Written by Kimiko Dunbar
Spoon Feed
Avoidant restrictive food intake disorder (ARFID) is associated with high risk of neurodevelopmental, GI, metabolic and neurologic disorders.
It’s not just about the food
This cohort study examines the mental and somatic conditions associated with ARFID using data from 30,795 Swedish children. The study included all twins, as the data were retrieved from the Child and Adolescent Twin Study in Sweden. They found that children with ARFID (2.0% prevalence) had significantly higher risks for mental conditions (HR 3.90; 95%CI 3.36-4.52), endocrine or metabolic conditions (HR 2.73; 95%CI 2.21-3.36), and digestive conditions (HR 2.03; 95%CI 1.76-2.35). The most common mental conditions in those with ARFID were ADHD (17.5%), autism (13.8%), and intellectual disability (9.1%). Children with ARFID were also found to have a higher risk of respiratory conditions such respiratory infections and asthma. Conversely, irritable bowel syndrome, OCD, diabetes and obesity were not significantly associated with ARFID. Those with ARFID also had increased rates of hospitalization. Finally, authors found an increased cancer risk in those with ARFID, although this should be interpreted with caution as data extraction cannot determine if cancer treatments may cause symptoms that mimic that of ARFID (i.e. decreased appetite, weight loss). Limitations include reliance on registry data. The findings emphasize ARFID’s broad health impact, necessitating multidisciplinary care.
How will this change my practice?
These findings support a multi-disciplinary approach in treatment of children with ARFID. If not done already, establishment of clinics that involve GI docs, psychiatrists, psychologists, feeding therapists and possibly even endocrinologists or geneticists would provide patients with more comprehensive services. On the individual patient level, it’s probably worth screening patients with diagnoses of ARFID for the presence of common comorbid conditions, such as ADHD and autism, as it might lead to earlier diagnosis and thus earlier access to services.
Source
Mental and Somatic Conditions in Children With the Broad Avoidant Restrictive Food Intake Disorder Phenotype. JAMA Pediatr. 2025 Apr 1;179(4):428-437. doi: 10.1001/jamapediatrics.2024.6065. PMID: 39960738
