ARFID in Teens and Children

What is ARFID? What is ARFID in teens, and how is it different than anorexia nervosa and other eating disorders? This is a common question. Thankfully, ARFID is being better understood by professionals who treat eating disorders.

ARFID in teens, children, adolescents, etc. are more than “picky eaters” as they are sometimes labeled. Before the inclusion of ARFID in the DSM-V, these patients would have likely received the diagnosis of Anorexia Nervosa or Eating Disorder Not Otherwise Specified.

Avoidant Restrictive Food Intake Disorder is the full name for this condition, and it was officially added to the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013 (DSM-V).

Diagnostic features of ARFID include [1]:

• an eating or feeding disturbance including the avoidance of food based on the sensory characteristics of food (such as smell or texture)
• significant weight loss
• significant nutritional deficiency
• dependence on a feeding tube or oral nutritional supplements
• interference with psychosocial functioning

Psychologist Helene Keery and her team at Children’s Minnesota hospital wanted to better understand the differences between anorexia and ARFID in teens and children.

So, they conducted a study to understand “the physical and psychological attributes of children and adolescents with ARFID, and to compare them to patients with full- threshold or atypical anorexia nervosa.”

Their findings shed light on this eating disorder, and their study presents several interesting results. [2]

Compared to patients with anorexia or atypical anorexia, patients with ARFID were:

• significantly younger
• more likely to be diagnosed with at least one co-morbid DSM-5 diagnosis
• less likely to be:
  • bradycardic
  • amenorrheic
  • admitted to the hospital
  • have a diagnosis of depression
• less likely to experience acute weight loss vs. chronic weight loss
• on self-report measures, reported fewer symptoms of:
  • depression
  • anxiety
  • perfectionism
  • clinical impairment
  • concerns about weight and shape
  • higher self-esteem

Dr. Keery and her team support the conclusion that ARFID should maintain a “distinct DSM-5 diagnosis” and that there are “significant” physical and psychological differences between ARFID and Anorexia and atypical anorexia.

Julie Lesser, MD, one of the physicians involved with the study at Children’s Minnesota, highlights the importance of identifying and treating ARFID appropriately. This is especially important in growing children and teens.

She writes, “One of the most common results of ARFID is significant weight loss or failure to gain weight and grow, for those who should be in a growth spurt.” [3]

The authors of the study recognize that more research is needed to “examine potential differences between ARFID subgroups” as well as develop better ways to measure ARFID.

If you are wondering if you or your child could be diagnosed with ARFID, we recommend that you reach out to an eating disorder professional as soon as possible. Recovery is possible.

---

References:

[1] Avoidant Restrictive Food Intake Disorder (ARFID). (2018, February 22). Retrieved October 14, 2019, from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid.

[2] Keery, H., Lemay-Russell, S., Barnes, T. L., Eckhardt, S., Peterson, C. B., Lesser, J., … Grange, D. L. (2019). Attributes of children and adolescents with avoidant/restrictive food intake disorder. Journal of Eating Disorders, 7(1). doi: 10.1186/s40337-019-0261-3

[3] More than picky eating-7 things to know about ARFID. (2018, October 4). Retrieved October 14, 2019, from https://www.nationaleatingdisorders.org/blog/more-picky-eating—7-things-know-about-arfid.

---

About the Author:

Travis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help.

This includes special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Specifically, he has worked with eating disorders since 2003 and has learned from many of the field’s leading experts. He has worked with hundreds of individuals facing life-threatening eating disorders in all levels of treatment. His website is wtravisstewart.com

---

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published October 15, 2019, on EatingDisorderHope.com
Reviewed & Approved on October 15, 2019, by Jacquelyn Ekern MS, LPC