Previously known as “Selective Eating Disorder.” Avoidant Restrictive Food Intake Disorder (ARFID) is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness.
Many people, mostly children, go through phases of selective and picky eating. Anywhere between 13 to 22 percent of children will exhibit picky eating behavior between three and eleven years of age, at any given time. While most young children will outgrow their pickiness, between 18 to 40 percent will persist in their pickiness, into adolescence. However, a child with ARFID fails to consume enough calories for normal physical development. The results are stalled weight gain and growth. Social problems may present as issues or difficultues eating in groups with not enough time to finish meals. In adults, this presents as being unable to maintain basic body function. This may also result in social problems for adults, with difficulties eating with others or an ability to finish a meal in the time allowed.
It is important to note that ARFID is beyond the normal scope of a persons food preferences.
According to the DSM-5, ARFID is diagnosed when:
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.
The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
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.
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.
It is important to note that we always rule out food allergies and sensitivities, or underlying health problems, before diagnosis. We work closely with patients physicians, and also make recommendations for testings, as well as providing referrals for these services.
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