Avoidant/restrictive food intake disorder

Nov 3, 2020 | Eating Disorders

What is AFRID?

Avoidant/restrictive food intake disorder (ARFID) has replaced the older diagnosis of “feeding disorder of infancy and early childhood.” This diagnosis was originally only applied to children under 7 years old. ARFID generally develops during infancy or early childhood, however it can persist into adulthood. This condition affects men and women at roughly the same rate. Those individuals with this disorder experience disturbed eating. This can be due to a lack of interest in eating or distaste for certain characteristics of food i.e. particular smells, tastes, colors, textures, or temperatures.

What are the symptoms of ARFID:

  • avoidance or restriction of food intake that prevents the person from eating sufficient calories or nutrients
  • eating habits that interfere with normal social functions, such as eating with others
  • weight loss or poor development for age and height
  • nutrient deficiencies or dependence on supplements or tube feeding

An important component of ARFID is that goes beyond what could be considered normal behaviors, like a picky eating toddler or decreased caloric intake in older adults. This does not include the limiting of foods due to lack of availability, and religious or cultural practices.

Diagnostic Criteria

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 averse 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.

Treatment of AFRID

There are several approaches to the successful treatment of AFRID.

In summary ARFID is an eating disorder that causes people to limit caloric intake to the point that medical invention can be required. This condition can be due to a lack of interest in food or an intense distaste for how certain foods look, smell, or taste.