Barney Angela, Bruett Lindsey D, Forsberg Sarah, Nagata Jason M
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA.
Eating Disorders Program, Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA.
J Eat Disord. 2022 May 4;10(1):61. doi: 10.1186/s40337-022-00583-0.
Avoidant Restrictive Food Intake Disorder (ARFID) is a relatively new eating disorder diagnosis, and there is need to better understand this disorder's presentation. Diagnostic criteria for ARFID require that there are no body image distortions. People with ARFID symptoms may have body image concerns that require careful consideration and more information about the interplay of these is needed to help clinicians appropriately diagnose and manage ARFID.
This clinical observation reports a case of ARFID in a nine-year-old with severe malnutrition who positively views her small size and values thinness. The patient reported that her own desire for thinness was influenced by social media beauty ideals and praise of thinness witnessed in social situations. Despite this, the motivation for avoidant and restrictive eating behaviors was low appetitive drive, fear of trying new foods, and fear of adverse consequences from eating.
Although concerning, the patient's body image was not of clinical significance as a motivating factor for the disordered eating behaviors. Body image dissatisfaction is common. The requirement to exclude body image distortions in the diagnostic criteria for ARFID may require consideration of the pervasiveness of societal body ideals to which young people are exposed.
回避性限制性食物摄入障碍(ARFID)是一种相对较新的饮食失调诊断,需要更好地了解这种疾病的表现。ARFID的诊断标准要求不存在身体形象扭曲。有ARFID症状的人可能存在身体形象问题,需要仔细考虑,并且需要更多关于这些问题相互作用的信息,以帮助临床医生正确诊断和管理ARFID。
本临床观察报告了一例9岁患有严重营养不良的ARFID病例,该患者积极看待自己的瘦小身材并重视消瘦。患者报告说,她自己对消瘦的渴望受到社交媒体上的美丽理想以及在社交场合中看到的对消瘦的赞扬的影响。尽管如此,回避性和限制性饮食行为的动机是食欲驱动力低、害怕尝试新食物以及害怕进食带来的不良后果。
尽管令人担忧,但患者的身体形象作为饮食失调行为的一个促发因素并无临床意义。身体形象不满很常见。ARFID诊断标准中排除身体形象扭曲的要求可能需要考虑年轻人所接触的社会身体理想的普遍性。