An Important Springboard Toward Establishing Diagnostic Connection Between Avoidant Restrictive Food Intake Disorder and Pediatric Feeding Disorder

Diagnostic ambiguity has surrounded the two primary diagnoses for dysfunctional feeding and eating in pediatric populations—that is, pediatric feeding disorder (PFD) and avoidant restrictive food intake disorder (ARFID). Recent expert consensus emphasized the need for diagnostic refinement to enhance understanding and improve clinical and research activities for both conditions. With the proposed revision of ARFID, Zickgraf and colleagues provide a research grounded springboard for beginning the revision process. The proposal centers upon a new Criterion A that emphasizes ARFID as a disorder driven by a negative, temporally proximate association with eating/food involving three distinct, yet potentially co-occurring responses of disgust/distaste, anhedonia/uncomfortable fullness, and acute fear/panic. In this commentary, we consider the potential benefits of the proposed framework from the PFD perspective and identify three additional areas—DSM text revisions, benefits of a shared feeding and eating disorder diagnosis, and a call for education and advocacy to complement future revisions—for further consideration during work to improve PFD and ARFID diagnostic systems.