As more has been learned in recent years about the symptoms associated with eating disorders, it has become clear that the initial diagnoses of anorexia and bulimia nervosa were not adequate to encompass the broad range of patient experiences.
More recently, there have been additions of binge eating disorder and eating disorder not otherwise specified (EDNOS), with the latter acting as a type of catchall for eating disorders that do not fit the characterizations of disorders listed in the DSM-IV.
A new study provides information about the prevalence of another disorder that is proposed for inclusion in the DSM-V. Avoidant/restrictive food intake disorder is considered clinically distinct from the other disorders listed in the DSM, according to the findings.
Martin M. Fisher, MD, FSAHM, of Cohen Children’s Medical Center in New York, explains that the disorder is often spotted in children and adolescents, who can exhibit significant impairment in their nutrition and development. They may also have mental health issues or problems with cognition.
The study used a retrospective case study to examine cases of children and adolescents between the ages of 8 and 18 who met the criteria for avoidant/restrictive food intake disorder in 2010. The children were treated at one of seven eating disorder programs in the United States designed to treat pediatric cases of eating disorders.
Of the 719 cases examined, 98 of the children or adolescents met the criteria for the avoidant/restrictive food intake disorder, with 98 meeting criteria for anorexia and 66 for bulimia.
Overall, the researchers found that those with avoidant/restrictive food intake disorder tended to be younger than the children with other types of eating disorders. Their average age was 12.9 versus 15.6 for anorexia patients and 16.5 for bulimia patients.
The children with avoidant/restrictive food intake disorder were also found to experience symptoms longer, for 30.5 months versus 14.5 for anorexia patients and 23.5 for bulimia patients. Their percent media BMI was recorded as between that of the anorexia and bulimia patients (86.5, 81 and 107.5, respectively).
Those with avoidant/restrictive food intake disorder were more likely than children with other types of eating disorders to have an additional medical disorder (55 percent versus 10 percent and 11 percent for anorexia and bulimia, respectively). Anxiety disorders were also more common at 58 percent, versus 36 percent and 32 percent for anorexia and bulimia, respectively.
The patients with avoidant/restrictive food intake disorder also had increased rates of autism spectrum disorder, food allergy, cognitive impairment, swallowing difficulty and sensory issues.
The distinct nature of avoidant/restrictive food intake disorder highlights the need for a separate set of criteria for diagnosis to be included in the DSM-V.
