Eating and feeding disorders

1. Muhammad Musawar Ali
MPHIL, ICAP
Psychmmusawarali@gmail.com

2.  Avoidant/restrictive food intake disorder
 Anorexia nervosa

3. Avoidant/restrictive food intake
disorder

4.  ARFID was introduced as a new diagnostic category in
the recently published DSM-V. The ARFID diagnosis
describes individuals whose symptoms do not match
the criteria for traditional eating disorder diagnoses,
but who, nonetheless, experience clinically significant
struggles with eating and food. Symptoms of ARFID
typically show up in infancy or childhood, but they
may also present or persist into adulthood.

5.  Individuals who meet the criteria for ARFID have
developed some type of problem with eating (or for
very young children, a problem with feeding). As a
result of the eating problem, the person isn’t able to
take in adequate calories or nutrition through their
diet. There are many types of eating problems that
might warrant an ARFID diagnosis – difficulty
digesting certain foods, avoiding certain colors or
textures of food, eating only very small portions,
having no appetite, or being afraid to eat after a
frightening episode of choking or vomiting.

6.  person with ARFID isn’t able to get enough nutrition
through their diet, they may end up losing weight. Or,
younger kids with ARFID might not lose weight, but
rather may not gain weight or grow as expected.

7. Diagnostic criterion
 1. An eating or feeding disturbance (e.g., apparent lack of
interest in eating or food; avoidance based on the sensory
characteristics of food; concern about aversive
consequences of eating) as manifested by persistent failure
to meet appropriate nutritional and/or energy needs
associated with one (or more) of the following:
 Significant weight loss (or failure to achieve expected
weight gain or faltering growth in children).
 Significant nutritional deficiency.
 Dependence on enteral feeding or oral nutritional
supplements.
 Marked interference with psychosocial functioning.

8.  2. The disturbance is not better explained by lack of
available food or by an associated culturally sanctioned
practice.
 3. The eating disturbance does not occur exclusively during
the course of anorexia nervosa or bulimia nervosa, and
there is no evidence of a disturbance in the way in which
one’s body weight or shape is experienced [body image].
 4. The eating disturbance is not attributable to a
concurrent medical condition or not better explained by
another mental disorder. When the eating disturbance
occurs in the context of another condition or disorder, the
severity of the eating disturbance exceeds that routinely
associated with the condition or disorder and warrants
additional clinical attention.

9. Causes
 Many interacting risk factors influence a child’s
adaptation to a certain level of caloric intake
 Avoidant/restrictive food intake disorder is
associated with:
 Family disadvantage, poverty, unemployment, social
isolation, parental mental illness, and maternal eating
disorders (specific risk factor)

10. Treatment
 Cognitive behavioral therapy (CBT) can be employed to
help ARFID patients change the thought patterns that
underlie their eating disturbance.
 Exposure therapy. Help patients tolerate anxiety-
provoking foods or the physical process of consuming
feared foods.
 Family-based approaches may also be helpful if
resistance or avoidance arises during family meals. Such
psychological interventions coupled with nutritional
education and medical monitoring can help eliminate
avoidant and restrictive behaviors and promote recovery
from ARFID.

11.  Treatment involves detailed assessment of feeding
behavior and parent-child interactions, while allowing
parents to play a role in the infant’s recovery

13.  Anorexia Nervosa is a psychological and possibly life-
threatening eating disorder defined by an extremely low
body weight relative to stature (this is called BMI [Body
Mass Index] and is a function of an individual’s height and
weight), extreme and needless weight loss, illogical fear of
weight gain, and distorted perception of self-image and
body.
 Additionally, women and men who suffer from anorexia
nervosa exemplify a fixation with a thin figure and
abnormal eating patterns. Anorexia nervosa is
interchangeable with the term anorexia, which refers to
self-starvation and lack of appetite.

14. Diagnostic Criteria:
A. Restriction of energy intake relative to requirements,
leading to a significantly low body weight in the context of
age, sex, developmental trajectory, and physical health.
B. Intense fear of gaining weight for becoming fat, or
persistent behavior that interferes with weight gain, even
though a significantly low weight.
C. Disturbance in the way in which one’s body weight or
shape is experienced, undue influence of body weight or
shape on self-evaluation or persistent lack of recognition of
the seriousness of the current low body weight.

15. causes
 The exact cause of anorexia nervosa is unknown. As
with many diseases, it's probably a combination of
biological, psychological and environmental factors.
 Biological. Although it's not yet clear which genes are
involved, there may be genetic changes that make
some people more vulnerable to developing anorexia.
Some people may have a genetic tendency toward
perfectionism, sensitivity and perseverance — all traits
associated with anorexia.

16.  Psychological. Some emotional characteristics may
contribute to anorexia. Young women may have obsessive-
compulsive personality traits that make it easier to stick to
strict diets and forgo food despite being hungry. They may
have an extreme drive for perfectionism, causing them to
think they're never thin enough. They may have high levels
of anxiety and restrict their eating to reduce it.
 Environmental. Modern Western culture emphasizes
thinness. Success and worth are often equated with being
thin. Peer pressure may help fuel the desire to be thin,
particularly among young girls.

17. Genetic factors:
 The eating disorders anorexia nervosa tend to run in
families, and twin studies support the role of genetics in
the actual disorder.
 Concordance rate for eating disorder is higher in MZ twins
as compared to DZ twins.
 Low level of serotonin have also been associated with
eating disorders.

18. Cont..
Sociocultural
Standards:
 As sociocultural standards
changed to favor a thinner
shape as the ideal for women,
the frequency of eating
disorders increased.
 Photos in magazines and
advertisement, and other
form of media pressure to be
thin “thin ideal”.

19. Treatment
 A number of different psychological treatments can be
used to treat anorexia. Depending on the severity of
the condition, treatment will last for at least 6 to 12
months or more.
 Cognitive analytic therapy (CAT)
Reformulation
Recognition
Revision

20.  Cognitive behavioral therapy (CBT)
 Interpersonal therapy (IPT)
 Focal psychodynamic therapy (FPT)
 Family interventions

21. thank you!!!