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J Adolesc Health. 2014 Jul;55(1):49-52. doi: 10.1016/j.jadohealth.2013.11.013. Epub 2014 Feb 5.

Characteristics of avoidant/restrictive food intake disorder in children and adolescents: a "new disorder" in DSM-5.

Author information

Division of Adolescent Medicine, Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York. Electronic address:
Departments of Pediatrics, Internal Medicine, and Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan.
Division of Adolescent Medicine and Eating Disorders, Penn State Hershey Children's Hospital, Hershey, Pennsylvania.
Department of Pediatrics, Oakland University William Beaumont School of Medicine, Division of Adolescent Medicine, Beaumont Children's Hospital, Royal Oak, Michigan.
Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Center for Adolescent Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio.
Division of Adolescent and Young Adult Health, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.
Division of Adolescent Medicine, Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York.
Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, New York.



To evaluate the DSM-5 diagnosis of Avoidant/Restrictive Food Intake Disorder (ARFID) in children and adolescents with poor eating not associated with body image concerns.


A retrospective case-control study of 8-18-year-olds, using a diagnostic algorithm, compared all cases with ARFID presenting to seven adolescent-medicine eating disorder programs in 2010 to a randomly selected sample with anorexia nervosa (AN) and bulimia nervosa (BN). Demographic and clinical information were recorded.


Of 712 individuals studied, 98 (13.8%) met ARFID criteria. Patients with ARFID were younger than those with AN (n = 98) or BN (n = 66), (12.9 vs. 15.6 vs. 16.5 years), had longer durations of illness (33.3 vs. 14.5 vs. 23.5 months), were more likely to be male (29% vs. 15% vs. 6%), and had a percent median body weight intermediate between those with AN or BN (86.5 vs. 81.0 and 107.5). Patients with ARFID included those with selective (picky) eating since early childhood (28.7%); generalized anxiety (21.4%); gastrointestinal symptoms (19.4%); a history of vomiting/choking (13.2%); and food allergies (4.1%). Patients with ARFID were more likely to have a comorbid medical condition (55% vs. 10% vs. 11%) or anxiety disorder (58% vs. 35% vs. 33%) and were less likely to have a mood disorder (19% vs. 31% vs. 58%).


Patients with ARFID were demographically and clinically distinct from those with AN or BN. They were significantly underweight with a longer duration of illness and had a greater likelihood of comorbid medical and/or psychiatric symptoms.


5th Edition of the diagnostic and statistical Manual (DSM-5); Anorexia nervosa (AN); Avoidant/Restrictive food intake disorder (ARFID); Bulimia nervosa (BN); Children and adolescents

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