Avoidant/restrictive food intake disorder: A diagnosis at the intersection of feeding and eating disorders necessitating subtype differentiation

Avoidant/restrictive food intake disorder (ARFID) is a diagnosis that sits squarely at the cross roads of feeding disorders and eating disorders. It is historically tied to feeding disorders as a replacement of the DSM-IV diagnosis of feeding disorder of infancy or early childhood. The revision process, however, extended the diagnostic umbrella by removing its predecessor's weight loss requirement and age of onset restriction (i.e., 6 years). Implications of this extension include capturing an older cohort of patients with ARFID accessing care at eating disorders clinics, as well as providing a diagnostic home to previously orphaned pediatric subgroups with feeding disorders that lacked a diagnostic home prior to DSM-5. While recognizing notable strengths of this now 5-year-old diagnostic entity, ARFID is largely recognized as a very heterogeneous condition that lacks specificity to best guide clinical and research activities. The current commentary discusses the implications of ARFID as a replacement and extension of the DSM-IV diagnosis of feeding disorder of infancy or early childhood and provides the rationale and guidance for developing a subtype taxonomy.