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ARFID Revisited

6/12/2018

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By: Maria Nemec, LCSW, Pathways to Peace, Inc.
In this article, Dr. Julie O’Toole notes the differences between Anorexia and ARFID as well as a shift in thinking among physicians.  Twenty years ago, most patients with eating disorders were diagnosed with anorexia nervosa.  However, there are currently many more patients with the ARFID diagnosis (Avoidant Restrictive Intake Disorder) which points us to a shift of physicians, dieticians, and therapists toward a more advanced understanding of weight loss and poor growth in childhood.
DSM -5 defines ARFID as: an eating or feeding disturbance (e.g., an apparent lack of interest in eating or food, avoidance based on the sensory characters of food, concern about aversive consequences of food) as manifested by persistent failure to meet appropriate nutrition and/or energy needs…
DSM – 5 further lists associated issues including significant weight loss or nutritional deficiency, dependence on nutritional supplements or enteral feeding, interference with functioning in society, and the lack of other medical reasons for the eating disturbance.
Dr. O’Toole points out that ARFID is based on additional factors, not only selective eating. Such factors could include depression, ADHD medication reaction, or even cancer.
Dr. O’Toole states that ARFID and Failure to Thrive are essentially the same thing, only one is a medical term and one is a psychological term. The treatment for both is essentially the same as well.  That is, ordered eating in an age appropriate setting with health care providers who will take the steps to make sure malnutrition is reversed so that growth and development occurs as well as healthy psychosocial functioning.
To read the article in it’s entirety:
 https://www.kartiniclinic.com/blog/post/arfid-revisited/
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