• Infants and children may not engage with the primary caregiver when feeding or to communicate hunger
• In older children and adolescents, the avoidance or restriction may be associated with more non-specific emotional difficulties that do not meet the full diagnostic criteria for an anxiety, depressive, or bipolar disorder
• Food avoidance or restriction can be a conditioned negative response associated with food intake following an aversive experience, e.g. choking

Criterion A. An eating or feeding disturbance (e.g. apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with at least 1 of the following:

1. Significant weight loss (or failure to achieve expected weight gain or faltering growth in children)
2. Significant nutritional deficiency
3. Dependence on enteral feeding or oral nutritional supplements
4. Marked interference with psychosocial functioning

Criterion B. The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.

Criterion C. The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one's body weight or shape is experienced.

Criterion D. The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.