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Review
. 2024 Jun 14;12(1):82.
doi: 10.1186/s40337-024-01034-8.

Assessing growth in children and adolescents with Avoidant/Restrictive Food Intake Disorder

Anna B Tanner  1 , Tracy K Richmond  2   3
Affiliations
Review

Assessing growth in children and adolescents with Avoidant/Restrictive Food Intake Disorder

Anna B Tanner et al. J Eat Disord. .

Abstract

Background: Although growth delays and disruption are a well described medical complication of restrictive eating disorders in children and young adolescents, this complication has received less attention in patients with Avoidant/Restrictive Food Intake Disorder (ARFID). Patients with ARFID have challenges with adequacy of food volume and variety that are not related to body image but are instead related to lack of interest in eating, sensory concerns, and/or fears of aversive consequences. Because onset of ARFID is commonly before puberty, concerns regarding growth adequacy may present an additional treatment challenge and a unique opportunity for support.

Review: Child and adolescent patients with other restrictive eating disorders are at risk of irreversible deleterious impact on growth and development, particularly when onset is before or around puberty. Although faltering growth is a defining feature of ARFID, less attention has been paid to methods for examining growth concerns in young patients with ARFID and training providers to assess growth adequacy when prepubertal and peripubertal patients present with this diagnosis. Providers working with patients under 18 years of age with eating disorders will benefit from the tools discussed in this narrative review to adequately assess growth and development against genetic potential, recognize alterations in growth that are a result of nutritional deficiencies, and support and maximize catch-up growth and development when it has been impaired.

Conclusion: Established pediatric growth monitoring tools and techniques to assess adequacy of growth can be applied to child and adolescent patients presenting with ARFID. These tools can improve long term outcomes in linear height for these patients and allow for monitoring during and after treatment until growth and development is complete. Medical providers caring for patients presenting with ARFID will need to establish best practices for assessing and monitoring growth.

Keywords: ARFID; Eating disorders; Growth and development.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Example growth chart of patient with ARFID fear of aversive consequences subtype
Fig. 2
Fig. 2
Example growth chart of a patient with ARFID lack of interest in eating subtype
Fig. 3
Fig. 3
Example growth chart of a patient with ARFID sensory sensitivity subtype
See this image and copyright information in PMC

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References

    1. Lin J, Hartman-Munick S, Kells M, Milliren C, Slater W, Woods E, et al. The impact of the COVID-19 pandemic on the number of Adolescents/Young adults seeking eating disorder-related care. J Adolesc Health. 2021;69:660–3. doi: 10.1016/j.jadohealth.2021.05.019. - DOI - PMC - PubMed
    1. van Eeden A, van Hoeken D, Hoek H. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021;34:515–24. doi: 10.1097/YCO.0000000000000739. - DOI - PMC - PubMed
    1. Morris A, Elliott E, Madden S. Early-onset eating disorders in Australian children: a national surveillance study showing increased incidence. Int J Eat Disord. 2022;55:1838–42. doi: 10.1002/eat.23794. - DOI - PMC - PubMed
    1. Swanson S, Crow S, Le Grange D, Swendsen J, Merikangas K. Prevalence and correlates of eating disorders in adolescents: results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry. 2011;68:714–23. doi: 10.1001/archgenpsychiatry.2011.22. - DOI - PMC - PubMed
    1. Fisher M, Rosen D, Ornstein R, Mammel K, Katzman D, Rome E, et al. Characteristics of avoidant/restrictive food intake disorder in children and adolescents: a new disorder in DSM-5. J Adolesc Health. 2014;55:49–52. doi: 10.1016/j.jadohealth.2013.11.013. - DOI - PubMed

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