onset of the disorder include emotional problems, social difficulties, or certain physical illnesses. The prevalence is about 25-35 percent in normal children and higher in children with developmental delays or disturbances. Risk factors that precipitate ARFID include autism spectrum disorder, anxiety disorders, obsessive-compulsive disorder, and ADHD. Environmental risk factors include familial anxiety and having a mother with an eating disorder. Various GI disorders, such as reflux and vomiting, may precipitate ARFID. Choking on food can be a risk factor for ARFID. Comorbidities include anxiety disorders, OCD, autism spectrum disorder, ADHD, and intellectual disabilities. This disorder may be treated with psychoeducation and cognitive behavioral therapy that challenges the patient’s beliefs about fears of choking, food aversions, and other cognitive distortions related to food and eating. There is family tension associated with ARFID and, when it occurs in children, it can affect the parent-child interactions. Certain infants will display fussiness in their temperament that persists through childhood and adulthood.
ANOREXIA NERVOSA (307.1) Anorexia nervosa has been included in previous Diagnostic and Statistical manuals. The person has a preoccupation with having a low body weight and who exhibits many behaviors that contribute to having a low body weight. The person will restrict food intake and will even starve themselves of all food in order to avoid gaining weight. They may impulsively exercise on a frequent basis. A simple explanation is that they fear gaining weight but there are complexities to this simple explanation. There can be specific events or social pressures to be thin that predispose the individual to anorexia nervosa. The male to female ratio is 10:1 with an incidence of 0.4 percent per year. Although these patients go to great lengths to hide evidence of their condition, the typical symptoms that can be identified include the following: A. Obsession with the caloric and nutritional content of food B. Using appetite suppressants or laxatives to control weight 155
