Pica is a feeding disorder in which an individual persists in consuming nonnutritive, nonfood substances. The eating behavior lies outside any cultural norm or social compulsion, and it is classified as pica if it continues for more than a month. For example, this may include the inexplicable consumption of substances such as lotion, soap, or dirt. When pica occurs in tandem with a psychiatric condition or intellectual disability, it may require clinical intervention.
Rumination disorder occurs when an individual regurgitates his or her food after swallowing it, re-chewing it and then swallowing again or spitting it out. To be classified as rumination disorder, the regurgitation behavior must not be related to any medical or gastrointestinal condition, and the behavior would continue for over a month. Learning self-awareness and mindful eating can help individuals correct rumination eating practices. As with pica, if rumination disorder occurs alongside a psychiatric condition or intellectual disability, it may require clinical intervention.
Avoidant/Restrictive Food Intake Disorder (ARFID)
Avoidant/restrictive food intake disorder is a condition in which individuals resist food intake for reasons that do not pertain to food preferences or any medical condition. It stems from a fear of the adverse consequences of eating food or being repelled by the sensory characteristics of food, and it may present as a total lack of interest in eating. Severe ARFID can result in malnutrition, significant weight loss or inability to meet weight standards for one’s developmental age, dependence on tube feeding or supplements, and impaired psychosocial functioning. If ARFID cannot be explained by a medical or mental health condition, its consequences to an individual’s quality of life may mandate clinical intervention.
Other Specified Feeding or Eating Disorder (OSFED)
Several other specific feeding and eating disorders fall on the spectrum of disturbed or atypical eating patterns. This includes low frequency forms of anorexia and bulimia, in which an individual is exhibiting behaviors of these conditions but not as often as once a week for three months. Because the minimum criteria according the DSM-5 are not met, these would be considered OSFED. Other OSFED include the following:
- Night eating syndrome, in which a person repeatedly consumes large portions of food in the evening, not as a response to hunger but out of compulsion.
- Atypical anorexia, in which an individual participates in starvation practices and the mental attitude characterizing anorexia but appears of normal weight.
- Purging disorder, in which a person does not participate in binge eating but continually purges using self-induced vomiting, laxatives, and diuretics.
Unspecified Feeding or Eating Disorder
The diagnosis of unspecified feeding or eating disorder is commonly used when there is not enough information to make any definitive diagnosis on a person’s disturbed eating practices. It may be used as a placeholder or to identify an eating disturbance that is either not fully developed or classified by the current DSM.