Avoidant/Restrictive Food Intake Disorder: An Eating Disorder on a Spectrum with Food Neophobia

Abstract

This chapter postulates that food neophobia, picky/fussy eating and avoidant/restrictive food intake disorder (ARFID) sit on the same continuum. All three constructs specifically manifest in early childhood and have, until recently, been considered as separate entities within the literature. Food neophobia, picky/fussy eating and ARFID share many predictive features within their behavioural expression. Moreover, researchers have failed to find suitable and specific measures for any one of these food related behaviours that does not also predict the other two. This chapter covers the similarities and differences between food neophobia, picky/fussy eating and ARFID and offers an applied perspective on the defining characteristics, as well as the limits of these three paediatric feeding phenomena. By understanding food neophobia in the context of an applied problem, the reader can gain deeper insight into the psychological construct. The reader will be guided through the diagnostic criteria of the relatively new disorder of ARFID – weight loss, nutrient deficiency, dependence on dietary supplementation and interference in psychosocial functioning. This will highlight how diagnosis of ARFID takes place and the difficulties the clinician has in differentiating it from typical developmental food neophobia. Once a full understanding of the diagnostic criteria is achieved, the similarities and differences between the three constructs will be highlighted and an argument advocating a continuum will be offered. In a scenario where constructs are defined by frequency of, rather than differences in, behaviour the only logical conclusion is that food neophobia, picky/fussy eating and ARFID exist on the same continuum.