Avoidant/Restrictive Food Intake Disorder Plus Eating Disorder Comorbidity: Are Two Diagnoses Better Than One?

Abstract

Zickgraf and colleagues propose an elegant revised framework for avoidant/restrictive food intake disorder that would recognize it as a diagnosis based on the presence of specific eating behaviors, and, importantly, allow for it to be diagnosed alongside other medical and psychiatric conditions, including other eating disorders. While likely to have good ecological validity, this radical proposal challenges the general conceptualization of ARFID as the eating disorder in which weight- and shape-concerns are not present. Here, we consider whether two diagnoses are indeed better than one, raising challenges we have observed in clinical and research practice. We offer an alternative hybrid categorical-dimensional framework for considering ARFID and co-occurring eating disorder symptoms and encourage a set of next steps for research in this nosological arena.