ARFID: Why a bride ate just chicken nuggets on her wedding day

A bride ate just chicken nuggets on her wedding day. Photo / 123rf

Welcome to Ask Doctor Zac, a weekly column from news.com.au. This week Dr Zac advises what do if you have a food aversion.

Question: Hi Dr Zac, today is the day I finally make a change in my life. Ever since I was a young girl I've had the same problem causing roadblocks in my life – it may seem ridiculous, but I can eat only chicken nuggets.

Any other food, especially fruits and vegetables, makes me nauseous and ill – I cannot even swallow before gagging uncontrollably. I've always swept the problem underneath the rug and to this day don't like eating in front of anyone.

I realised the full extent of my problems when on my wedding day, in front of all the people I love in my life, they saw me eat chicken nuggets while they ate the beautiful food my husband and I paid thousands of dollars for.

What's wrong with me? And how can I change it? – Stacy, Tasmania

Answer: Hi Stacy, you have what medical professionals call a food aversion, and a serious one. I'm especially worried about your food aversion because of how dangerous chicken nuggets are. They are nutritional landmines.

Food aversions are the clearest display of how uncontrollable the mind can be, which is why I always stress to my patients the importance of looking after ourselves. Stay clear of unnecessary pitfalls such as alcohol, saturated fats, not enough water, too much caffeine, and learn how to meditate so you can notice signs of stress in your life.

Remember, proactive mental health care is a marathon not a sprint.

Now what is a food aversion? To put it simply, it is a natural response from the brain that signals the gag reflex to stop food from being swallowed. When I was a kid – I had exactly this kind of condition with overcooked brussels sprouts – thanks Mum. To this day I steer clear of them in the supermarket.

Instead, I supplement brussels sprouts for lots of other veges, so I'm good on that front. Your food aversion is a whole different ball game.

Back in the days of cavemen, this gag reflex would've been used to stop ourselves from eating rotten meat or poisonous berries and not just your partner's attempt at bacon covered asparagus (I mean how can bacon be ruined … it applauds itself while being cooked).

Now, although our mind is a supercomputer, glitches can still occur. Modern-day food aversions are most commonly formed from food poisoning. Let's say you ate a tuna salad and became extremely sick. Your brain will subconsciously register that illness and associate it with the food.

Dr Zac Turner on food aversion. Photo / Supplied

Now your brain may think it was the salad that caused the illness, but it was actually the tuna. And just like that you could struggle to eat vegetables the rest of your life.

If you nibble your favourite comfort food when you have got flu, you could unwittingly be programming yourself to go off said food. For this reason, people are often advised to lay off beloved foods when undergoing chemotherapy.

Avoidant Restrictive Food Intake Disorder (Arfid) is a new diagnosis for people with similar symptoms to yourself. Although many children go through phases of picky or selective eating, a person with Arfid does not consume enough calories to develop properly often resulting in stunted growth.

One recent study from Switzerland estimated the prevalence of Arfid among children aged 8–13 at about 3.2 per cent. Very little is known about the rate of Arfid in adults: some research suggests it affects about 9.2 per cent of adult patients with eating disorders, and that it affects more women than men.

Arfid denies the body the essential nutrients it needs to function normally. Thus, the body is forced to slow down all its processes to conserve energy, resulting in serious medical consequences.

The body is generally resilient at coping with the stress of eating disordered behaviours, and laboratory tests can generally appear perfect even as someone is at high risk of death. Electrolyte imbalances can kill without warning; so can cardiac arrest.

Your high salt, high fat diet astronomically raises the risk for future chronic health problems, including heart disease, stroke, and cancer.

Since you are skipping colourful fruits and vegetables loaded in vitamins A, C, E, K, and folate, you could very well end up with scurvy, vision problems or blood clotting issues.

Food aversions are, for the most part, psychological. You are not allergic to the food, your mind is just associating the food with a time you got sick. Here are a few ways to try and combat food aversions:

• Make new associations. You may associate coconut flavour with the time you got ill after eating coconut cream pie, so you associate coconut with vomit. Instead, consciously try associating coconut with tropical islands, holidays or relaxing on a warm beach.

• Make the food in a new way. If you became sick after eating fried eggs, try to prepare your eggs in a different way — such as an omelette — to avoid associating eggs with sickness.

• Increase your exposure. Slowly increasing your exposure to the taste you have an aversion to can prevent you from feeling sick or disgusted about the taste. Try just smelling it first, then taste a small amount.

I recommend you see your doctor and get a referral to a mental health practitioner; they can set out a tailored treatment plan for you and guide you along your journey back to normal eating. Hopefully you can renew your vows one day, and proudly eat the same food as everyone else.

Dr Zac Turner has a Bachelor of Medicine and Bachelor of Surgery from the University of Sydney. He is both a medical practitioner and a co-owner of telehealth service, Concierge Doctors and is also a qualified and experienced biomedical scientist, past registered nurse and currently a PhD candidate in Biomedical Engineering. | @drzacturner