New Eating Disorder in DSM Seeing More Diagnosis

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When the Diagnostic and Statistical Manual of Mental Disorders saw its 5th Edition released in 2013, it included a new eating disorder. That disorder, called Avoidant/Restrictive Intake Disorder, targets eating problems not related to body image or weight loss ideals. Instead, it covers eating disorders commonly found in people who've had bad experiences that cause reluctance to eat in certain situations, eat certain foods, or otherwise restrict their diet in such a way that it affects their well being.

Examples of Avoidant/Restrictive Intake Disorder were given when experts discussed in commentary published in the June 18 edition of the Journal of Adolescent Health. These disorders are most common in children and young adults.

New tools mean new diagnosis.

One example given in the journal is Jason, a 10 year old boy. He was not picky about eating until choking on a hot dog. The incident was frightful, but did not result in a hospital visit or serious injury. Jason is now afraid to eat outside of his house and has not been gaining weight despite continuing to grow.

Another example given was of a five-year-old girl who will not eat foods with texture or flavor, preferring things like soup, pasta and oatmeal. This has greatly restricted her diet. She is now the smallest child in her class and is considered severely underweight.

Avoidant/Restrictive Food Intake Disorder is difficult to diagnose, experts say, because it is not just "picky eating," but problems usually associated with something deeper. Traumatic experiences, such as that of young Jason, could be the trigger. It could also be something deeper and not yet understood, as with the little girl's example. Sometimes, the reasons for the restrictive diet are undiagnosed medical problems.

"Parents have a significant role in identifying unhealthy patterns in their child," says coauthor Dr. Mark Norris, Adolescent Health Physician and Associate Professor of Paediatrics within the Department of Pediatrics at CHEO. "Concerned parents should talk to their child's paediatrician or family doctor early on, rather than letting the problem persist for months or even years."



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