Major depressive disorder. In major depressive disorder, appetite might be affected to such an extent that individuals present with significantly restricted food intake, usually in relation to overall energy intake and often associated with weight loss. Usually appetite loss and related reduction of intake abate with resolution of mood problems. Avoidant/ restrictive food intake disorder should only be used concurrently if full criteria are met for both disorders and when the eating disturbance requires specific treatment.
Schizophrenia spectrum disorders. Individuals with schizophrenia, delusional disor- der, or other psychotic disorders may exhibit odd eating behaviors, avoidance of specific foods because of delusional beliefs, or other manifestations of avoidant or restrictive in- take. In some cases, delusional beliefs may contribute to a concern about negative conse- quences of ingesting certain foods. Avoidant/ restrictive food intake disorder should be used concurrently only if all criteria are met for both disorders and when the eating dis- turbance requires specific treatment.
Factitious disorder or factitious disorder imposed on another. Avoidant/restrictive der imposed on another. In order to assume the sick role, some individuals with factitious disorder may intentionally describe diets that are much more restrictive than those they are actually able to consume, as well as complications of such behavior, such as a need for enteral feedings or nutritional supplements, an inability to tolerate a normal range of foods, and/ or an inability to participate normally in age-appropriate situations involving food. The presentation may be impressively dramatic and engaging, and the symptoms re- ported inconsistently. In factitious disorder imposed on another, the caregiver describes symptoms consistent with avoidant/restrictive food intake disorder and may induce physical symptoms such as failure to gain weight. As with any diagnosis of factitious dis- order imposed on another, the caregiver receives the diagnosis rather than the affected in- dividual, and diagnosis should be made only on the basis of a careful, comprehensive assessment of the affected individual, the caregiver, and their interaction.
The most commonly observed disorders comorbid with avoidant/restrictive food intake disorder are anxiety disorders, obsessive-compulsive disorder, and neurodevelopmental disorders (specifically autism spectrum disorder, attention-deficit/hyperactivity disor- der, and intellectual disability [intellectual developmental disorder]).
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Sig- nificantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue in- fluence of body weight or shape on seIf-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
Coding note: The |CD-9-CM code for anorexia nervosa is 307.1, which is assigned re- gardless of the subtype. The lCD-10-CM code depends on the subtype (see below).
Specify whether: (F50.01) Restricting type: During the last 3 months, the individual has not engaged in re- current episodes of binge eating or purging behavior (i.e., self—induced vomiting or the mis- use of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
(F50.02) Binge-eating/purging type: During the last 3 months, the individual has en- gaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
Specify if: