(ARFID) Avoidant Restrictive Food Intake Disorder with Michelle Sader (PhD)

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Avoidant Restrictive Food Intake Disorder (ARFID)

Speaker 1  00:02

Cool. Okay, hello, and welcome back to the JenUp podcast. So if you’re struggling with an eating disorder and feeling lost, you’ve come to the right place. Both myself and Becky Cerner, former sufferers of eating disorders and we understand the challenges that you’re facing, join us for inspiring, educational and relatable content, whether you’re seeking support, guidance or just someone who understands we are here for you. So today I’m super excited to introduce Michelle Sader on the show. So Dr. Michelle Sader is a post doctorate researcher at the University of Aberdeen, working on eating disorders and the autism collaborative. So this is a research project in collaboration with the University of Edinburgh and King’s College London. Michelle also has a degree in neuroscience and psychology from the University of Aberdeen, with her PhD, having focused on further the neuro mechanisms involved in emotional and appetite regulation, her role is also to assist and provide support for people with autism and eating disorders. So I’m so excited to have you on, Michelle, I mean, I think it’d be really good to kick start off you telling us about your research and what you’re doing. Absolutely and thank you so much for the introduction. Jenny, that was that was phenomenal. So as you mentioned, I am a postdoctoral research fellow, and my work has really focused on eating disorders from the autistic perspective, and I particularly have a background when it comes to neuroimaging and MRI research. But more recently, from my PhD, I’ve moved more so towards the work that the eating disorders and autism collaborative does, or EDAC, for short, in which we really implement this research approach known as CO production. And what we do when we engage in CO produced research is that people with lived and learned experience work as a unit to kind of determine the research priorities that people have, what individuals of the lived experience community want answers to what type of research would really benefit them, and then we do our best working alongside them to kind of accomplish these research goals, and as a researcher with a predominantly quantitative numbers based background, working with EDAC and really experiencing the autistic perspective in this hands On way, has been so valuable to my own research journey, and it’s been absolutely phenomenal. One of my special research interests is avoidant restrictive food intake disorder, or ARFID, for short. And to be transparent, right off the bat, ARFID is something I was diagnosed with in 2021 so I was particularly, I was in a very interesting circumstance of going through my PhD and realising, Oh, I think I actually have the condition that I’m researching, that’s quite interesting. And then, lo and behold, I ended up getting a formal diagnosis. Um, and so I find myself in a very interesting position of being able to learn something about myself, um, almost on a daily basis, which is, which is really enjoyable.

Speaker 2  03:56

Okay, now that’s fascinating. So I’ve heard Arthur come up, like so much recently, like, I’ve seen it being talked about a lot in the sort of eating disorder world, being published in, like, news articles and stuff. And it, obviously, I see a lot of, is it linked to autism or not?

