Avoidant/Restrictive Food Intake Disorder inDSM-5

CME Educational Objectives 1. Explain the core clinical features of avoidant/restrictive food intake disorder (ARFID). 2. Understand the diagnostic limitations of feeding disorders of infancy or early childhood in DSM-IV . 3. Describe the rationale for the recommendation that ARFID be included in DSM-5 . It is well recognized that a number of patients present with a feeding or eating disturbance that is difficult to classify and diagnose using DSM-IV criteria. 1 The frequent use of the diagnosis Eating Disorder Not Otherwise Specified 2 has been widely discussed. 3 In addition, there are a number of presentations familiar to clinicians working in this field that simply do not fit current diagnostic placeholders. This is particularly the case in presentations characterized by restricted or otherwise inadequate eating, most commonly seen in child and adolescent populations, 4 but also in adults. 5 Examples include individuals who eat only a very narrow range of foods, and those who restrict their food intake to cope with difficult feelings, an emotional crisis, or an unpleasant experience. Such individuals do not fit the existing DSM-IV feeding and eating disorder diagnoses; yet they can experience clinically significant levels of impairment in development or functioning, as well as potentially severe medical complications.