Characteristics of Avoidant/Restrictive Food Intake Disorder in a Cohort of Adult Patients

Nakai, Yoshikatsu; Nin, Kazuko; Noma, Satoshi; Teramukai, Satoshi; Wonderlich, Stephen A.

doi:10.1002/erv.2476

Cited by 60 publications

(43 citation statements)

References 13 publications

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“…In contrast to previous literature (Bryson et al, ; Nakai et al, ; Nicely et al, ; Norris et al, ; Strandjord et al, ), the average %mBMI of individuals with ARFID in our study was within the normal range, and was higher than %mBMI for AN. This is distinct from previous studies comparing these disorders, which have reported higher weights for those with ARFID relative to AN, but still found that individuals with ARFID were, on average, within an objectively low‐weight range (e.g., Fisher et al, ; Ornstein et al, ).…”

Section: Discussioncontrasting

confidence: 99%

“…This is distinct from previous studies comparing these disorders, which have reported higher weights for those with ARFID relative to AN, but still found that individuals with ARFID were, on average, within an objectively low‐weight range (e.g., Fisher et al, ; Ornstein et al, ). Many of the published chart reviews on ARFID retrospectively classified individuals who had been evaluated before the inclusion of ARFID in the DSM‐5 (e.g., Nakai et al, ; Nicely et al, ; Norris et al, ; Ornstein et al, ). It is possible that individuals with certain presentations of ARFID, such as significant weight loss or reliance on enteral feeding, presented or were referred to eating‐disorder programs because of complications related to low‐weight, and that those with other forms of ARFID (e.g., those with nutritional deficiencies) were not captured in earlier comparison studies.…”

Section: Discussionmentioning

confidence: 99%

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Impact of expanded diagnostic criteria for avoidant/restrictive food intake disorder on clinical comparisons with anorexia nervosa

Becker

Keshishian

Liebman

et al. 2018

Intl J Eating Disorders

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Objective Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are restrictive eating disorders. There is a proposal before the American Psychiatric Association to broaden the current DSM‐5 criteria for ARFID, which currently require dietary intake that is inadequate to support energy or nutritional needs. We compared the clinical presentations of ARFID and AN in an outpatient sample to determine how a more inclusive definition of ARFID, heterogeneous for age and weight status, is distinct from AN. Methods As part of standard care, 138 individuals with AN or ARFID completed an online assessment battery and agreed to include their responses in research. Results Individuals with ARFID were younger, reported earlier age of onset, and had higher percent median BMI (%mBMI) than those with AN (all ps < .001). Individuals with ARFID scored lower on measures of eating pathology, depression, anxiety, and clinical impairment (all ps < .05), but did not differ from those with AN on restrictive eating (p = .52), and scored higher on food neophobia (p < .001). Discussion Allowing psychosocial impairment to be sufficient for an ARFID diagnosis resulted in a clinical picture of ARFID such that %mBMI was higher (and in the normal range) compared with AN. Differences in gender distribution, age, and age of onset remained consistent with previous research. Both groups reported similar levels of dietary restriction, although ARFID can be distinguished by relatively higher levels of food neophobia. Currently available measures of eating pathology may capture certain ARFID symptoms, but highlight the need for measures of impairment relative to ARFID.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of expanded diagnostic criteria for avoidant/restrictive food intake disorder on clinical comparisons with anorexia nervosa

Becker

Keshishian

Liebman

et al. 2018

Intl J Eating Disorders

View full text Add to dashboard Cite

show abstract

“…For example, a series of case reviews and clinical studies across eating disorder treatment programs in North America found that between 7.2% and 17.4% of patients across sites had ARFID 4,5,6 In a similar retrospective chart review of individuals seeking treatment for eating disorders in Japan, 11% met criteria for ARFID. 7 Further, ARFID was even more common (22.5%) among youth in a day treatment program for eating disorders. 8 By contrast, a retrospective review of 2,231 consecutive referrals (aged 8–18 years) to pediatric gastrointestinal clinics in the Boston area showed an ARFID prevalence of only 1.5%.…”

