Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID) is a clinically significant eating or feeding disturbance characterized by persistent failure to meet appropriate nutritional and/or energy needs. Individuals with ARFID exhibit a general lack of interest in eating or food, food avoidance based on sensory characteristics, or concern about adverse consequences of eating unrelated to body image or weight concerns.

DSM-5 Diagnostic Criteria

  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:
  2. a. Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
  3. b. Significant nutritional deficiency.
  4. c. Dependence on enteral feeding or oral nutritional supplements.
  5. d. Marked interference with psychosocial functioning.
  6. The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
  7. 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.
  8. 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.

Warning Signs

(May Include)

  • Exhibit little interest in the act of feeding or eating
  • Extreme pickiness in choosing food
  • Difficulty chewing food
  • Lack of appetite
  • Social isolation
  • Anxiety when presented with “fear” foods
  • Vomiting or gagging after exposure to certain foods
  • Trouble digesting specific types of foods
  • Dependence on feeding tubes or nutritional supplements
  • Avoidance of specific food items as related to sensory features (i.e. texture, color, taste, smell)
  • Food refusal related to aversive or fear-based experience
  • For adults, weight loss; for children, failure to gain weight

Health Complications

(May Include)

  • Difficulty concentrating
  • Cardiac complications
  • Fatigue
  • Kidney and liver failure
  • Bone density loss/osteoporosis
  • Anemia (iron deficiency)
  • Electrolyte imbalances
  • Low blood sugar
  • Gastrointestinal problems: constipation and/or bloating
  • Hair loss
  • Growth failure or increased risk to not thrive in adolescents

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