Differential Diagnosis Between Avoidant/Restrictive Food Intake Disorder and Anorexia Nervosa

Abstract

Differential diagnosis between avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa may be challenging due to shared clinical features. Diagnostic criteria for ARFID prohibit disturbance of one's body shape/weight. In contrast to body image disturbance, body image dissatisfaction is normative and ubiquitous and may characterize those with ARFID. Distinguishing between body image disturbance and dissatisfaction is critical to derive accurate diagnoses. We compare these constructs, highlighting that body image dissatisfaction rises to the level of clinically significant body image disturbance when it results in: (1) behavioral symptoms, such as persistent behavior that interferes with weight gain; and/or (2) eating disorder cognitions, such as a distorted perception of one's shape/weight or overvaluation of shape/weight. We illustrate the application of this definition via a brief case example and conclude by providing recommendations to aid providers in differential diagnosis between ARFID and its most similar eating disorder, anorexia nervosa. [ Psychiatr Ann . 2024;54(2):e37–e41.]