Five years of Avoidant/Restrictive Food Intake Disorder: no consensus of understanding among health professionals in New Zealand

ABSTRACT In 2013, Avoidant/Restrictive Food Intake Disorder (ARFID) was introduced as a new diagnosis. Prior 2013 there was great variability in professionals’ understanding of children’s food intake. Children with a restricted intake of food had limited recognition amongst health services, which the ARFID diagnosis aimed to change. Over time, it is useful to evaluate whether the formulation of this eating disorder has improved understanding of food refusal or ‘picky eating’ to ultimately enable effective outcomes for children and their families. This study explored changes in perspective from 2013 to 2018 regarding understanding of picky eating amongst health professionals (medical practitioners, dietitians and speech-language therapists) working with children and feeding difficulties in New Zealand. An online survey conducted in 2013 and 2018 targeted understanding of food refusal and consensus within the medical field for the labelling of picky eating. Responses were analysed with descriptive statistics, and qualitative content analysis. Health professionals in both years reported there was no consensus in the labelling of picky eating, with a significant increase in those reporting ‘no consensus’ in 2018 (n = 141, p = .035). However, health professionals demonstrated an increased awareness from 2013, by seeking further information regarding labelling of the condition portrayed. Despite an increase in awareness since 2013, health professionals are yet to agree on the diagnosis and treatment of ARFID. The impact of picky eating on parental stress may be underestimated in the literature. Consensus and guidelines are necessary to support health professionals, individuals and their families to obtain necessary services and resources.