Avoidant Restrictive Food Intake Disorder

Excerpt

Avoidant restrictive food intake disorder (ARFID) represents a distinct entity established by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) within the spectrum of feeding and eating disorders. ARFID is characterized by significant limitations in food intake leading to malnutrition, weight loss, or nutritional deficiency, without the concurrent body image disturbances typically seen in anorexia nervosa or bulimia nervosa. Individuals with ARFID display avoidance or restriction of food intake, often due to sensory issues, fear-related avoidance of eating, or low appetite, leading to nutritional deficiencies, weight loss, and psychosocial impairments. ARFID can occur at any age but typically arises in childhood and can persist into adulthood. Furthermore, this condition may also occur with other medical or psychiatric disorders, complicating both diagnosis and treatment. Adding to the diagnostic complexity, ARFID manifests differently in individuals, with an array of symptoms across the 3 significant drivers of the disorder, making it a challenging disorder.

The DSM-V outlines criteria for diagnosing ARFID, emphasizing the absence of body image disturbance and ruling out other eating disorders or medical conditions as the cause. Diagnosis involves a comprehensive medical, nutritional, and psychological evaluation to assess the patient's physical health, eating behaviors, and mental well-being. Treatment for ARFID focuses on addressing immediate health concerns, restoring nutritional health, expanding food variety, and addressing fears or discomforts related to eating. Interventions may include cognitive behavioral therapy, family-based therapy, exposure therapy, and, in certain cases, pharmacotherapy. Hospitalization may be necessary for patients with severe malnutrition or medical complications. Nutritional rehabilitation, psychological interventions, and collaborative care involving a multidisciplinary team of healthcare professionals are essential for optimizing treatment outcomes and improving the quality of life for individuals with ARFID.