Warning: the article below contains sensitive information and images around eating disorders.
In March 2024, Josh Mazzara’s organs nearly shut down. A few months earlier, his health saga began when he couldn’t find anything to eat in an airport.
“There were like 10 different restaurants and cafes,” said his mum, Yvonne. “But he couldn’t find anything. So it was either a sandwich that was cold in the fridge that he’s not going to have — he doesn’t know how long it’s been there for, he doesn’t want it toasted — then he doesn’t want that cafe because of the way it looks; he doesn’t want that because of the people that are serving it; I’m like, there’s nothing that I can do in the middle of the airport to buy him what he wants. I think he wanted a steak that day. But, it was impossible for it to happen because you just can’t miraculously make it appear.”
Josh wasn’t just being fussy, and it wasn’t a scene that Yvonne and Josh thought they’d find themselves in.
It started back in July of 2023. Josh Mazzara began experiencing pain in his upper abdomen. After several appointments and an endoscopy, doctors said it was inflammation of the stomach and told him to avoid acidic foods that could potentially inflame his stomach. To help with this, Josh began seeing a dietician who provided a variety of food options but nothing was helping.
It was at this point, three months after the initial pain had begun, that Josh began displaying symptoms of anorexia.
Eventually, Josh would be diagnosed with ARFID (Avoidant/Restrictive Food Intake Disorder). ARFID is a recent diagnosis term, used to differentiate between other eating disorders, such as anorexia and bulimia. One of the main points of difference between ARFID and other eating disorders is that individuals are often less worried about their looks or body image but instead, have a true fear around foods. Registered nutritionist, Hannah Zweck, says that ARFID is a growing issue among young Australians.
“From a nutritionist point of view, usually it’s a fear of being able to try new foods because of taste, because of texture, it’s because of a variety of different sensory things. They’ve got, I wouldn’t define it as an irrational fear, but they’re just too scared because it’s kind of like the unknown.”
This fear of food manifests itself and becomes dangerous when people avoid certain foods and thus restrict their nutritional intake. While the need to avoid food for sensory reasons is a physical manifestation of the illness, it also afflicts the mind and an individual’s mental health.
“It’s not a kid who sits there and screams at their plate because they’re scared of seeing something on there. It’s actually being able to sit down and understand the reasons why kids feel that way and I think that’s because we’re now realising the relationship with the mind and body is such an important connection.I think with that has come an understanding of people’s relationship with food and being able to differ from ARFID to anorexia or bulimia or other kind of eating disorders,” Ms Zweck said.
For Josh, ARFID looked like a fear of foods that could potentially inflame his stomach. Accordingly, he would avoid most foods. Meals needed to occur at set times. He couldn’t speak while eating for fear of choking. Meals with groups made him feel guilt and shame.
“I’d get nervous. Even like when I have stuff at work, like if they had barbecues or anything, I’d feel scared straight away before lunch. Because I don’t want to have it. And I’d feel bad for them that I can’t have it because I feel like there’s something wrong with me,” Josh said.
Despite seeing a dietician, Josh was losing a kilogram to a kilogram and a half each week. The dietician gave him Sustagen, a dietary supplement drink, to try and help him put on weight.
“I didn’t like it but I kept having it. Everyone was pushing me to have it.”
Photos of Josh during his period of weight loss
This illness didn’t just affect Josh but also his family. His mother, Yvonne, quickly became extremely worried about what was happening to her son.
“Going through this, I’ve never been through it before. I don’t know how to deal with it. I don’t know what to say. I said ‘I’ll do exercise if you drink the Sustagen’; I was following him around with a spoon of Nutella.
“I just wanted him to eat something. That’s what I wanted.”
This wasn’t a few weeks battling, either. Rather, the family faced months of problems. Yvonne even called the ambulance to their home twice because of the pain that Josh was in. There were visits to cardiologists to check that his heart was still functioning correctly. Not only was day-to-day life hard for Josh but he quickly found it difficult to derive enjoyment from anything.
“I felt like nothing could make me happy. I didn’t want to talk to anyone because I felt so uncomfortable in how I was. I didn’t want people to look at me because of how I looked. Even back when we were on holidays, I didn’t enjoy it because I was so stressed and in pain.”
“I felt bad because when we were on holidays, we’d get out of the airport and I couldn’t even lift my luggage bags. Because I was that weak. They were pretty heavy. And I was like, ‘Oh mum, dad, can you take my luggage? I can’t go over the steps’, I felt bad for them. Because they were doing everything for me.”
“The doctor, our GP, referred us to the eating disorder clinic in Wollongong, which is in the Illawarra Mental Health Unit.”
This initial visit to the clinic couldn’t have been better timed. At 185 centimetres tall, Josh weighed in at 50.8 kilograms. Doctors said that if he lost three more kilograms, his organs would begin shutting down. Yvonne was determined to stop this.
“They said to him that he was in a position that he could actually be hospitalised with a feeding tube. I didn’t want him to go to the hospital. I said to myself that I’m gonna fight for everything that I can do at home with him.”
Happily, this was a turning point for Josh. Working with the clinic, he began to gain weight and develop small, achievable goals.
“I set my own goals each week. So, I said ‘I’m going to try different desserts’. So now I’m going to go there next week and be like, ‘oh yeah that was okay, I can keep having that’. And then once I kept having them, I felt more comfortable with what I could have. That made me really happy.”
Josh in recovery
However, the ultimately positive outcome for Josh isn’t an outcome experienced by many. Eating disorders have one of the highest mortality rates of any mental illness. With around four per cent of the Australian population being affected by an eating disorder, it’s a prevalent issue that needs more attention.
Part of Josh’s life now is looking at what can be done to help others. Working with NSW Health, he has been part of a promotional video that encourages people to reach out for help. He’s spoken with the Secretary of NSW Health to commend the treatment he received at the Eating Disorder Clinic. His main message is that of reaching out.
“Just get help straight away. So that you don’t have to recover as much. Or suffer as much.”
Now, Josh and his family are planning a trip to Europe next year to celebrate his 21st. Josh is no longer worried about finding something to eat in the airport.