Avoidant/Restrictive Food Intake Disorder (ARFID): What the pediatrician should know

Abstract

Feeding problems during childhood have been described over time by various authors. In 2013, Avoidant/Restrictive Food Intake Disorder (ARFID) was included in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), as a new diagnosis within the Feeding and Eating disorders, to describe a group of patients with avoidant or restrictive eating behaviors unrelated to body image disorder or weight loss desire. ARFID may appear as significant weight loss and/or nutritional deficiency and/or a marked interference in psychosocial functioning. There are three forms of presentation, which can co-occur or occur independently. The first one includes children with sensory aversions (selective), who reject certain foods due to their taste, texture, smell, or shape; the second one includes those children with poor appetite or limited intake (limited intake); and the third one includes those children who reject certain foods or stop eating as a result of a traumatic event (aversive). Due to the recent incorporation of ARFID into the DSM-5, there is a lack of information regarding its treatment. The purpose of this review is to clarify diagnostic criteria and to describe targeted management and treatment interventions with a multidisciplinary approach, without deepening on the treatment of organic medical causes.