Speaker 1  04:15

Always, phenomenal question. And so I think, prior to to delving into that, I think it’s really important at least for me to explain what ARFID is, especially since it’s really being picked up in not only the scientific community, but just the general public as well. So ARFID is a feeding and eating disorder that was recently introduced in the Diagnostic and Statistical Manual of Mental Disorders, or the DSM five, for short, in 2013 so it’s a relatively novel feeding and eating disorder, just over 10 years old, essentially, and it’s primarily characterised by extreme restriction or avoidance in dietary intake, to the point where an individual’s weight, growth or their nutritional intake or ability to manage life is significantly impacted. What’s important to note about ARFID is that it is clinically distinct from other eating disorders such as anorexia or bulimia nervosa, and for the most part, this is due to the fact that it’s not primarily driven by these body shape and weight concerns. However, what’s quite interesting is that research shows that there are similar psychological and physiological effects that people with ARFID have relative to people with anorexia, let’s say similar impact on psychological well being, ability to manage meal times. And even some studies have noticed similarities in bone density and the reduction of bone density in those who have ARFID as well as anorexia, so it is incredibly important to tackle, but it can oftentimes be overlooked as just fussy eating or picky eating, which is something that, as academics and clinicians, we need to be careful to mitigate so one thing that leads me into a discussion of the link between ARFID and autism is these three underpinning drivers of ARFID, and these are also termed as ARFID profiles. They’re essentially different types of symptoms that people are grouped under if they have ARFID. And these are sensory sensitivities that might be associated with food, a lack of interest when it comes to engaging with food, and lastly, a fear of aversive consequences when it comes to engaging with food, and that might be a fear of choking or a fear of vomiting. So these three drivers are really, really new when it comes to the ARFID literature. They were only introduced in the text revision of the DSM five, which was in 2022 so we’ve only had a few years to really grapple with the very diverse set of symptoms that people with ARFID can present with. However, what’s also really important to note is that there is indeed a very strong link between ARFID and autism. In fact, the link we’ve recently conducted kind of a meta analysis, taking a look at all of the literature when it comes to this link between ARFID and autism, the fact that people with ARFID are more likely to be diagnosed as autistic, or that autistic individuals are more likely to have ARFID, and what we ended up finding was that those with ARFID ended up having an autistic diagnostic prevalence that was about 16 times higher than the general population. And what I mean by that is that there’s a general prevalence rate of about 1% of autistic individuals in the general population. And when we take a look at that autistic diagnostic prevalence in those with ARFID, it’s about 16, slightly more, which indicates there’s a huge overlap between these two conditions, or rather a huge overlap of ARFID traits in autistic individuals and autistic traits in those with ARFID, which definitely requires further investigation. Our work has only looked at the overlap in that prevalence rate, but what that actually means when it comes to engaging with autistic children who might have ARFID or assisting them with their diet and nutrition is a different story altogether,

Speaker 2  09:21

because I can imagine if there’s, if there are, they’re going to end up with, like, nutritional deficiencies and, you know, lack of variety in the diet. Gut, I’m thinking about gut health, how that’s going to affect their gut.

Speaker 1  09:33

Absolutely, absolutely, and it can really impact not only weight, but especially if you’re a younger child, growth trajectories, psychosocial behaviour, so that could be behaviour during meal times, or perhaps going out with friends, going out to a restaurant or field trip, whatever that might be, it’s likely that they’re going to be. Okay? Difficulties experiencing those sorts of instances.

Speaker 2  10:05

Okay? And are there any suggestions to help children who are struggling at mealtimes especially well okay? At school and at home as well right?

Speaker 1  10:20

So it, I would say it’s a bit of a tricky one to answer, especially first and foremost, because the ARFID literature itself, itself is relatively novel. So when it comes to available interventions or treatments associated with ARFID, some methods have been explored so that could be family based, therapy that could also consist of food exposure therapy and also your standard cognitive behavioural therapy as well (CBT), so there are some methods that have been approached when it comes to a professional setting. But these are also highly dependent on the type of symptoms that the individual shows. For instance, if there’s an individual with sensory sensitivity and that’s been a long standing trait or characteristic that’s, to a certain extent, simply a part of who they are. Food exposure therapy isn’t going to inherently benefit these individuals. So I would say, when it comes to supporting an individual with ARFID, I think a lot of it comes down to the specific symptomatology or what driver might be at play explaining that ARFID-like behaviour or that ARFID diagnosis. And it can get even trickier when it comes to autistic individuals who experience ARFID as well. A good portion of our work at EDAC when it comes to autism and eating disorders is firstly, trying to understand and treat the eating disorder while supporting the autism. And in fact, with some of our focus groups, it’s even been raised as to whether it’s clinically important to pick apart the eating disorder and the autism, some of our collaborators say, Yes, this has been really beneficial to pick apart, because then I understand what are my autistic traits and what is the eating disorder taking over, whereas other people say, Actually, it’s it’s been a bit detrimental towards my treatment. Sometimes I feel like the clinicians are overlooking my experience when I try to stand up for myself and say, No, this is my identity as an autistic person engaging with food. I want to approach recovery through other means. So it’s really when it comes to an autistic person with ARFID, it’s a whole different can of worms. Yeah, it, I would say the biggest thing to consider is the underlying symptoms and traits that are at play when it comes to ARFID. And most importantly especially as a parent or potentially a faculty member at school flexibility empathy understanding.