Section: What Is Currently Known?mentioning

confidence: 96%

Avoidant/Restrictive Food Intake Disorder: a Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment

Thomas

Lawson

Micali

et al. 2017

Curr Psychiatry Rep

256

233

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Purpose of review: DSM-5 defined Avoidant/Restrictive Food Intake Disorder (ARFID) as a failure to meet nutritional needs leading to low weight, nutritional deficiency, dependence on supplemental feedings, and/or psychosocial impairment. We summarize what is known about ARFID and introduce a three-dimensional model to inform research. Recent findings: Because ARFID prevalence, risk factors, and maintaining mechanisms are not known, prevailing treatment approaches are based on clinical experience rather than data. Furthermore, most ARFID research has focused on children, rather than adolescents or adults. We hypothesize a three-dimensional model wherein neurobiological abnormalities in sensory perception, homeostatic appetite, and negative valence systems underlie the three primary ARFID presentations of sensory sensitivity, lack of interest in eating, and fear of aversive consequences, respectively. Summary: Now that ARFID has been defined, studies investigating risk factors, prevalence, and pathophysiology are needed. Our model suggests testable hypotheses about etiology and highlights cognitive-behavioral therapy as one possible treatment.

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“…Overall, patients with ARFID tend to be younger than patients with other eating disorders and the reported gender proportions among them are less skewed towards female gender, although girls or women still make up a majority of patients. An exception is the study by Nakai et al (2016), in which all ARFID patients were female.…”

Section: Dsm-5 Criteriamentioning

confidence: 99%

A systematic scoping review of diagnostic validity in avoidant/restrictive food intake disorder

Strand

Hausswolff-Juhlin

Welch

2018

Intl J Eating Disorders

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Objective Avoidant/restrictive food intake disorder (ARFID) was introduced as a new diagnosis in the DSM‐5. This systematic scoping review explores how ARFID as a diagnostic entity is conceptualized in the research literature and evaluates the diagnostic validity according to the Feighner criteria. Method A systematic scoping review of papers on ARFID in PubMed/MEDLINE and Web of Science was undertaken, following PRISMA and Joanna Briggs Institute guidelines. Results Fifty‐one original research publications, 23 reviews and commentaries, and 20 case reports were identified. The use of ARFID as a conceptual category varies significantly within this literature. At this time, the ARFID diagnosis does not fulfil the Feighner criteria for evaluating the validity of diagnostic constructs, the most urgent problem being the demarcation toward other disorders. A three‐dimensional model—lack of interest in food, selectivity based on sensory sensitivity, and fear of aversive consequences—is gaining support in the research literature. Discussion The introduction of the ARFID diagnosis has undoubtedly increased the recognition of a previously largely neglected group of patients. However, this article points to an inability of the current DSM‐5 diagnostic criteria to ensure optimal diagnostic validity, which risks making them less useful in clinical practice and in epidemiological research. To increase the conceptual validity of the ARFID construct, several possible alterations to the current diagnostic criteria are suggested, including a stronger emphasis of the three identified subdomains and further clarifying the boundaries of ARFID.

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Characteristics of Avoidant/Restrictive Food Intake Disorder in a Cohort of Adult Patients

Abstract: Adult patients with ARFID in this study were clinically distinct from those with AN and somewhat different from paediatric patients with ARFID in previous studies. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Cited by 60 publications

References 13 publications

Impact of expanded diagnostic criteria for avoidant/restrictive food intake disorder on clinical comparisons with anorexia nervosa

Impact of expanded diagnostic criteria for avoidant/restrictive food intake disorder on clinical comparisons with anorexia nervosa

Avoidant/Restrictive Food Intake Disorder: a Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment

A systematic scoping review of diagnostic validity in avoidant/restrictive food intake disorder

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