Eating Disorder : Avoidant/Restrictive Food Intake Disorder (ARFID)

BY Chaisarn A, PAWARISA PHADUNGWONG, PHUTHAMAS SORAJLICHINDA

Edited by Napasjutha Kongsonthana, Napai Pattamjintathumrong

What is ARFID?

Avoidant/Restrictive Food Intake Disorder is an eating disorder characterised by a restrictive behaviour to consume a certain type of food, the amount of food intake or both. It is one of the disorders found in Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5)

Causes/Risk factors and Symptoms

Risk Factor

There is insufficient evidence linking to what causes ARFID, but ARFID most commonly develops in early childhood or infancy and may persist in adulthood. However, some risk factors include:

• Temperamental. Anxiety disorders, ASD, OCD, and ADHD may increase the risk of ARFID

• Environmental. Family anxiety. Higher rates of feeding disturbance may occur in children of mothers with eating disorders.

• Genetic and physiological. History of gastrointestinal conditions, gastroesophageal reflux disease, vomiting, and a range of other medical problems.

• Cultural. ARFID shall not be diagnosed when the avoidance of food intake is solely related to religion or culture.

• Gender. ARFID is equally common in both males and females, but ARFID comorbid with ASD is male dominant.

Symptoms

• Severe weight loss

• Delayed growth in children

• Nutrition deficiency

• Short list of acceptable food

• Avoidance of specific food such as vegetables, protein, and fruit

Diagnosis criteria

• Lack of interest in food or concern about consequences of eating

• Significant weight loss or failure to achieve expected weight gain

• Delayed growth

• Severe nutritional deficiency

• Only depend on enteral feeding or oral nutritional supplement

• Interference with psychosocial functioning

• The disturbance does not occur during anorexia nervosa or bulimia nervosa and there’s no evidence of a disturbance in body weight or shape

• The disturbance is not caused by a medical condition

• The disturbance shall not be explained by cultural or sanction practice

Treatment

Doctors will focus on enhancing nutrition and the patient’s feelings about food. Treatment may include:

• Personalized meal plan by a dietitian

• Prescription nutrition supplement

• Speech therapy

• Prescription drugs to help with appetite or anxiety

• Treating other related mental conditions

• Cognitive behavioral therapy about food and eating prevention

• Treating related mental health conditions

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

• Nazario, B. (2021, February 25). What is ARFID? WebMD. Retrieved July 3, 2022, from https://www.webmd.com/mental-health/eating-disorders/what-is-arfid

• Center For Discovery. (n.d.). What is ARFID: Symptoms, causes, and complications. Center For Discovery. Retrieved July 3, 2022, from https://centerfordiscovery.com/conditions/arfid/