Speaker 2  13:34

Okay, so I’m just taking everything in that you just

13:39

said absolutely it

Speaker 2  13:41

makes sense treating the symptom, because obviously it’s like with anything or any health problem, and you’re going to have symptoms that’s looking at the symptoms, so obviously it’s going to present in different ways. So it makes sense what you said and what what struck me there was with the treating the eating disorder and the autism, like, it’s, do you separate them. And as you said, I think so. Because if the autism is feeling the eating disorder like the kind of the thinking and the mindset they need to understand that, don’t they like going forward, how how to like, manage that.

Speaker 1  14:18

I think I think understanding goes a long way from a personal perspective, but I I also understand the experience that many autistic people have had going into eating disorder clinics, where, for instance, a lot of clinicians don’t screen individuals presenting with anorexia for autism because they there is don’t want to get too controversial here but there is a there are a couple of studies that are not necessarily outdated but a little bit older when it comes. Is the literature, and those studies state that autistic traits might be secondary to starvation. What that means is that if an individual, let’s say, is really restricting, pathologically low BMI, and they come into the clinic, they’re not going to get screened for autism, and that, that study states, when you get weight restored, the autism essentially goes away. There have been loads of studies kind of following up this concept that have shown the autistic traits seem to be relatively stable. They don’t seem to change when it comes to weight restoration, it seems it is a, you know, it’s a neuro developmental component indicating that it shouldn’t really go away, according to that line of thinking, when it comes to weight restoration. So it is, it can be quite difficult for an autistic individual to or their families to, let’s say, advocate for their autistic identity when it comes to engaging with services, there are definitely some clinics and services out there that have been phenomenal, such as the peace pathway, and they are a service in London, I think they were founded in King’s College, and they primarily focus on assisting autistic people who suffer with an eating disorder. And there have been loads of different implementations that have been incorporated into their service or adaptations, okay, one of those, let’s say, is the peace menu, and that is a different set of foods that autistic people with an eating disorder can kind of engage with to facilitate recovery while attending to their sensory differences.

17:14

So at the end of the day, it’s a bit tricky,

Speaker 1  17:18

yeah, because I going back to the original topic at hand, my perspective as a researcher is to immediately line up with your perspective there of, oh, yes, we should pick these apart. It’s really important to understand these differences. Then we can understand, oh, how do we support the autism while treating the eating disorder, but at the end of the day, I am coming from a non autistic perspective, and it is important to listen to the collaborators that we’ve had at EDAC stating I’ve had a lot of trouble in services. Small differences actually have a huge impact on on my experience and services and and in recovery, and the fact that sometimes these almost please for different implementations go ignored, that can make it a bit difficult to want to engage and want to digest these two different aspects, yeah, of yourself.

Speaker 2  18:24

So what was the name? The clinic again? What was it? What are they called?

Speaker 1  18:29

Right? The peace pathway. Okay, cool, okay, the peace, okay, yes,

18:36

okay, amazing. Absolutely. It also

Speaker 2  18:39

makes sense to work with them, not against them, but you’re trying to work with them, and you know, that’s what recovery is about. Like, you know otherwise, you know, if you’re working with them, and you know you’re working with that profile, then you know, surely recovery is going to be you know you’re going to get good recovery outcomes. Surely,

Speaker 1  19:00

absolutely, yeah, yeah, completely

Speaker 3  19:05

listening, isn’t it? It’s really listening to what the person is saying and then adapting what is achievable and what’s going to work, as well as including the autism in and the sensory side, and then bringing it all together as a collaborative so it’s going to work. But when, when they’re not being listened to, I

