A 12-year-old girl who stopped eating due to a rare but extreme food phobia will be able to have her first Christmas dinner in five years.
Ella Witrock, of Pennsylvania, developed a medical condition that made her petrified of choking or throwing up her meals and would only eat tiny bits of food.
She even shunned her favorites like mac and cheese and pizza.
Ella had been in and out of hospitals since she was seven and was more than 40 pounds underweight, with a body mass index (BMI) of just 12.5. Anything under 18.5 is considered underweight.
Christmas was an especially traumatic time of year for the family, as they wouldn’t be able to enjoy a feast together or savor holiday classics like turkey and pumpkin pie.
But this year, Ella has started to recover, and her family is excited to have a ‘normal’ Christmas with turkey and all the trimmings.
Ella Witrock, a 12-year-old from Pennsylvania, developed Avoidant Restrictive Food Intake Disorder (ARFID) when she was seven
Within a few weeks of starting therapy, Ella overcame malnutrition and now eats about 2,800 to 3,200 calories a day
Carolyn Witrock, Ella’s mother, said: ‘We have plans for Christmas to celebrate in a restaurant with family. We are so excited.’
Ella has Avoidant Restrictive Food Intake Disorder (ARFID), a new but rising eating disorder affecting as many as 16,000 Americans. It causes patients to eat only very restrictive or small amounts of food, depriving them of vital nutrients.
Though the exact cause is unclear, it typically stems from having other gastrointestinal disorders or suffering a traumatic event that involved vomiting or choking.
It typically occurs in children, though adults can have the condition as well. The National Eating Disorders Association estimates that up to five percent of Americans have it.
WHAT IS AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER (ARFID)?
ARFID is the second-most common eating disorder in children under 12 years old.
It is categorized as extreme picky eating.
The common signs are food refusal, anxiety, being underweight, or growing slowly.
A child may have a short list of acceptable foods and skip one or more entire food groups.
This can lead to weight loss, nutrient deficiencies, growth disturbances, and social anxiety.
The onset of ARFID may be due to a form of food-related trauma, including a negative experience with eating, such as choking, gagging or vomiting.
Ella’s ordeal began when she was seven years old and caught a virus that caused her to go into septic shock – the body’s extreme reaction to an infection. This triggered a chain reaction and led her to be hospitalized with organ failure.
Though she recovered, the ordeal made her afraid of throwing up, which contributed to her developing ARFID.
‘The experience really affected her. Whenever she got sick, she would throw up a lot and developed a total fear of being full,’ Ms Witrock said.
‘Ella thought that if she became full, the probability of her throwing up increased, and that prompted her to eat less over time.’
Ella eventually eliminated foods from her diet that she used to love, including mac and cheese and pizza.
Her family had to pull her out of school because she could not handle being in the lunchroom.
When Ms Witrock took some time off work in August, she noticed that Ella would shake uncontrollably at night. At 4ft11, she was just 62 pounds.
‘That was very, very concerning,’ Ms Witrock said. ‘She was getting severely malnourished. We couldn’t say “get sick” or “throw up” around her. She was so afraid of it – even just the word.’
Ms Witrock reached out to Focused Approach, an organization that specializes in disorders like ARFID.
Dena Kelly, a licensed professional counselor and founder of the organization, told the family that Ella had severe ARFID and recommended therapy.
‘ARFID is often talked about in the same breath as anorexia and bulimia, but it can be dangerous to be treated in the same way,’ Ms Kelly said.
‘ARFID requires a specialized feeding therapist to improve symptoms for the child as well as facilitate behavior change for the entire family.’
‘It is important for medical professionals to recognize the difference and help the child/family access the appropriate care.’
Ms Kelly gave Ella choices of foods and implemented a reward system. Every time she ate, she would receive a heart, and once she collected enough hearts, she could use them to get a new doll.
Within a few weeks, Ella went from being hospitalized to eating about 2,800 to 3,200 calories a day and trying new foods, including holiday favorites like cookies and strawberries, as well as vegetables.
‘The last four years have been a challenge with the holidays because of Ella’s ARFID and anxiety, so we have not been able to go out to a restaurant or enjoy a normal holiday with food,’ Ella’s mother, Carolyn (pictured here with Ella), said. ‘We have plans for Christmas to celebrate in a restaurant with family. We are so excited’
‘Her anxiety went down tremendously once we got past the initial phase of malnutrition,’ Ms Witrock said.
‘She was so motivated that she started to try foods again – and once she saw she wasn’t getting sick, she was able to continue to eat foods again and more of them.’
‘She’s eating things that my husband and I could never get her to eat, like broccoli and cauliflower. She went back to eating the food she originally enjoyed, like mac and cheese, too.’
‘We went to a restaurant for Thanksgiving, and now we are so excited to do things we’ve not been able to do in years this holiday season.’
This leads to patients only being able to eat small amounts of select foods and not getting enough vitamins, minerals, and calories.
The condition typically develops in childhood, though it can occur at any age. According to the National Eating Disorders Association, it affects just 0.5 to five percent of children and adults in the US.
ARFID can lead to significant weight loss, decreased appetite, stomach cramps, slowed heart rate, fatigue, weakened immune system, and patients eating fewer and fewer types of foods over time.
