Which patient behavior is most consistent with avoidant restrictive food intake disorder (ARFID)?

Question

BlackTom AI · Accepted Answer

ARFID is defined by restrictive eating driven by factors other than body-image concerns, most commonly sensory sensitivity (taste/texture/smell), lack of interest in eating, or fear of aversive consequences like choking.

1. Relevant knowledge points and concepts
- Avoidant/Restrictive Food Intake Disorder (ARFID) involves restrictive eating that leads to significant weight loss, nutritional deficiency, reliance on supplements/feeding tubes, or marked psychosocial impairment.
- ARFID is not motivated by concerns about weight or shape; there is no body-image disturbance.
- Common presentations include sensory aversion to food textures, limited variety, or fear of consequences (vomiting/choking).
- Differential diagnoses: anorexia nervosa (weight/shape fear), bulimia nervosa (binge-purge cycles), pica (eating non-food items).

2. Step-by-step reasoning
- Examine each option against the diagnostic features of ARFID.
- Determine which behavior reflects restriction due to sensory aversion, absence of weight/shape concerns, and leads to avoidance/limited intake.

3. Intermediate steps / analysis
- "Ritualized binge-and-purge cycles": implies recurrent binge eating and compensatory behaviors—fits bulimia nervosa or anorexia binge-purge subtype, not ARFID.
- "Eating non-food items such as paper": represents pica (ingestion of non-nutritive substances), a different feeding disorder.
- "Restriction due to sensory aversion to textures": directly matches a prototypical ARFID presentation—avoidance driven by sensory sensitivity, causing restricted intake without weight/shape concerns.
- "Strict fear of weight gain": is the core of anorexia nervosa (and often bulimia), inconsistent with ARFID.

4. Why the correct answer is correct
Restriction from sensory aversion is a hallmark ARFID mechanism; patients avoid foods because of texture, smell, or taste, leading to nutritional/functional impairment while lacking body-image concerns.

5. Why other options are incorrect
- Ritualized binge-and-purge cycles → bulimia nervosa/anorexia binge-purge subtype.
- Eating non-food items → pica.
- Strict fear of weight gain → anorexia nervosa.

6. Conclusion
The correct choice is "Restriction due to sensory aversion to textures," which matches the provided answer.

Which patient behavior is most consistent with avoidant restrictive food intake disorder (ARFID)?单项选择题

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