19:26

think that’s where it goes, a bit peaked on

Speaker 1  19:29

Absolutely. Yeah, and it’s not only in services. It can happen in research as well. Yeah. So you know, one thing that I focus on very much and adore as a scientific method is MRI. But you know, we received a bit of caution when it comes to MRI research, because our collaborators are asking, you know, what’s really the purpose of the research is to is it to understand what’s wrong with our brains, or is it to understand what the. Differences are and again, that kind of comes towards challenging the autism versus supporting the autism. So it you know, part of what we do at EDAC is really trying to bridge that gap, again, between lived experience and and clinical services as well as research

Speaker 2  20:22

Yeah, nice. Great and then just touching it now, because I know going back to what a couple of questions from teachers in schools like so like send departments and stuff so obviously we’re touching on obviously sensory issues here so so how how can pupils with autism manage sensitivities to different textures of food. That was one question that we had from a teacher in Pacific,

20:46

absolutely. And

Speaker 1  20:49

prior to answering any questions here, I’d say kudos to all of the faculty members here, asking questions, trying to seek understanding. I think it’s incredibly impressive and it promotes such good discussion when it comes to understanding pupils and trying to work with them as you mentioned not against them necessarily so I would say addressing sensory differences in autistic pupils it can be a bit tricky. So as an example we’re currently having to think about some of the implementations that could reasonably be introduced within University canteens. And I imagine this is even more difficult than, say, primary school settings, but I would state kind of going back to to listening again is the most important thing would be to firstly, listen to your pupils. They likely have very personalised and distinct differences, as one of our autistic collaborators mentioned, she stated that if you’ve met one autistic person you’ve met one autistic person, which really stuck with me, and it’s absolutely true, and that also goes for differences when it comes to preferences in food as well what’s also important to Think about is that these differences might also be due to other secondary factors, such as the potential for a certain food item to cause, let’s say, gastrointestinal distress. So I think it’s important to think about not only the preferences themselves from a neurodevelopmental or a psychological perspective but to also think about are there any physical side effects that pupils are experiencing when they eat let’s say fish or x is there something that’s truly bothering them physically in their gut whatever that might Be I think that’s another important facet to consider so that overarching suggestion would be to kind of listen to and believe pupils when they’re talking about those preferences or those differences when it comes to Food so I think aside from listening to pupils again, the question is kind of thinking about, how can we encourage them to eat as well and maintain a healthy diet? So one thing that we’ve been kind of juggling and grappling with at EDAC is moving away from contemporary or traditional ideas of that healthy food pyramid that perfect ideal as to what we should be putting into our bodies how many times a day how many portions

23:51

I think

23:54

it’s important to

Speaker 1  23:57

try to strike a balance between maintaining that healthy diet but also attending to these preferences as well especially when it comes to a sensory aspect that could some examples that I’m thinking of could perhaps include offering some extra choices about a given food item for example if mashed potatoes are going to be served that day. Perhaps some baked potatoes could be provided as an option on the side. Or if it’s scrambled eggs, that might be a problem, let’s say maybe some hard boiled eggs, at least, giving some sense of options being presented to the pupils I think that does go a long way. I think the most ideal option I could think of, and I’m not necessarily sure how feasible that would be, but to almost incorporate some a salad bar esque presentation when it comes to food, perhaps filling that with some simple ingredients. Ingredients, simple yet healthy ingredients that pupils could engage with. They’d have the option to kind of incorporate different foods, and feel as if they have that flexibility and the freedom to make that decision for themselves when the faculty is also offering healthy options, trying to again, strike that balance between healthy eating and attending to individual preferences and maintaining flexibility which is a

Speaker 3  25:29

really good idea, because my grandson’s um definitely autistic he hasn’t had a diagnosis yet, but what we do like for not we my daughter sorry, she puts out loads of different selections of bits and pieces for breakfast and then what we’ve got as well is like I don’t know if they’re called Munch box but they’re like little squares in a and we what we do is put loads and loads of different foods all in lines I think there’s about 12 little sections that go in it something like that for kids or teenagers to go into school with or even adults actually to go in and have like, a selection, they’ve got choice, would be such a good idea. And I think that’s what works. I call him little man. That’s what works for little man. And he loves the choices. And some days he’ll eat certain foods, and other days he won’t touch it with the barge pole. But I think having choices is so important.

