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

Abstract

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