A case series on the clinical profile of avoidant–restrictive food intake disorder in Singapore

Abstract

Little is known about the new Diagnostic and statistical manual of mental disorders, fifth edition, diagnosis of Avoidant–Restrictive Food Intake Disorder (ARFID). Without sufficient knowledge about the disorder, its detection and treatment are hampered. This study highlights eight cases diagnosed with ARFID between 2013 and June 2016 who presented to our treatment facility, the only specialized Eating Disorders program in Singapore. Informed consent was obtained from the patients and their parents, and their case notes retrieved and reviewed. There were five males and three females, with ages ranging from 15 to 39 years, a mean age of 20 years and body mass index of 16.1 kg/m2 at time of diagnosis. The presentation of cases was heterogeneous, including selective eating behaviors, very restricted food choices, anxiety towards specific foods and with comorbid mood symptoms. A majority of the cases displayed ARFID symptoms early in childhood, suggesting the need to inform parents, educators and healthcare professionals. The study also found a high treatment default rate amongst the patients, warranting further investigation. Due to the heterogenous presentation of ARFID, the authors appeal for further exploration to be carried out and more to be done to increase the awareness of this condition in both the medical profession and general population.