Long ago, many mothers may have tried to coax their picky eaters to dinner with misguided reminders of starving children. Perhaps they let them imitate farm animals. But, modern parents have a scarier prompt.

A British youth has permanent vision loss, hearing loss, and weak bones after years of eating only select types of junk food. The ‘youngster’s doctors eventually diagnosed him with a relatively newly defined eating syndrome called avoidant-restrictive food intake disorder. They account the ‘adolescent’s case this week in the Annals of Internal Medicine.

The case is an erratic one in developed countries, which have a ready supply of nutritious foods. The progressive symptoms initially stumped the teen’s doctors in Bristol. But they caution another medical doctor in their case report. Such damage from poor nutrition is potentially reversible—if it gets caught early—and even people with standard weights may get stressed with eating disorders.

Mystifying deterioration

The first clue of the ‘youth’s troubles came when the boy was 14 years old. He showed up to his family specialist complaining of tiredness. Other than getting described as a “fussy eater,” the teen was healthy and not taking any medications. Tests designated that he had a type of anemia that makes red blood cells remarkably large, as well as low vitamin B12 levels. His doctor treated him with vitamin B12 doses and dietary advice.

But the ‘teen’s condition deteriorated. Just a year later, he returned to medics with unexplained earshot loss. Shortly after, he advanced problems with his vision. Over the next two years, his seeing capability continued to worsen. By age 17, his visual acuteness was 20/200 in his two eyes. It means he would need to get 20 feet away to see something someone with normal vision would see sharply from 200 feet away.

Scans discovered no lacerations on his optic nerves. Also, genetic tests were negative for hereditary explanations for blindness. His blood tests were mostly standard except that his blood cells got inflamed.

Evidence Linking Unhealthy Diet and Macular Degeneration

Although nutritional deficiencies affect about 2 billion people around the world, nutritional optic neuropathy is relatively rare, according to the authors. The cause of glaucoma is by malabsorption of nutrients, certain drugs, or poor diet combined with alcohol abuse or smoking. The condition is possibly reversible if caught early; if left untreated, it leads to permanent blindness.

The link between nutrition and glaucoma eye disorder has gotten established in the existing literature. A study published in July 2014 found that an unhealthy diet seemed to increase the risk of age-related macular degeneration a condition that leads to blurry vision. Researchers compared people who ate a higher amount of red meat, processed meat, French fries, refined grains, and eggs to people who ate a plant-based diet high in fruits, vegetables, legumes, whole grains, and seafood.

The lower prevalence of macular degeneration in the healthy-eating group led the authors to get a conclusion. “Diet plays an essential role in the growth of AMD and that the prevention of AMD may be achievable through dietary intervention.”

A New Diagnosis: Avoidant-Restrictive Food Intake Disorder

Surprisingly, his nerve damage was not reversible. Even after he got treated with vitamin B12, according to Elizabeth Bradley, MD. The medical director was of the Cleveland ‘Clinic’s center for functional medicine in Ohio, who was not a writer of the paper. Dr. Bradley has “never seen this deficiency impact glaucoma eyesight before.” She says that she had patients with anorexia. The patients have developed neuropathy of the legs that was irreversible.

Once doctors discovered the degree of these deficiencies, the boy was prescribed nutritional supplements and referred to mental health services for his eating disorder. Although his vision stabilized, his eyesight did not improve.

The teen patient in the UK case study denied drinking alcohol, smoking, or using drugs — all of which could increase his risk for nutritional optic neuropathy. But his diet was severely limited nutritionally. The young man told doctors that beginning in elementary school; he would not eat foods with certain textures. His daily diet consisted of fries from a local fish-and-chip shop, as well as Pringles, white bread, and processed ham slices and sausage.

This type of self-imposed food restriction can signal an eating disorder known as avoidant restrictive food intake disorder, formerly called selective eating disorder. People with ARFID may avoid foods with certain textures or smells or be concerned about the consequences of eating, such as choking or even death. Weight loss is common, but people with ARFID can be in the healthy weight range as well, as was the case with the teen in England. The eating disorder can lead to serious medical consequences, including death by cardiac arrest. Even people who eat fruits and vegetables ‘don’t always get the nutrients they need because of the low quality of the soil.

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