Avoidant/Restrictive Food Intake Disorder 337
tions, especially those with on going symptoms such as vomiting, loss of appetite, nausea, ab-
dominal pain, or diarrhea. A diag nosis of avoidant/restrictive food intake disorder requires
that the disturbance of intake is beyond that directly accounted for by physical symptoms con-
sistent with a medical condition; the eating d isturbance may also persis t after being triggered
by a medical condition and following resolution of the medical condition. 
Underlying medical or comorbid mental cond itions may complicate  feeding and eating.
Because older individuals, postsurgical pati ents, and individuals receiving chemotherapy
often lose their appetite, an additional diagno sis of avoidant/restric tive food intake dis-
order requires that the eating disturbance is a primary focus for intervention. 
Specific neurological/neuromuscular, structural, or congenital disorders and condi-
tions associated with feeding difficulties. Feeding difficulties are common in a number
of congenital and neurological conditions often related to problems with oral/esophageal/
pharyngeal structure and function, such as hy potonia of musculature, tongue protrusion,
and unsafe swallowing. Avoidant/restrictive food  intake disorder can be diagnosed in in-
dividuals with such presentations as long as all diagnostic criteria are met.
Reactive attachment disorder. Some degree of withdrawal is characteristic of reactive
attachment disorder and can lead to a distur bance in the caregiver-child relationship that
can affect feeding and the child’s intake. Avoi dant/restrictive food intake disorder should
be diagnosed concurrently only if all criter ia are met for both di sorders and the feeding
disturbance is a primary focus for intervention.
Autism spectrum disorder. Individuals with autism spectr um disorder often present with