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Avoidant / Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID)
 

ARFID was introduced as a new diagnostic category in the recently published DSM-V.  The ARFID diagnosis describes individuals whose symptoms do not match the criteria for traditional eating disorder diagnoses, but who, nonetheless, experience clinically significant struggles with eating and food.  Symptoms of ARFID typically show up in infancy or childhood, but they may also present or persist into adulthood.

Individuals who meet the criteria for ARFID have developed some type of problem with eating (or for very young children, a problem with feeding). As a result of the eating problem, the person isn’t able to take in adequate calories or nutrition through their diet. There are many types of eating problems that might warrant an ARFID diagnosis  – difficulty digesting certain foods, avoiding certain colors or textures of food, eating only very small portions, having no appetite, or being afraid to eat after a frightening episode of choking or vomiting.

Because the person with ARFID isn’t able to get enough nutrition through their diet, they may end up losing weight. Or, younger kids with ARFID might not lose weight, but rather may not gain weight or grow as expected. Other people might need supplements  to get adequate nutrition and calories. And most of all, individuals with ARFID may have problems at school or work because of their eating problems – such as avoiding work lunches, not getting schoolwork done because of the time it takes to eat, or even avoiding seeing friends or family at social events where food is present. It is possible that some individuals with ARFID may go on to develop another eating disorder such as anorexia or bulimia.

Diagnostic Criteria for ARFID (Based on the DSM-V)

1. An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

  • Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
  • Significant nutritional deficiency.
  • Dependence on enteral feeding or oral nutritional supplements.
  • Marked interference with psychosocial functioning.

2. The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.

3. The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced [body image].

4. The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.

More on ARFID...

If you think you or your child has some of the symptoms discussed above, or if you want to find out more about ARFID, please read What Is ARFID? on our blog.  This post discusses the diagnosis in more detail, including examples of ARFID symptoms, what ARFID is not, and the implications of this new diagnostic category.

As always, if you would like to speak to a professional about treatment for ARFID or any other eating disorder, please call us at (410) 938-5252 or email EatingDisorderInfo@Sheppardpratt.org.

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