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Avoidant restrictive food intake disorder: First do no harm.

Debra K Katzman1,2, Mark L Norris3,4, Nancy Zucker5,6

  • 1Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.

The International Journal of Eating Disorders
|January 25, 2019
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Summary
This summary is machine-generated.

Nasogastric tube (NGT) feedings for avoidant restrictive food intake disorder (ARFID) in children require caution. Oral sensitivities and psychological effects can make NGTs aversive, potentially worsening food avoidance.

Keywords:
ARFIDadolescentavoidant restrictive food intake disorderchildrenconditioned taste aversionnasogastric tube feedingsensory aversion

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Area of Science:

  • Pediatric Gastroenterology
  • Child Psychology
  • Eating Disorders

Background:

  • Avoidant Restrictive Food Intake Disorder (ARFID) is a complex eating disorder in children and adolescents.
  • Nasogastric tube (NGT) feedings are established for anorexia nervosa but lack empirical support for ARFID.
  • Pragmatic considerations for NGT use in ARFID are needed.

Purpose of the Study:

  • To explore medical and psychological considerations for using NGT feedings in pediatric ARFID treatment.
  • To highlight the need for cautious application of NGTs in ARFID due to specific patient characteristics.

Main Methods:

  • This is an opinion piece based on clinical experience and existing literature.
  • It reviews potential medical and psychological impacts of NGTs on ARFID patients.

Main Results:

  • There is limited empirical evidence supporting NGT use in ARFID, unlike in anorexia nervosa.
  • Oral sensitivities common in ARFID can make NGT insertion and feeding aversive.
  • NGT use may lead to iatrogenic conditioned food aversions, exacerbating the disorder.

Conclusions:

  • Clinicians should carefully consider the risks and benefits before initiating NGT feedings for ARFID in children and adolescents.
  • The potential for negative psychological consequences and worsening food aversion necessitates a cautious approach.
  • Further research is needed to establish evidence-based guidelines for NGT use in ARFID.