Current Medical Issues (Oct 2024)

Avoidant Restrictive Food Intake Disorder: A Case Series

  • Swetha Madhuri Chikkala,
  • Paul Swamidhas Sudhakar Russell,
  • Mona Basker,
  • Rachna George Joseph,
  • Santhanababu Bavishna,
  • Sneha Maria Sebastian,
  • Y. S. Reshmi

DOI
https://doi.org/10.4103/cmi.cmi_74_24
Journal volume & issue
Vol. 22, no. 4
pp. 249 – 254

Abstract

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Avoidant restrictive food intake disorder (ARFID), a recently described eating disorder categorized under DSM-5, has varied clinical presentations. The primary eating disorders have well-established practice parameters for management. However, there is no evidence-based first line of management for ARFID. There is a significant gap in this evolving construct and clinical practice. We present a case series from a tertiary care center in India, focusing on clinical management. Four adolescents with 3 girls and 1 boy between 12 and 17 years of age were included in the study. Diagnosis and management were delayed in all. Mean body mass index was 15.36 (5.26) kg/m2 at the time of diagnosis. Key drivers were dread of choking, sensory characteristics, and avoidance of unpleasant upper and lower gastrointestinal symptoms. This series supports a culturally cognizant hypothesis, an evidence based, viable management model for ARFID in low- and middle-income countries (LMIC). A combination of family-based treatment (FBT) and cognitive behavior therapy is an effective treatment model for India and other LMICs.

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