Avoidant Food Intake Disorder is a serious eating disorder in which individuals significantly limit the volume or variety of foods they consume causing malnutrition, weight loss or psychosocial problems. ARFID was formerly known as selective eating disorder and in 2013 was introduced in the DSM-V as a replacement for and expansion of the previous diagnosis. Prior to the DSM-V it was evident that a subset of children, adolescents and adults experienced eating difficulties that did not fit into existing diagnostic categories. Many often received various diagnoses including mainly eating disorder unspecified which was inadequate as these individuals did not exhibit weight or shape concerns. The limited understanding of avoidant and restrictive eating poses challenges to effective treatment and management impacting directly on the growth and development of children and adolescents.
ARFID is defined by the following criteria according to the DSM-V
A. 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.
B. The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
C. 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.
D. 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 mental disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.
