Format

Send to

Choose Destination
Curr Psychiatry Rep. 2017 Aug;19(8):54. doi: 10.1007/s11920-017-0795-5.

Avoidant/Restrictive Food Intake Disorder: a Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment.

Author information

1
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA, 02114, USA. jjthomas@mgh.harvard.edu.
2
Department of Psychiatry, Harvard Medical School, Boston, MA, USA. jjthomas@mgh.harvard.edu.
3
Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
4
Department of Medicine, Harvard Medical School, Boston, MA, USA.
5
Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
6
Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
7
Institute of Child Health, University College London, London, UK.
8
Pediatric Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
9
Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
10
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
11
Divison of Neurotherapeutics, Massachusetts General Hospital, Boston, MA, USA.
12
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA, 02114, USA.

Abstract

PURPOSE OF REVIEW:

DSM-5 defined avoidant/restrictive food intake disorder (ARFID) as a failure to meet nutritional needs leading to low weight, nutritional deficiency, dependence on supplemental feedings, and/or psychosocial impairment. We summarize what is known about ARFID and introduce a three-dimensional model to inform research.

RECENT FINDINGS:

Because ARFID prevalence, risk factors, and maintaining mechanisms are not known, prevailing treatment approaches are based on clinical experience rather than data. Furthermore, most ARFID research has focused on children, rather than adolescents or adults. We hypothesize a three-dimensional model wherein neurobiological abnormalities in sensory perception, homeostatic appetite, and negative valence systems underlie the three primary ARFID presentations of sensory sensitivity, lack of interest in eating, and fear of aversive consequences, respectively. Now that ARFID has been defined, studies investigating risk factors, prevalence, and pathophysiology are needed. Our model suggests testable hypotheses about etiology and highlights cognitive-behavioral therapy as one possible treatment.

KEYWORDS:

Avoidant/restrictive food intake disorder; Eating disorder; Feeding disorder

PMID:
28714048
PMCID:
PMC6281436
DOI:
10.1007/s11920-017-0795-5
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center