Speaker 1  26:19

I agree. Yeah, yeah, and education as well. You know, there have been some schools and I’ve been reading up on some of the literature here. Some schools have even incorporated kind of almost sensory workshops when it comes to food, explaining why mashed potatoes have that texture. What does that mean, or why some bananas might be a bit mushier than others. Um, having that understanding of how the food works and how it ages can can go a long way as well. I found it really interesting.

Speaker 2  26:52

Okay, so like a banana as it was this longer, you leave it out of it as it ripens. You know, it all tastes different, won’t it? Because it has more fructose in it when a banana goes rougher. So you can

Speaker 1  27:04

really, yeah, and you know that could even allow the opportunity for for a pupil or a child to say, Oh, I don’t like them when they’re mushy like that. I actually like them when they’re a bit greener. And I didn’t know they could be greener, let’s say just that ability to, as you were saying, Becky, explore the choice and have that flexibility in the palm of their hand a bit.

Speaker 2  27:30

Yeah, no, that’s great. I’m just thinking like, first of all, schools need to, you know, be looking at their lunch options for the students, especially in Zen departments and obviously, specialists, you know, autistic, schools they need to make sure that there’s good lunch options available. Otherwise, I guess it’s, you know, allowing the student to bring in their own options, perhaps, if they don’t like the thing absolutely

Speaker 1  27:53

yes, yes. And I think another aspect of kind of engaging and with eating and allowing flexibility during meal times, at times might not even involve the food itself. It could involve the environment. Let’s say, if a lunch hall is very busy, very loud, you’re I’m imagining, and I’ve gotten this, some of these experiences have been kind of sent my way from our collaborators as adults, kind of going back and retroactively, reflecting on their experiences. You know, there have been mentions of, if the environment itself is so hectic and loud and I have that potential to get overwhelmed I’m already directing all of my resources towards managing myself, and I don’t have any extra resources to attend to actually thinking about, Oh, is let’s say is my banana machine today. Oh, can I can I stomach these mashed potatoes. Let’s say so, it might also involve the environment and mitigating factors where possible, maybe allowing another room or another quieter space to eat could be, could be a factor to consider as well.

Speaker 2  29:19

It’s funny you say that I have heard that in schools, find, yeah, the lunch hall, obviously, with the work I do in schools that they find the lunch hall very stressful, you know, they feel really anxious, and they feel like they just can’t that they’re struggling to eat in front of others, and they feel like that, the lunch queue like that, you know, all of that, the whole thing was just quite stressful. And, yeah, and it’s interesting to see that because that I’ve heard that a lot, so Right? And then obviously we talked about Okay, is there a safe place or space or room they can go to where they feel comfortable where they can eat with other peers in a similar position, creating that safe space you know it’s difficult I know schools are trying to do their best but I have heard. A lot say, yeah,

Speaker 1  30:01

yeah, and, and, you know, again, huge kudos to the schools that that are doing their best out there, because the traditional system is difficult and challenging enough as is, and to try to incorporate meaningful adaptations and implementations is, is a fruitful yet challenging effort.

Speaker 2  30:24

Yeah, nice. It’s really difficult. And I know that. I know what we’ve touched on autism here, like sensory issues. Arthur, I’ve loved it. Just another question we just had, obviously, Becky, and I talk a lot about ADHD eating disorders on the podcast. And, yeah, I, you know, got late, diagnosed with it, with a massive emphasis on hyperactivity, and so that, you know, explained a lot for me and the issues that I went through. And, you know, I was offered medication for it, but I actually turned that down, because I know that it suppresses appetite, and having it, having a history of anorexia, I was but no, I can’t do that. I can’t take that. I can’t risk putting that upon myself. And so I’ve managed without it. I try my best that I’ve implemented, tried to implement certain strategies that I feel are working for me. But we’ve had, obviously, a lot of hear this, a lot, and teachers asking about this that you know, and if you can come up comment on this great, um, but students are on ADHD medication, and it suppresses their appetite, and they’re just not eating breakfast or lunch or coming into school, you know, not being able to focus. I mean, you know. And you know, these teachers are trying to, you know, support these students in the best way they can. But do you have any advice around that at all, or any support that you can give for that?

