Updated in 2013, the DSM-5 is still being picked apart for its revisions. One of its additions included Avoidant/Restrictive Food Intake Disorder (ARFID), a new eating disorder. This particular eating disorder is different from Anorexia Nervosa (AN) and Bulimia Nervosa (BN). Published in the July 2014 issue of Journal of Adolescent Health, Dr. Martin M. Fisher's study looks closely at the DSM-5 diagnosis of ARFID in children and adolescents with poor eating habits not associated with body image concerns. His goal was to test if the changes to the DSM-5 were accurate, and to see how ARFID differs demographically and clinically from other eating disorders.

A Retrospective Case-Control Study

Martin studied 712 subjects between the ages of eight and 18, whom had been admitted to seven different adolescent eating disorder programs across the United States and Canada. A randomized table was used to select equal numbers of children with AN and BN. All patients diagnosed with ARFID at each program were also identified. The following demographic data was collected:

  • Age
  • Gender
  • Ethnicity
  • Weight
  • Height

Next, Martin looked at clinical data such as:

  • Duration of Illness
  • Highest and Lowest Weights
  • Body Mass Index (BMI) Percentile
  • Anxiety Disorders

The goal of Martin's study was to clearly delineate the differences between ARFID, AN, and BN. These are only a few of the categories that were recorded and examined.

Patients with ARFID Twice as Likely to Have Anxiety

Out of all the individuals, 98 showed symptoms of ARFID. That translates to 13.8% of the participants showing DSM-5 defined symptoms of the disorder. Looking at the data, Martin found the following:

  • Patients with ARFID were younger than those with AN or BN
  • Patients with ARFID had longer durations of illness
  • Patients with ARFID were more likely to be male
  • Patients with ARFID had picky eating habits since early childhood
  • Patients with ARFID were almost twice as likely to have an anxiety disorder
  • Patients with ARFID were less likely to have a mood disorder

Martin also writes that ARFID patients are “significantly underweight, often with associated medical and/or psychiatric symptoms."

The Implications and Conclusions

The results affirm that those with ARFID are demographically and clinically distinct from those suffering from AN or BN, and supports the changes made in the DSM-5. Those with children who have been diagnosed with an eating disorder prior to the release of the DSM-5 should revisit a doctor. Due to information lacking in the DSM-4, many have been misdiagnosed and may have ARFID. Symptoms for ARFID defined in the DSM-V include:

  • Lack of interest in eating or in food
  • Concern about nutritional value
  • Concern about weight gain
  • Dependence on supplements
Date of original publication:
Updated on: October 23, 2015