[1] Unlike eating disorders such as anorexia nervosa and bulimia, body image disturbance is not a root cause.
[1][2] Individuals with ARFID may have trouble eating due to the sensory characteristics of food (e.g., appearance, smell, texture, or taste), executive dysfunction, fears of choking or vomiting, low appetite, or a combination of these factors.
[5] Avoidant/restrictive food intake disorder is not simple "picky eating" commonly seen in toddlers and young children, which usually resolves on its own.
In some cases, ARFID presents as extreme "picky eating," often due to sensory sensitivities or a fear of aversive consequences.
Within this group, a low body weight or failure to thrive are common and the experienced lack of interest is long-lasting.
[12][13] The most common symptom seen in patients with both autism and ARFID is sensory-based avoidance, however fear-based restriction and lack of interest in food are prevalent in this population as well.
[citation needed] Anorexia nervosa is distinguished from ARFID by the fact that body image or weight concerns motivate food restriction.
Alternately, an adolescent may at first restrict intake due to severe sensory processing issues, often seen in ARFID, and later develop body image concerns.
[20] Those with attention deficit hyperactivity disorder (ADHD) often struggle with inattentiveness or distraction, which may lead to missing meals or forgetting to eat for long periods of time.
[21] Additionally, people with ADHD are more likely than the general population to struggle with mood disorders, such as anxiety and depression, which have a strong link with ARFID.
[21] Medication used to treat ADHD, such as stimulants, often suppress appetite, which can make eating disorder treatment more difficult.
[21] Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by a sudden onset of obsessive-compulsive symptoms or severely restricted food intake.
[citation needed] The Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS)[26] has been developed to assess the presence of ARFID.
[30] Pharmacological interventions: The U.S. Food and Drug Administration has not approved any psychotropic medication for treatment of ARFID, and empirical evidence on this front is currently extremely limited.
[16][29] In Australia, a common treatment is responsive feeding therapy (RFT)[31] Responsive feeding treatment involves a support person establishing mealtime routines with pleasant interactions and modeling to encourage the person struggling with ARFID to respond to hunger cues.
[32] A suitable treatment for older children and adults alike is CBT-AR (Cognitive Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder), in which one study found 90% of participants had high levels of satisfaction with the program.
[33] The main goals of treatment for CBT-AR are to achieve or to maintain a health weight, treat nutritional deficits, consume items from all five of the basic dietary groups, and to be more comfortable in social settings and circumstances.
A key tool in spotting whether a child's intake is actual cause for concern is the growth chart maintained by their pediatrician.
[36] (Families can also maintain growth charts at home by plugging height and weight data from their doctors into an app.)
[43][44] In a study conducted between 2008 and 2012, 22.5% of children aged 7–17 in day programs for eating disorder treatment were diagnosed with ARFID.
"[50] Prior to the DSM-5, the DSM was not inclusive in recognizing all of the challenges associated with feeding and eating disorders in 3 main domains:[24] The definition introduced in the DSM-5 is broad, which can be both a detriment and an advantage: Stephanie G. Harshman of the neuroendocrine unit at Massachusetts General Hospital has been quoted saying: "The broad definitions used among DSM-5 criteria for [ARFID] provide substantial flexibility in a clinical setting".