What is Avoidant Restrictive Food Intake Disorder?

Avoidant restrictive food intake disorder (ARFID), previously known as “selective eating disorder,” is characterized by highly selective eating habits, disturbed feeding patterns, or both. It often results in significant nutrition and energy deficiencies, and for children, failure to gain weight.

A diagnosis of avoidant restrictive food intake disorder is given when a person has one or more of the following symptoms:

• Significant weight loss, failure to achieve expected weight gain, or faltering growth in children.
• Significant nutritional deficiency
• Dependence on enteral feeding or oral nutritional supplements
• Marked interference with psychosocial functioning

ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness.The disorder is not better explained by lack of available food or by an associated culturally sanctioned practice. A diagnosis of ARFID also requires that the eating problem is not attributable to a concurrent medical condition or other mental disorder.

What is Pica Disorder?

Pica is a compulsive eating disorder in which people eat non-food items, such as dirt, hair, and paint chips. A diagnosis of pica disorder is based on:

• Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month.
• The eating of nonnutritive, nonfood substances is inappropriate to the developmental level of the individual.
• The eating behavior is not part of a culturally supported or socially normal practice.
• If the eating behavior occurs in the context of another mental disorder (e.g., intellectual developmental disorder, autism spectrum disorder, schizophrenia, or medical condition (including pregnancy), it is severe enough to warrant serious clinical attention.

What is Rumination Disorder?

Rumination disorder involves the regular regurgitation of food that may be re-chewed, re-swallowed, or spit out. A diagnosis of rumination disorder is based on:

• Repeated regurgitation of food over a period of at least 1 month.
• The repeated regurgitation is not attributable to an associated gastrointestinal or other medical condition (e.g., gastroesophageal reflux, pyloric stenosis).
• The eating disorder does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder.
• If the symptoms occur in the context of another mental disorder (e.g., intellectual disability or another neurodevelopmental disorder), they are severe enough to warrant serious clinical attention.