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By Sept. 6, 2023
For 27 years, I tried to make myself eat vegetables. Last fall, I ate my first salad.
Since I was 2 years old, I had an eating disorder known as ARFID — avoidant/restrictive food intake disorder. After an infant ear surgery, I mysteriously could only tolerate bread and cheese. Every other food made me gag. A ripe orange, for example, smelled like rotting flesh.
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ARFID often presents as an extreme “picky eating” in both children and the adults who try to hide their disorder. Because of extensive exposure therapy throughout my childhood, I understood my diagnosis and feared how it would affect my health as I aged. But no matter what I tried, my ARFID wouldn’t go away. Many adults with ARFID learn to cope with the anxiety and fear they associate with food, but a cure seems off the menu.
Research focuses mostly on children, with one study estimating that it affects up to 3.2% of people between 8 and 13 years old. Data on ARFID beyond adolescence is incomplete, so adults are left to navigate limited resources that lump many varieties of the condition — both in terms of what they eat can and how they got it — under the same name. Some patients experience ARFID alongside an autism or obsessive compulsive disorder (OCD) diagnosis. For others, ARFID stems from a traumatic experience that forever changes their relationship with food.
In my case, after an ear surgery, I began to feel disgusted by most edible tastes, smells, and textures. I don’t know whether this was a toddler coping mechanism, a developmental hurdle I got stuck in, or if a surgeon accessing my Eustachian tubes through my mouth literally changed my senses. But my family witnessed my diet and life change.
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My ARFID grew with me into my adulthood. I patient-hopped between in-network anxiety-focused therapists and out-of-network ARFID specialists to process my emotions about food, to alleviate social anxiety from years of missing meals with family and friends, and to practice exposure therapy. I tried prescription drugs for anxiety and OCD. In spring 2022, I found a wonderful ARFID specialist who helped me try 10 new foods — a piece of basil on a pizza, a new flavor of yogurt, miso broth. I did it, but I experienced immense distress and struggled to integrate these foods into my diet. An eating disorder isn’t pickiness or preference — I desperately wanted to change.
I attribute my treatment struggles to unrealistic expectations. I’ve learned that for adults with my form of ARFID, too many treatments help us incrementally cope without curing the root issue. We learn skills to tolerate our condition instead of healing it. For me, that changed last summer.
In July 2022, settled in bed and half-asleep, I watched “How to Change Your Mind” on Netflix, a documentary based on Michael Pollan’s book of the same name. I learned researchers at universities like Johns Hopkins and Yale administer psilocybin-containing mushrooms to help patients cure their anxiety, depression, and eating disorders like anorexia. My eyes widened. My husband and I sat up, looked at each other, and simultaneously said: “ARFID?”
But overlooked and misunderstood, ARFID isn’t yet studied in clinical trials for psychedelic-assisted therapy. In fact, it wasn’t until 2013 that ARFID even received clinical recognition and its name.
The documentary piqued my curiosity and hope. For six weeks I read clinical trial protocols, first-person trip reports on Reddit (none referenced ARFID), and Indigenous histories of psychedelic healing ceremonies. For every positive story, I sought to balance my perspective — I read The Challenging Psychedelic Experiences Project and assessed my personal risks. This self-guided research contributed to my own protocol: I decided how I’d replicate a therapeutic setting and made a plan to try new foods at every post-trip meal.
In August, I self-administered a therapeutic dose of psilocybin mushrooms and intentionally ate a dozen new-to-me foods during my psychedelic trip. I didn’t get answers about how my eating disorder was triggered or why it had remained with me — but my brain invented a fuzzy purple monster named “ARFID,” who I politely asked to leave me alone. After it agreed and we tearfully said goodbye, I opened my eyes and asked my husband to cut me a nectarine. The day before, it smelled like a sun-baked dumpster. After ARFID’s departure, it was delicious. As ridiculous as this may sound, it was through this process that I healed my lifelong eating disorder. I tried an untested DIY therapy, and it worked.
Nearly a year later, I’m the most adventurous eater I know. I go days without eating my former bread and cheese meal staples, now replaced with Caesar salads, passionfruit, sushi, and curry-soaked tofu. Six cheese pizzas — purchased before my trip — rest frostbitten in the back of my freezer.
It makes sense that I was drawn to nonaddictive psychedelics as a last-ditch effort to cure myself. Desperate patients — including me — are more willing to trust a wider variety of sources and try almost anything. Sometimes these are sound wellness solutions. But sometimes these are snake oil, like working with unskilled health coaches or taking supplements with hidden ingredients. In many cases, these options are presented to consumers in much the same way — a celebrity endorsement, a persuasive TikTok, a best-selling self-help book — making it particularly difficult to decipher between them.
On the sub-Reddit community r/ARFID, commenters have shared their many attempts at treatment: They’ve tried ketamine therapy (a more-available yet addictive substance used for assisted therapy), THC (either self-administered or prescribed), and cognitive behavioral therapy (CBT) with mixed results. The group’s “Treatment” tag is full of posts on the potential of hypnotherapy, residential support, and exposure therapy, but few long-term transformative success stories.
So many contemporary psychedelic use cases come in pursuit of a cure when there are no other options. It’s possible our friends with treatment-resistant depression are wise to consider psilocybin treatment — new research found this can be “effective for up to a year for most patients.” Another study from Johns Hopkins correlates psychedelic therapy with lower opioid use: “Results suggest the potential that psychedelics cause reductions in problematic substance use.” And smoking cessation studies with psilocybin yield some of the best outcomes of all: Since the advent of the psychedelic LSD in the 1950s, “small, open-label pilot studies have shown promising success rates for both tobacco and alcohol addiction.” While these largely-illegal treatments still come with their own risks — like the potential to trigger psychosis or negatively interact with some medications — they also offer the rare possibility of relief.
Let me be clear: I’m not a physician or scientist. I cannot ethically recommend others try this for their ARFID. We just don’t have enough research.
But for me, the risks psychedelics could pose felt much less concerning than the malnutrition and distress I was already living with.
Patients with seemingly untreatable conditions are desperate, but also creative and full of hope. Science and the law are just catching up. ARFID is a complex and poorly understood condition. So self-guided research and experimentation — despite its dangers — are leading to breakthroughs in treatment where traditional therapies have failed. Until we have better treatments, our ingenuity and distress will lead us to hidden Reddit posts and how-to guides emailed between friends.
For lunch I pan-fried cabbage with chili crisp and ate it over a bed of tofu and brown rice. Tonight I’ll eat a salad with my family.
Danielle Meinert is a writer and journalist who loves food. She lives with her husband and adopted mini poodles in Atlanta, Georgia.
nutrition
psychedelics
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