The case of Kojo with sensory hypersensitivity 

 

Kojo is a 33-year-old man who ate only nine types of food. Salty crunchy crackers, French fries, Doritos, peanuts, peanut butter, ice cream, oranges and spaghetti with tomato sauce. But most of the time, just fries and crackers. Even these few foods always had to be prepared the same way to be able to eat them. For example, he would strain the tomato sauce so that he wouldn't accidentally leave a piece of vegetable in it. It was difficult for him to explain why he would not eat anything else. It was like a mental block. Ever since he could remember, it had always been like this, food with the wrong texture, taste and appearance just upset him. As in many cases, what happened was that while he wasn't getting enough nutrients from his restricted diet, he was also getting enough calories. Her body mass index fell into the overweight range and her blood sugar levels rose, putting her at risk of type 2 diabetes. Although he was successful in his work, his social life was greatly affected by ARFID. When he visited his family in Africa, he often had chips sent in advance to avoid starvation. He also often cancelled social events that included meals. When he did attend, he would tell his friends that he was not hungry because he had already eaten. He felt guilty for lying, but also justified it because he had had many bad experiences in the past. As a child, he was often teased by his peers when he could not eat a new food.Like Kojo, people with ARFID with sensory sensitivities eat very few meals, usually limiting themselves to pre-made biscuits and dairy products, and eating either no or very little meat, vegetables, fruit and protein. 

 

Fear of negative consequences 

The case of Astrid illustrates this type. Astrid is a 24-year-old woman who used to have no problems with eating. However, a few years ago, after eating a bowl of pasta, seemingly without any warning, she became ill. She went to the doctor, who diagnosed her with gluten sensitivity. For a while the gluten-free diet worked, she didn't feel nauseous or vomit. However, after a few occasional bouts of eating food containing gluten, her symptoms returned with renewed intensity. She felt nauseous and vomited every time she ate, even when no gluten was in the food. In a desperate attempt to avoid vomiting, Astrid began to avoid any food that was associated with even the slightest nausea. Over the next few months, she eliminated almost all foods from her diet and began to obsessively read labels describing the ingredients of foods. He ate only the food he cooked herself and did not go to any social events. She ate worryingly small portions. Although these precautions prevented the recurrence of sickness, they made Astrid abnormally thin and led to a dangerously low heart rate.The precautions she took made her situation worse in the long run and led to an increasingly restricted diet. 

 

The case of Penny, who is not interested in food and eating

 

Penny sought help for her alarmingly low weight at the age of 25. Her poor physical condition was in stark contrast to the way she was leading her life. She loved her job, lived with her boyfriend and was supported by a loving family. She said that she was not usually very interested in eating and did not usually feel hungry. She occasionally felt hungry but did not feel the need to stop. She usually only ate a small portion of food at lunchtime and in the evening, always skipping breakfast. She had been thin all her life, but because of the delicate build of her brothers and sisters, no one ever thought this would be a problem. Although she ate very small portions, her diet was relatively varied: she ate pasta, bread, all kinds of meat, cheese and many vegetables. She avoided fruit, fish and dairy products.  She arranged her life in such a way that her eating habits had as little influence on it as possible. At work, she ate lunch at her own desk and often ate with friends and family, but as she always ate little, no one picked on her. People like Penny cannot eat enough food. Many people forget to eat, and when they start to eat they feel full too soon. For many, eating seems more like a task than an enjoyable experience. Most are underweight. Over time, chronically low calorie intake dulls hunger and leads to feelings of fullness too quickly, which makes people like Penny feel full too quickly, even if they haven't eaten enough.