ABSTRACT
Chapter 14 examines the eating disorder diagnosis avoidant restrictive food intake disorder (ARFID). Patients lack interest in food, avoid sensory aspects of food, or are concerned about unlikely consequences of eating food, such as choking (phagophobia) or vomiting (emetophobia). This leads to inability to meet their energy intake needs to the extent that they lose weight (or arrest growth), develop a nutritional deficiency, become dependent on feeding tubes or oral supplements, or experience significant interference in psychosocial functioning. ARFID can also occur as patients become hesitant to eat due to an intercurrent medical problem such as severe irritable bowel syndrome, whose symptoms eating seems to worsen. Those with ARFID do not fear weight gain and do not have body distortions. ARFID can, however, lead to anorexia nervosa and other eating disorders due to the cognitive changes of a persistently starved brain. It can also lead to severe malnutrition even if it does not morph into another type of eating disorder. Prompt diagnosis and expert intervention, possibly at a higher level of care initially, is indicated.
