current pediatrics reports
Avoidant Restrictive Food Intake Disorder

Avoidant/Restrictive Food Intake Disorder (ARFID): Its Medical Complications and Their Treatment—an Emerging Area

Current Pediatrics Reports (2021)
By Allison Nitsch, MD, FACP Jamie Manwaring, PsyD Philip S. Mehler, MD, FACP, FAED, CEDS Erin Knopf

Review Purpose

Avoidant/restrictive food intake disorder (ARFID) is a relatively new psychiatric and eating disorder diagnosis that most often emerges in childhood. Due to ARFID’s diagnostic infancy, its medical complications are just starting to be delineated in the literature, and some are extrapolated from the medical manifestations of malnutrition in anorexia nervosa, restricting subtype (AN-R). Pediatric patients with ARFID can have a myriad of physical complaints, most commonly gastrointestinal, that prompt them to seek medical evaluation; thus, familiarity with its medical manifestations is important for all physicians.

Review Findings

Electrolyte abnormalities may be more common in ARFID compared to patients with AN, while bradycardia has been shown to be comparatively less common. ARFID has been found to be associated with low bone density in both males and females. Addressing nutritional deficits and weight issues are paramount. Cognitive behavioral therapy for ARFID (CBT-ARFID) and several psychotropic medications have been found to be acceptable treatment modalities, but randomized controlled trials are needed.

In Summary

ARFID has numerous reported and theoretical medical complications due to the resulting malnutrition that can last until adulthood if left untreated.

Written by

Allison Nitsch, MD, FACP

Dr. Nitsch became Assistant Medical Director of ACUTE in 2020 and loves caring for ACUTE’s medically and psychiatric complex patients and advancing their care through research.
Written by

Jamie Manwaring, PsyD

Dr. Jamie Manwaring began clinical research in eating and weight disorders after graduating with her degree in psychology from UCLA. This clinical research continued in graduate school at...

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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