TABLE 1.

Operationalizing ARFID core diagnostic criteria A1–A3

	Strict	Expansive
A1: Weight loss, growth faltering	Outside records documenting: • Stunted growth, • Growth faltering, and/or • Weight loss …attributed to the eating disturbance	Outside records documenting: • Small stature with stable growth/no documented history of stunting or faltering • Low weight without stunting, underweight, or weight loss/growth faltering • Difficulty gaining weight …attributed to the eating disturbance
A2: Nutritional deficiency	Outside records documenting that… • Patient is unable to meet nutritional needs with food alone and is not using supplements or despite supplement use …attributed to the eating disturbance Determined by nutritional analysis of diet or results of bloodwork	Outside records documenting that… • Diet interferes with nutritional management of a medical condition (e.g., weight loss, gastroesophageal reflux, type I diabetes) Or… • PCP recommended supplements but patient refuses • PCP expresses general concerns about nutritional status based on restricted range/volume, but no specific deficiencies identified
A3: Supplement dependence	Outside records documenting that… • Patient requires nutritional supplements (including boost and other commercial supplements, homemade supplements, supplementation with high-calorie preferred foods, or calorie-boosting) to meet nutritional needs …attributed to the eating disturbance Determined by nutritional analysis of diet or results of bloodwork	• Use of fiber supplements or multivitamins to compensate for perceived deficiencies • Use of nutritional supplements without evidence of dependence
A4: Psychosocial interference	Evidence from clinical interview for one or more of the following • Accommodation (preparing a different meal or preparing foods in a specific way, providing specific brands of food) at one or more meals/day • Interference (avoiding activities, extra preparation or putting off eating to be able to participate) at least once/week • Distress (anxiety, guilt, embarrassment, parents: Conflict with other adults/other parent) related to eating at least once/week	No expansive criteria were developed/used for A4

Note. PCP = Primary care provider. Information summarized in Table 1 was collected using the ARFID Diagnostic and Severity Interview, an author-developed semistructured interview, or obtained from review of outside records. The distinction between strict and expansive criteria for A1–A3 was subsequently developed for the current chart review.