Avoidant/restrictive food intake disorder is an eating disorder characterized by eating very little food and/or avoiding eating certain foods. It does not include having a distorted body image (as occurs in anorexia nervosa) or being preoccupied with body image (as occurs in bulimia nervosa).
Avoidant/restrictive food intake disorder can cause substantial weight loss, slower-than-expected growth in children, difficulty participating in normal social activities, and sometimes life-threatening nutritional deficiencies.
Doctors base the diagnosis on the nature of the restricted food intake and its effects after they have ruled out other causes of eating very little.
Cognitive behavioral therapy can help people learn to eat normally and help them feel less anxious about what they eat.
The exact cause of avoidant/restrictive food intake is unknown, but there may be genetic, psychologic, and social factors involved (for example, trauma, anxiety, autism, and developmental disorders).
Avoidant/restrictive food intake disorder typically begins during childhood and may initially resemble the picky eating that is common during this phase of life. For example, children may refuse to eat certain foods or foods of a certain color, consistency, or odor. However, picky eating typically involves only a few foods, and children who are picky eaters, unlike those with this disorder, have a normal appetite, eat enough food overall, and grow and develop normally.
People with avoidant/restrictive food intake may not eat because they lose interest in eating or because they think eating has harmful consequences.
Symptoms
People with avoidant/restrictive food intake disorder eat very little and/or avoid eating certain foods. They may eat so little that they lose a substantial amount of weight. Children with the disorder may not grow as expected.
Nutritional deficiencies are common and may become life threatening.
Because of their problems with eating, people with this disorder may have difficulty participating in normal social activities, such as eating with other people and maintaining relationships with others.
Diagnosis
A doctor's evaluation
Tests to check for physical disorders
Evaluation for other mental disorders
Doctors suspect avoidant/restrictive food intake disorder in people who avoid food or eat very little and have one or more of the following:
Significant weight loss or, in children, not growing as expected
A severe nutritional deficiency
The need for tube feeding or for nutritional supplements taken by mouth
Great difficulty participating in normal social activities and interacting with others
No evidence of a distorted body image
When people eat so little that they lose weight and develop nutritional deficiencies, doctors typically do tests for physical disorders that can cause such problems. Such physical disorders include food allergies, digestive tract disorders that impair food absorption (malabsorption), and cancer.
Doctors also consider other mental disorders that sometimes lead to weight loss, such as other eating disorders (particularly anorexia nervosa or bulimia nervosa), depression, and schizophrenia. Doctors do not diagnose avoidant/restrictive food intake disorder if people restrict their food intake because food is unavailable or is part of a cultural tradition (such as religious fasting).
Usually, doctors also do not diagnose avoidant/restrictive food intake disorder if they identify another disorder or a medical treatment (such as radiation therapy or chemotherapy) as the cause.
Treatment
Cognitive behavioral therapy
Cognitive behavioral therapy may be used to help people with avoidant/restrictive food intake disorder learn to eat normally. It can help them feel less anxious about what they eat.
More Information
The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
National Eating Disorders Association (NEDA): Large nonprofit organization that provides access to online screening tools, a helpline, forums, and a variety of support groups (some virtual)
