restrictive food intake disorder is avoidance or restriction of food intake (Criterion A)
manifested by clinically significant failure to  meet requirements for nutrition or insuffi-
cient energy intake through oral intake of food. One or more of the following key features
must be present: significant weight loss, si gnificant nutritional deficiency (or related
health impact), dependence on enteral feedin g or oral nutritional supplements, or marked
interference with psychosocial functioning.  The determination of whether weight loss is
significant (Criterion A1) is a clinical judgme nt; instead of losing weight, children and ad-
olescents who have not completed growth may not maintain weight or height increases
along their developmental trajectory.
Determination of significant nu tritional deficiency (Criterion A2) is also based on clin-
ical assessment (e.g., assessment of dietary intake, physical examination, and laboratory
testing), and related impact on physical health can be of a similar seve rity to that seen in
anorexia nervosa (e.g., hypother mia, bradycardia, anemia). In severe cases, particularly in
infants, malnutrition can be life threatening.  “Dependence” on enteral feeding or oral nu-
tritional supplements (Criterion A3) means that  supplementary feeding is required to sus-
tain adequate intake. Examples of individu als requiring supplementary feeding include
infants with failure to thrive who require na sogastric tube feeding, children with neuro-
developmental disorders who are dependent on  nutritionally complete supplements, and
individuals who rely on gastrostomy tube feeding or complete oral nutrition supplements
in the absence of an underlying medical condit ion. Inability to participate in normal social