Speaker 1  31:50

Yeah, I mean, I can, I can certainly do my best. It’s an incredibly important question. And of course, any suggestions that I might provide would be from the literature itself. Yeah, you know, from my perspective, it’s very important to say I’m not a clinician. I can’t make any any diagnoses, let’s say, but I can provide suggestions based off literature.

32:16

So I think, first and foremost,

Speaker 1  32:20

outside of the discussion of medication, let’s say, think it might be something that could be really beneficial towards a family system. Let’s say is to try to pick apart pre treatment eating problems and medication induced eating problems, to at least get a sense and be able to keep track of, okay, what has what do I believe the medication has directly caused? Have these problems existed prior to the medication? And more often than not, the parents will say, this seems to be a direct result of the of the medication itself. And so in the case of the medication causing or inhibiting that appetite, let’s say I think it’s important to adapt flexible ways of engaging with food where possible, and almost again deviating from that traditional conceptualisation of what healthy eating might look like, um, three meals at this exact time of day might not cut it for individuals who are receiving medication for ADHD. So one thing that I do know that practitioners recommend is providing the medication after meals. That’s not always going to be an option during lunchtime or in the middle of a school day, let’s say, but that might mean, for instance, that breakfast might become the most important meal of the day, trying to incorporate as many healthy foods, calorie rich foods, as possible, keeping them fuelled during really important school days and moments of learning and formative experiences is really important. It could also mean that there may need to be a bit more of that flexibility when it comes to quote, unquote, power struggles when it comes to food as well. It dietary patterns might not look as ideal as they would without medication in the picture. So another facet that could be important to incorporate would be implementing preferred snacks no calories will always be worse off than some calories provided by a less than ideal snack. Health wise, if crisps are the only thing they can get down during life. Inch time, I’d recommend pack the crisps. And I think a lot of practitioners that at the very least I’ve read in literature, have recommended pack the crisps, at least for now, the calories, the calories are worth it. Another thing that might be important to think about, would be to incorporate late night snacks, so potentially snacks after mealtime. Some practitioners recommend even snacks before bed. Depends on how the pupil or how that child might work with it on a digestion related level, if that, if that might be a bit tough for them to go to sleep right after eating a relatively heavy meal, perhaps incorporate a smoothie, which are always, you know, you can make those very energy rich, healthy options to kind of take as A snack, as a drink before laying down for bed. And if none of those options are really working, I think a final a last resort might be to try to strike a balance between maintaining nutritional levels and the medication dosage, whether that’s lowering the dosage where reasonable or maybe even changing the formulation.

36:30

Perhaps

Speaker 1  36:33

a rapid release might work a lot better than an extended release, which lasts all day. So there are options to consider, I’d say, certainly as a parent, don’t panic. There are options at your disposal, and there are certainly paths that you can consider and take, especially working with your GP or your child’s pediatrician.

37:00

Okay, amazing. Becca. Is anything you want to ask on that as well?

Speaker 3  37:03

I think it’s about just really understanding, getting all the information, all the research, what’s working for the individual, and trying to find a way forward. I think it’s like a bespoke way of working with the young person or the adult, absolutely.

Speaker 1  37:20

And I think that especially comes into play when it comes to neurodivergent individuals and eating more and more practitioners and services are incorporating personalised approaches, and at the very least when it when I’m coming from a research perspective, and it seems that there are more and more publications and more and more articles that are stating this really seems to work. You know, remission or relapse rates are lower. Recovery seems to take a slightly shorter amount of time, or individuals are really engaging with the treatment. So I, I’m certainly a promoter of a personalised approach when it comes to to recovery,

Speaker 3  38:07

really splitting it apart. I think because I’m I’m definitely ADH I’m in the process of getting diagnosed, and I’ve I actually think a lot of my ADHD fueled my eating disorder thinking. And I think once you understand and you can separate both bits out and listen to what the person’s saying of what’s going to work, what’s not going to work, I think then you can then really get recovery.

Speaker 1  38:30

Absolutely, I if, if I could be incredibly honest as well, I’m in the process of getting diagnosed for ADHD, the

38:40

race it’s the racing brain,

Speaker 1  38:43

truly that that fidgeting, that hyperactivity, it’s, it’s unbelievable how pieces start to fall into place when you start recognising, oh, this might be something that I’ve neglected to face in my life. It might be explaining loads of different things about my behaviour, but also my eating. And one thing that I’ve really been thinking about when it comes to disordered eating and a neurodivergent brain, or neurodivergent perspective, is this concept of monotropism? Is this something that either of you have kind of heard before? Have

39:24

no idea what it even means.

Speaker 1  39:29

It’s been such a fascinating rabbit hole of research and and perspective and way of thinking that I think really explains, not only the way neurodivergent individuals might interact with life, but also eating patterns as well. So in a simplistic fashion, because I’m nervous, I might butcher the definition here, but a monotropic mind and monotropism. Itself is a term that’s used to explain an interest based nervous system so that, for example, would manifest as an autistic person having very specialised interests in which a lot of energy and a lot of time goes into pursuing those interests. And there aren’t a lot of things outside of that interest bubble, um, that kind of intrigue them or or something that they might want to engage with. And this concept of monotropism extends beyond the autistic perspective and frame of mind, and also comes into play with those who have ADHD as well. And when I’m thinking about a monotropic mind, or a monotropic perspective, in which you’re really focused on your set basic amount of interests, and you’re likely to have fewer amounts of diverse interests. Let’s say your resources are really allocated towards those three or four or five special things that really call to you in life. Let’s say or a hobby that you’re really invested in, food might not be one of those interests, and for a lot of people with ARFID, and with a huge overlap when it comes to autism and ARFID, again, this is a very underdeveloped field of research, but I think monotropism really comes into Play here, where, especially with this lack of interest driver, when it comes to people with ARFID, I mean, it’s a very fascinating concept that doesn’t really happen in any other animal, aside from human beings, a lack of interest in food, when for the majority of other species and animals out In the world, it’s their primary, one of their primary drivers. So this concept of a of limited yet very powerful sets of interest, I think, does come into play when it comes to eating and engaging with food.

42:20

Reckon, that’s another podcast

42:23

you want to get. No,

Speaker 3  42:26

I’m just sitting here thinking, because that interesting food really makes sense. Because sometimes, I mean, I’m really good, good with food now, but there is times where I just sit there and I look at my food and I just think, I can’t be bothered. I’m bored of looking at it, and I can’t be asked to eat it, right? And that, that is exactly what you’re talking about. I literally, I can cook a whole meal, and I can sit there and go, No,

Speaker 1  42:53

right? Just, you know, there, there are three other things I can list off the top of my head that I’d rather do right now, yeah,

Speaker 3  42:59

and I know that I’ve got to eat that because that’s fuel, but I really there’s nothing exciting. I I’m I’m over it, and it hasn’t even gone in my mouth. And I think we don’t talk about this stuff, and like, I know I’m not the only person who gets has that feeling, because I’ve spoken with my clients. And then sometimes it’s about finding what’s going to work. I will tend to have like a heel shake, if that, if I get to that point, and I know that I’m looking at it thinking, Oh, I’ve got better things to do in my life now than eat this. I will make sure that I have a complex meal drink, and I know this moment will pass. It’s only temporary, and I will go off and then go and amuse myself with something else that I’m going to hyper focus on, because my hyper focus is not that meal sitting in front of me, and I know that I’ll eat the same food over and over again until the like cottage cheese. Can’t even touch it now, jacket potatoes, I love, but mashed potatoes, as soon as you said that, like traumatised on it. And I think maybe come we could, if you’re happy, to come back do a podcast on it, because this is never spoken about, absolutely,

Speaker 1  44:05

and I think, I mean, I’d certainly be more than happy to jump on board. But I I also want to give a due diligence towards Fergus Murray. You know, he’s a huge proponent of monotropism. He’s an autistic individual. He’s really coined the term, and I believe one of his family members assisted in, you know, developing the term. They’ve been on our on our EDAC podcast Table Talk. So I’d really recommend that you reach out to them. They’re an absolute wealth of knowledge when it comes to monotropism,

Speaker 3  44:44

really interesting. I just thought it was because I was bored, like, right? I thought it was just part of the ADHD. I thought of just bored. But, like, it’s a it’s a thing.

Speaker 1  44:59

But. Well, imagine the pupils that are also kind of grappling with that as well during childhood. I think there’s so much power that comes from knowledge.

Speaker 2  45:08

Oh, yeah, and I agree with that, but surely having someone been done as ADHD also suffered with with really bad burnout through just not resting and not eating properly, I now know that if I want to feel good, like, be nourished, like, be on top of my game, I keep saying to myself, I know now that I need to eat regularly in order to feel that. Otherwise, if I don’t, I’m not gonna be able to do my sport like I love my sport because of the hyperactivity. You know, I want to be able to do that, you know, and I have to do that, and I know that. I know that makes me feel good. So I know I need to feel myself. And if I don’t Well, my performance goes downhill, my mood goes downhill, my hormones go out of whack. That that really helps me. I kind of I have to eat my structured meals to help me stay on track, and I think that, I think that could help other people as well.

Speaker 1  46:05

I think you’re right on the money honestly, because I kind of incorporate a similar approach when it comes to ARFID as well. Ironically, I need to eat the food to do the ARFID research. Yeah. Which feels quite silly, but it is true, and so I take a similar approach. Of I need the fuel. I need the brain power. I use my brain for my job. I need to make sure it’s nourished. So kind of using the food to facilitate the special interests can be such an interesting way to explore recovery, in some sense, and

Speaker 3  46:43

having a backup plan, a bit like with the heel shakes when I I know that moment of me being bored of what’s in front of me will pass, because I love it. But when I’m in that zone, I know you have to have that plan A, and you’ve got to have that plan B, and not shaming yourself or beating yourself up because a bit like Jen, me and Jen are quite similar. We both don’t sit still, and we’re both like this nervous energy is got to be fuelled, otherwise, I know I’m miserable. Mm, and if you don’t nourish your belly, you can’t nourish your soul. As I say, Absolutely,

47:17

absolutely,

Speaker 2  47:21

I agree. I think that’s a great way to end the podcast. I think, um, Michelle, I might have to get you back on. Like, we try and keep this podcast short so people can listen to them on break. But oh, my God, you’ve been absolutely amazing, like, such amazing talk. And I hope this helps a lot of people listening to this. And thank you so much for coming on. I really appreciate it.

Speaker 1  47:43

Thank you so much more than happy to touch base again for a future part two, fascinating discussion. Always happy, and it’s always happy to have these conversations, and it’s always such a pleasure to see it take form in some way

Speaker 3  47:58

that’s been amazing. Thank you so much for listening to the JenUp podcast. Please subscribe and share this podcast so others can benefit. You can find us on Facebook, Instagram, at JenUp and Jenny’s website, at www.jenup.com if you visit the website and you find lots of different resources available there, please like, subscribe and share,

48:21

thanks, guys. Cheers to.

How to get help?

Jenny Tomei is a Nutritional Therapist and Eating Disorder coach. See all her credentials on her About Jen page and then should you need help then make contact with her today. Your road to recovery can start now!