Assessment of Patients With ARFID Presenting to Multi-Disciplinary Tertiary Care Program

J Pediatr Gastroenterol Nutr. 2023 Jun 1;76(6):743-748. doi: 10.1097/MPG.0000000000003774. Epub 2023 Mar 13.

Abstract

There are no standard assessment approaches for Avoidant Restrictive Food Intake Disorder (ARFID). We describe our approach to multidisciplinary assessment after assessing more than 550 patients with ARFID. We collected online survey (ARFID-specific instruments, measures of anxiety, depression) measures. Electronic medical record data (mental health and gastrointestinal diagnoses, micronutrient and bone density assessments, and growth parameters) were extracted for the 239 patients with ARFID seen between 2018 and 2021 with both parent and patient responses to online surveys. We identified 5 subtypes/combinations of subtypes: low appetite; sensory sensitivity; fear + sensory sensitivity; fear + low appetite; fear + sensory sensitivity + low appetite. Those with appetite-only subtype had higher mean age (14.0 years, P < 0.01) and the lowest average body mass index z score (-1.74, P < 0.01) compared to other subtypes. Our experience adds to understanding of clinical presentations in patients with ARFID and may aid in assessment formulation.

MeSH terms

  • Adolescent
  • Anxiety / diagnosis
  • Avoidant Restrictive Food Intake Disorder*
  • Body Mass Index
  • Feeding and Eating Disorders*
  • Humans
  • Retrospective Studies
  • Tertiary Healthcare
  • Weight Loss