals should ask about what they are eating and how often they are eating. This situation could have been prevented if the people in this teens life had known that people of any size and gender can have an eating disorder and that eating disorders can have serious health consequences. Those of us who have eating disorders or who have loved ones with eating disorders deserve to be taken seriously. We deserve professional help, regardless of our gender or size and regardless of which eating disorder we have. And we deserve to be treated with dignity.