New York Must Codify What Science Already Knows About ARFID
By Connie Altamirano
When medicine advances and law does not, families suffer in the gap.
In 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) formally recognized Avoidant/Restrictive Food Intake Disorder (ARFID) as a distinct and diagnosable eating disorder. More than a decade later, families across New York State continue to confront a troubling reality: ARFID is clinically recognized, medically billable, and scientifically validated yet it remains inconsistently protected, misunderstood, and structurally under-supported within state statute.
New York Senate Bill S9063, sponsored by Senator Joseph Addabbo, and its Assembly companion A9600, sponsored by Assemblymember Jenifer Rajkumar, address that gap directly. These bills do not create a new diagnosis. They correct a statutory omission. By amending the Mental Hygiene Law and the Public Health Law, this legislation formally codifies ARFID alongside anorexia nervosa, bulimia nervosa, and binge eating disorder aligning New York law with established psychiatric science.
This alignment is not symbolic. It is operational.
When state statute fails to explicitly reflect modern diagnostic standards, families face insurance denials, delayed authorizations, limited provider networks, and inappropriate treatment pathways. Codification removes ambiguity. Ambiguity is where access collapses.
ARFID is fundamentally different from the eating disorders most familiar to the public. It is not driven by body image disturbance or fear of weight gain. Instead, it is often associated with severe anxiety, sensory processing differences, traumatic feeding experiences, gastrointestinal distress, or neurodevelopmental conditions including autism spectrum disorder and ADHD. A child may gag at certain textures. An adolescent may restrict intake due to an overwhelming fear of choking or vomiting. An adult may survive on an extremely narrow set of “safe foods,” leading to profound nutritional deficiencies while appearing at a normal or even elevated weight.
Weight is not the diagnostic determinant. Functional impairment and nutritional compromise are.
Because ARFID does not conform to outdated stereotypes, it is frequently dismissed as “picky eating.” That dismissal carries consequences. Children are shamed. Parents are blamed. Treatment is delayed. In some cases, ineffective and psychologically harmful interventions including coercive feeding practices are attempted instead of evidence-based care.
For many years, I have advocated for children with special needs across New York State. In that work, a troubling pattern became impossible to ignore.
Children were repeatedly labeled “selective” or “difficult.” Yet these were children surviving on fewer than ten foods. Nutritional supplements such as Pediasure and Ensure became medical lifelines. Some, in certain cases, experienced gagging or vomiting when exposed to specific triggering foods. Exposure alone could trigger physiological panic. This was not defiance. It was not indulgence. It was not poor parenting.
It was ARFID.
The recognition did not emerge from theory alone. It surfaced through direct advocacy through conversations with families carrying binders of feeding logs, growth charts, and insurance denial letters. Through repeated accounts of children returning home from school with untouched lunches. Through parents being told, year after year, that their child would “grow out of it,” even as nutritional compromise deepened.
When I began speaking publicly about ARFID, the response was immediate and statewide. Parents of newly diagnosed children reached out, alongside families whose children remained undiagnosed despite clear clinical indicators. Adults who had lived decades without a name for their condition contacted me. Families still being dismissed sought guidance. The pattern was undeniable: ARFID is not rare. It is under-recognized.
Today, I facilitate a statewide ARFID support network, including a WhatsApp group connecting parents and adults navigating diagnosis, treatment access, and insurance barriers. The stories shared are not abstract policy discussions. They include children who, in some cases, experience gagging or vomiting when exposed to triggering foods; adolescents who avoid social settings because food-related anxiety overwhelms them; and adults who were shamed rather than diagnosed.
This is precisely why S9063 and A9600 matter. Public health statutes exist to safeguard vulnerable populations, and individuals living with ARFID deserve full statutory protection. We cannot continue to permit legislative gaps to disproportionately burden those most in need of protection.
The legislation provides explicit legal recognition of ARFID within New York’s statutory framework. It reinforces treatment access and parity protections. It modernizes outdated diagnostic references, removing reliance on ICD-9-CM codes that no longer reflect contemporary psychiatric standards. And it strengthens public health awareness at a time when clinician education and insurance clarity remain uneven.
In addition to Senator Addabbo and Assemblymember Rajkumar’s sponsorship, the legislation has drawn support from experienced lawmakers committed to mental health and public health equity. Assemblymember Linda B. Rosenthal and Assemblymember Andrew Hevesi serve as co-sponsors of A9600. In the Senate, co-sponsors include Senator Jessica Ramos, Senator Monica R. Martinez, Senator Kevin Parker, and Senator Luis R. Sepúlveda. Their collective support signals recognition that statutory precision is essential for meaningful access to care.
ARFID is already recognized within the DSM-5. Major medical institutions across New York diagnose and treat it. The issue is not whether ARFID exists. The issue is whether our laws fully reflect and protect what medical science already affirms.
ARFID can result in severe malnutrition, micronutrient deficiencies, growth disruption, reliance on nutritional supplementation, social isolation, academic impairment, and significant psychiatric distress. It affects children, adolescents, and adults. It does not discriminate by weight. It does not resolve itself through willpower.
Recognition under law is not rhetorical validation. It is structural protection.
During this legislative session, I will return to Albany to continue advancing this legislation through direct and sustained engagement with lawmakers and legislative leadership. When statutory language lags behind established medical science, families are left navigating preventable barriers. That gap must close. I intend to remain actively involved in this effort until New York law fully reflects what medicine has already confirmed.
New York must codify what science already knows.
