ARFID: A New (and Underdiagnosed) Eating Disorder.


 Children can be picky eaters, of course. But their fussiness can grow out of control—no texture, no color, nothing solid—becoming a disorder and leading to serious health issues.

Now there’s a name for it, ARFID, which stands for “avoidant/restrictive food intake disorder.” It’s different from other “well-known” eating disorders like anorexia nervosa because it doesn’t have to do with distorted body image or a desire to lose weight, and most people diagnosed with the disorder are children. Symptoms seem to be caused by something that happened in early life—a choking or vomiting event, an unhealthy relationship with a caretaker, or psychosocial problems such as depression or anxiety. A higher percentage of ARFID occurs in boys than other eating disorders, but still, most of the children diagnosed (70%) are girls.

The new category was added to the DSM-5—the Diagnostic and Statistical Manual of Mental Disorders, 5th edition—in May 2013, making the term still relatively unknown. A recent study published in the Journal of Adolescent Health takes stock of the newly coined term so that pediatricians, mental health professionals, and parents can provide better help. Experts behind the study are hoping to create more awareness.

“ARFID is not just about picky eating—it’s a very challenging diagnostic category in the DSM-5,” said co-author Dr. Debra Katzman, a staff physician in the Eating Disorders program at the Hospital for Sick Children in Canada.

ARFID is complicated to treat, and must address both the medical aspects and psychosocial issues. “If left untreated, children and teens may be left with serious, long-term complications,” Katzman said. About 13 percent of the patients seen in pediatric eating disorder programs like SickKids are now diagnosed with ARFID.

The experts hope that creating awareness about ARFID will help with its prevention and treatment, especially where it counts: the home. “Concerned parents should talk to their child’s pediatrician or family doctor early on, rather than letting the problem persist for months or even years,” said co-author Dr. Mark Norris.

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