Today I wanted to describe more in detail the stages of ARFID recovery, continuing on from my last post. The stages seem to be roughly as follows:

1. Begin nutritional and weight stabilisation/restoration – risk assessment, start increasing food, manage any deficiencies with supplements, stop activity or any dangerous life limiting behaviours. Assess goals of treatment – what are the main elements of the ARFID (are they related to limited diet, to unhealthy routines, to executive function).
2. Once weight gain is regular, if necessary, and the goals are established, educating self on healthy habits around food and activity, as well as autism and self management techniques, AS WELL AS distress tolerance and anxiety management. This is all very personalised, and down to what works for you.
3. Trialling, testing, and regularly but gradually changing.
4. Relapse prevention – I guess the final stage is all about continually practicing and doing the ‘right thing’ and making the changes your new routine and part of your new lifestyle, so you can move on with life! It focuses more on talking about how you feel and less about food specifics.

I think I often skip some of the hard bits, and I need to focus right now on stages 1 and 2. Taking time for those. I have to be strict about what HAS to change, and also kind to myself around giving myself space to manage the distress and anxiety. I need to break down into small manageable steps what I need to cope with the big changes, and then gradually build new positive habits.
Working with my outpatient team now they’ve finally, a month after leaving the ward, got stuff together, from today I have cut out all activity and moved to chair/bed rest at home, am having more intensive monitoring, and am going to take a step back from other activities to focus on recovery. I’ve only stopped exercise once before outside of hospital, and I did not prioritise managing or building healthy positive habits or routines, in a staged way, and making lasting changes. This time will be different.

(Research/study/scoping review link) https://onlinelibrary.wiley.com/doi/full/10.1002/eat.24073 and https://www.oslo-universitetssykehus.no/4a9393/contentassets/eff5346b78e14cc48a6b46781477134d/dokumenter/towards-an-evidence-based-out-patient-care-pathway—arfid.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC9100178/#sec5-nutrients-14-01739

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