Beyond Western Frameworks: Rethinking ARFID Diagnosis and Treatment—Lessons From Latin America

Abstract

Avoidant/Restrictive Food Intake Disorder (ARFID) presents significant diagnostic and treatment challenges across diverse populations. Although recent studies from Sweden and the Gulf Cooperation Council (GCC) provide valuable data on ARFID prevalence and assessment limitations, they highlight critical gaps in the applicability of diagnostic tools across cultural contexts. ARFID in Latin America remains largely underdiagnosed due to limited awareness, inadequate clinician training, and a lack of validated screening instruments adapted to the region's dietary habits, socioeconomic conditions, and healthcare infrastructure. Our research in Mexico, presented at ICED 2019, confirms that ARFID is not a culture-bound syndrome but manifests in culturally specific ways. A strong preference for traditional foods such as tortillas, beans, and rice was frequently observed, with food neophobia playing a central role in restriction. The Nine Item ARFID Screen (NIAS), originally developed in English, has been translated and validated in Spanish (Medina-Tepal et al.). However, further adaptation is required to ensure it addresses these regional nuances. Additionally, post-pandemic healthcare strain and the rise of underqualified professionals exacerbate diagnostic delays and treatment failures. This commentary underscores the urgent need for culturally tailored diagnostic tools, increased clinician training, and institutional policies that support the development of specialized ARFID treatment frameworks in Latin America.