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Concept
Avoidant/restrictive food intake disorder
Summary
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder in which people avoid eating or eat only a very narrow range of foods. This can be either due to the sensory characteristics of food, such as its appearance, smell, texture, or taste, or due to fear of negative consequences such as choking or vomiting. Others might show no interest in eating or food.
This avoidance or restriction of food can lead to significant weight loss (or lack of appropriate growth or weight gain in children), nutritional deficiency, dependence on a feeding tube or supplements to meet nutritional needs, and/or influences a person's psychosocial functioning.
In contrast to anorexia and bulimia, the eating behavior in ARFID is not motivated by concerns about body weight or shape.
ARFID was first included as a diagnosis in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published in 2013, extending and replacing the diagnosis of feeding disorder of infancy or early childhood included in prior editions. It was subsequently also included in the eleventh revision of the International Classification of Diseases (ICD-11) that came into effect in 2022.
ARFID comprises a range of selective and restrictive eating behaviors. People with ARFID either avoid certain kinds of foods, restrict the amount of food they eat, or both. They might do so due to sensory sensitivities, a fear of aversive consequences, or a lack of interest in eating. For some people with ARFID, multiple or all reasons apply.
Sensory issues with food are among the most common reasons. For example, people who experience the taste of fruits or vegetables as intensely bitter might avoid eating them. For others, the smell, texture, appearance, color, or temperature of certain foods is unbearable. Some might find it impossible to tolerate the smell of food eaten by others. Sensory sensitivities can also lead people to refuse eating foods of specific brands.
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