Helen Burton Murray1, Abbey P Bailey2, Ani C Keshishian3, Casey J Silvernale2, Kyle Staller4, Kamryn T Eddy5, Jennifer J Thomas5, Braden Kuo4. 1. Department of Psychology, Drexel University, Philadelphia, Pennsylvania; Harvard Medical School, Boston, Massachusetts; Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: hbmurray@mgh.harvard.edu. 2. Center for Neurointestinal Health, Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts. 3. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts. 4. Harvard Medical School, Boston, Massachusetts; Center for Neurointestinal Health, Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts. 5. Harvard Medical School, Boston, Massachusetts; Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.
Abstract
BACKGROUND & AIMS: Avoidant/restrictive food intake disorder (ARFID) is a feeding and eating disorder that is characterized by avoidant or restrictive eating not primarily motivated by body shape or weight concerns. We aimed to determine the frequency of ARFID symptoms and study its characteristics and associated gastrointestinal symptoms. METHODS: We conducted a retrospective review of charts from 410 consecutive referrals (ages, 18-90 y; 73.0% female) to a tertiary care center for neurogastroenterology examination, from January through December 2016. Blinded coders (n = 4) applied Diagnostic and Statistical Manual of Mental Disorders, 5th edition, criteria for ARFID, with substantial diagnostic agreement (κ = 0.66). RESULTS: Twenty-six cases (6.3%) met the full criteria for ARFID and 71 cases (17.3%) had clinically significant avoidant or restrictive eating behaviors with insufficient information for a definitive diagnosis of ARFID. Of patients with ARFID symptoms (n = 97), 90 patients (92.8%) cited fear of gastrointestinal symptoms as motivation for their avoidant or restrictive eating. A series of binary logistic regressions showed that the likelihood of having ARFID symptoms increased significantly in patients with eating- or weight-related complaints (odds ratio [OR], 5.09; 95% CI, 2.54-10.21); with dyspepsia, nausea, or vomiting (OR, 3.59; 95% CI, 2.04-6.32); with abdominal pain (OR, 4.72; 95% CI, 1.87-11.81); or with lower GI diagnoses (OR, 2.40; 95% CI, 1.34-4.32). CONCLUSIONS: In a retrospective study of patients undergoing neurogastroenterology examinations, we found ARFID symptoms to be related most frequently to fear of gastrointestinal symptoms. Patients undergoing neurogastroenterology or motility examinations should be evaluated for symptoms of ARFID, particularly when providers consider dietary interventions.
BACKGROUND & AIMS: Avoidant/restrictive food intake disorder (ARFID) is a feeding and eating disorder that is characterized by avoidant or restrictive eating not primarily motivated by body shape or weight concerns. We aimed to determine the frequency of ARFID symptoms and study its characteristics and associated gastrointestinal symptoms. METHODS: We conducted a retrospective review of charts from 410 consecutive referrals (ages, 18-90 y; 73.0% female) to a tertiary care center for neurogastroenterology examination, from January through December 2016. Blinded coders (n = 4) applied Diagnostic and Statistical Manual of Mental Disorders, 5th edition, criteria for ARFID, with substantial diagnostic agreement (κ = 0.66). RESULTS: Twenty-six cases (6.3%) met the full criteria for ARFID and 71 cases (17.3%) had clinically significant avoidant or restrictive eating behaviors with insufficient information for a definitive diagnosis of ARFID. Of patients with ARFID symptoms (n = 97), 90 patients (92.8%) cited fear of gastrointestinal symptoms as motivation for their avoidant or restrictive eating. A series of binary logistic regressions showed that the likelihood of having ARFID symptoms increased significantly in patients with eating- or weight-related complaints (odds ratio [OR], 5.09; 95% CI, 2.54-10.21); with dyspepsia, nausea, or vomiting (OR, 3.59; 95% CI, 2.04-6.32); with abdominal pain (OR, 4.72; 95% CI, 1.87-11.81); or with lower GI diagnoses (OR, 2.40; 95% CI, 1.34-4.32). CONCLUSIONS: In a retrospective study of patients undergoing neurogastroenterology examinations, we found ARFID symptoms to be related most frequently to fear of gastrointestinal symptoms. Patients undergoing neurogastroenterology or motility examinations should be evaluated for symptoms of ARFID, particularly when providers consider dietary interventions.
Authors: Stephanie G Harshman; Jenny Jo; Megan Kuhnle; Kristine Hauser; Helen Burton Murray; Kendra R Becker; Madhusmita Misra; Kamryn T Eddy; Nadia Micali; Elizabeth A Lawson; Jennifer J Thomas Journal: J Clin Psychiatry Date: 2021-09-07 Impact factor: 4.384
Authors: Christopher J Black; Peter A Paine; Anurag Agrawal; Imran Aziz; Maria P Eugenicos; Lesley A Houghton; Pali Hungin; Ross Overshott; Dipesh H Vasant; Sheryl Rudd; Richard C Winning; Maura Corsetti; Alexander C Ford Journal: Gut Date: 2022-07-07 Impact factor: 31.793
Authors: Helen Burton Murray; Melissa J Dreier; Hana F Zickgraf; Kendra R Becker; Lauren Breithaupt; Kamryn T Eddy; Jennifer J Thomas Journal: Int J Eat Disord Date: 2021-04-22 Impact factor: 4.861