From the Guidelines
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by highly selective eating habits, disturbed eating patterns, or both, without concerns about body weight or shape, as defined by the DSM-5 diagnostic criteria 1.
Key Characteristics of ARFID
- A feeding problem that results in at least one of the following: significant weight loss or failure to meet the expected weight or height gain in children, significant nutritional deficiency, dependence on nonfood nutrition, or marked interference with psychosocial functioning
- The problem is not attributable to food availability or cultural ideas
- The problem is not attributable to AN, and there is no distortion in body image; and not attributable to another condition, medical or mental
Treatment Approach
Treatment typically involves a multidisciplinary approach including:
- Cognitive-behavioral therapy
- Exposure therapy to feared foods
- Nutritional rehabilitation
- Family-based treatment For severe cases, hospitalization may be necessary to address malnutrition, as recommended by the American Psychiatric Association practice guideline for the treatment of patients with eating disorders 1.
Importance of Early Intervention
ARFID can affect people of all ages but is commonly diagnosed in children and adolescents. The disorder stems from complex interactions between biological factors (such as sensory sensitivities), psychological factors (anxiety, trauma), and environmental influences. Early intervention is important as ARFID can lead to serious health complications if left untreated.
Diagnosis and Assessment
Diagnosis of ARFID should be based on a comprehensive assessment, including medical, psychiatric, psychological, and nutritional evaluations, as outlined in the American Psychiatric Association practice guideline 1.
From the Research
Definition and Characteristics of Avoidant/Restrictive Food Intake Disorder (ARFID)
- Avoidant/Restrictive Food Intake Disorder (ARFID) is defined as a failure to meet nutritional needs leading to low weight, nutritional deficiency, dependence on supplemental feedings, and/or psychosocial impairment 2.
- ARFID is a distinct clinical entity that is characterized by avoidant or restrictive eating behaviors that are not motivated by a body image disturbance or a desire to be thinner 3.
- The disorder involves a complex and heterogeneous etiology, and its characteristics and medical and psychiatric comorbidities are distinct from other eating disorders such as anorexia nervosa and bulimia nervosa 4.
Diagnostic Criteria and Assessment
- The DSM-5 diagnostic criteria for ARFID include a lack of interest in eating, avoidance based on sensory characteristics of food, and/or concern about aversive consequences of eating 5.
- Several studies have been published on the development of new assessment measures for ARFID, including self-report measures and clinical interviews 6.
- However, there is still a need for further research on the diagnosis and assessment of ARFID, including the development of more effective screening tools and treatment interventions 3.
Treatment and Management
- Cognitive-behavioral therapy is one possible treatment approach for ARFID, although more research is needed to develop evidence-based treatments 2.
- Other treatment approaches, such as family-based therapy and nutrition counseling, may also be effective in managing ARFID symptoms 4.
- Further research is needed to identify the most effective treatment interventions for ARFID and to develop personalized treatment approaches that take into account the individual's unique needs and circumstances 6.