TABLE 3.

Strict versus expansive ARFID criteria

Age/gender	Referral	Criteria met: Strict (expansive)	A1: Weight loss or growth faltering	A2: Nutritional deficiency	A3: Supplement dependence	A4. Psychosocial impairment	Psychological comorbidity	Medical comorbidity	ARFID presentation
Impairment only (A4): n = 7
1. 4/M	Feeding clinic	A4	Ruled out; Normal BMI, stable growth	Ruled out	Ruled out	Family	None	None	Selective
2. 5/M	Feeding clinic	A4	Ruled out; stable growth trajectory	Ruled out	Ruled out	Family	OCD, GAD, ADHD	None	Selective
5. 7/F	Feeding clinic	A4	Ruled out; BMI% = 50, stable growth trajectory	Ruled out	Ruled out	Family, social, occupational	GAD	None	Selective
8. 8/M	Outside psychologist	A4	Overweight	No PCP concern	No PCP concern	Family	Tics, ADHD	None	Selective
12. 10/F	Self-referreda	A4	No PCP concern	No PCP concern	No PCP concern	Family, social	GAD, OCD, tics	Asthma	Selective
13. 11/M	PCP	A4	No PCP concern	No PCP concern	No PCP concern	Family	Unspecified anxiety disorder	None	Selective
14. 13/M	PCP	A4	Overweight	No PCP concern	No PCP concern	Family, social, occupational	MDD, LDs	None	Selective
Strict weight/nutrition criteria (A1–A3): n = 4
3. 6/M	Feeding clinic	A1, A3, A4	Small stature, history of BMI < 5th %. At intake BMI% = 15, stable growth trajectory since age 3	Ruled out	Supplement use (Pediasure 1×/day)	Family, social, occupational	GAD, SAD	None	Selective, appetite/interest
16. 14/M	Self-referred	A1, A4 (A2)	BMI % < 5	PCP concerns but no evidence of deficiency	PCP recommended, patient refuses	Family, occupational	SAD	None	Selective
Age/gender	Referral	Criteria met: Strict (expansive)	A1: Weight loss or growth faltering	A2: Nutritional deficiency	A3: Supplement dependence	A4. Psychosocial impairment	Psychological comorbidity	Medical comorbidity	ARFID presentation
17. 15/M	PCP, endocrinologist	A1, A4 (A2)	Evidence of stunting: Growth hormone deficiency ruled out BMI % = 9th	PCP concerns but no evidence of deficiency	PCP recommended, patient refuses or uses sporadically	Family	GAD	None	Selective, appetite/interest
19. 19/M	PCP	A1, A3, A4	BMI = 16 (<5%) consistent growth curve, no evidence of stunting: Tall, low weight	Ruled out	Boost high protein 2×/day	Family, social, occupational	ADHD	None	Selective, appetite/interest
Expansive weight/nutrition criteria (A1–A3): n = 11
4. 7/M	Feeding clinic	A4 (A1, A3)	Small stature, BMI% = 14, consistent growth trajectory	Ruled out	Refuses supplements; relies on ice cream for calories at feeding clinic recommendation	Family	None	None	Selective, appetite/interest
6. 7/M	Feeding clinic	A4 (A2)	Overweight	Per feeding and diabetes care team: Diet interferes with weight management and type I diabetes	Ruled out	Family	None	Type I diabetes	Selective
7. 7/M	PCP	A4 (A3)	BMI% = 75th, consistent growth trajectory, no PCP concern	No PCP concern	No PCP concern (given protein bars because other food sources of protein are non-preferred)	Family	Unspecified anxiety and mood disorders	None	Selective
9. 9/M	PCP	A4 (A1)	Tall, thin-appearing BMI % = 5th, consistent growth, no stunting	No PCP concern	No PCP concern	Family, occupational	None	None	Selective, appetite/interest
10. 9/M	Feeding clinic	A4 (A2)	Overweight	Per feeding clinic: Diet interferes with weight management	Ruled out	Family, social, occupational	GAD	Asthma	Selective
11. 10/M	PCP and GI	A4 (A2, A3)	No PCP concerns	Per GI: Diet contributes to constipation	Fiber supplements	Family, social, occupational	None	Chronic	constipation
Selective
15. 13/M	Self-referred	A4 (A2)	Small stature; no documented evidence of stunting or underweight	PCP concerns but no evidence of deficiency	PCP recommended, patient refuses	Family	Unspecified anxiety	None	Selective
18. 16/F	PCP	A4 (A2)	Family concerned about stunting due to short stature, but not known whether height is attributable to ARFID; overweight BMI	PCP concerns but no evidence of deficiency	PCP recommended, patient refuses	Family	OCD	History of failure to thrive (preterm birth)	Selective
20. 22/M	Self-referred	A4 (A2)	No PCP concern	No specific PCP concerns raised but patient believes present given diet	No PCP concern, but uses multivitamins and occasionally supplements or protein shakes	Family, social	MDD	None	Selective, appetite/interest
Age/gender	Referral	Criteria met: Strict (expansive)	A1: Weight loss or growth faltering	A2: Nutritional deficiency	A3: Supplement dependence	A4. Psychosocial impairment	Psychological comorbidity	Medical comorbidity	ARFID presentation
21. 24/M	Outpatient weight and eating disorders psychologist	A4 (A1, A2, A3)	BMI = 19.5 tall, low weight – Difficulty gaining and building muscle	No PCP concerns, but patient believes present	No PCP concern, but patient drinks large amounts of milk for calories and minerals (multivitamins)	Family, social, occupational	GAD	None	Selective, appetite/interest
22. 25/F	Outpatient weight and eating disorders psychologist via PCOS care team	A4 (A2)	Obese BMI	Per PCOS team and GI: Diet interferes with weight management, triggers GERD	No PCP concern (multivitamins); patient refusing GI surgery due to concerns about liquid diet (refuses supplements)	Family, occupational	MDD	Polycystic ovarian syndrome, GERD	Selective

Note. FSC = Feeding and Swallowing Clinic, PCP = Primary care physician, GYN = Gynecologist, GI = Gastroenterologist, ED clinic = Eating disorders clinic, GAD = Generalized anxiety disorder, SAD = Social anxiety disorder, MDD = Major depressive disorder, ADHD = Attention deficit/hyperactivity disorder, LD = Learning disability, GERD = Gastroesophageal reflux disease, PCOS = Polycystic ovarian syndrome.

^aNot referred for feeding problems.