Review Association of Avoidant/Restrictive Food Intake Disorder (ARFID) and Neurogastroenterology Disorders... 2025 Mikhael-Moussa et al

Full title: Association of Avoidant/Restrictive Food Intake Disorder (ARFID) and Neurogastroenterology Disorders (Including Disorders of Gut–Brain Interaction [DGBI]): A Scoping Review

ABSTRACT
Background
Patients with neurogastroenterology disorders like disorders of gut–brain interaction (DGBI) and gastrointestinal (GI) motility disorders often adopt restrictive diets to manage symptoms. Without professional guidance, these patients may risk developing avoidant/restrictive food intake disorder (ARFID), potentially affecting their physical and mental health.

Purpose
This scoping review aimed to explore the prevalence of ARFID in patients with neurogastroenterology disorders and vice versa, the direction of their association, potential risk factors, and available treatments.

Methods
Following PRISMA-ScR guidelines, we searched PubMed, Web of Science, and Cochrane. Abstracts were screened for eligibility by two independent reviewers.

Key Results
Eighteen studies met our inclusion criteria. The prevalence of ARFID symptoms in neurogastroenterology patients ranged from 10% to 80%, while the prevalence of neurogastroenterology disorders and related GI symptoms in ARFID patients ranged from 7% to 60%. Findings on the direction of the association between eating difficulties and GI symptom occurrence were conflicting. Patients with ARFID-neurogastroenterology disorder overlap were more likely to be female, have a lower BMI, higher anxiety and depression levels, and poorer quality of life. Two small studies evaluating treatment for this overlap suggested promising effects of cognitive behavioral therapy (CBT).

Conclusions and Inferences
This review highlights heterogeneity in study designs and questions the suitability of ARFID assessment tools in this context. It also underscores gaps in understanding the underlying pathophysiology and treatment approaches. Future research should prioritize validating ARFID screening tools specific to this population and standardizing study methodologies. Improved understanding of this overlap will help healthcare professionals improve management strategies and patient outcomes.


Summary

• The overlap between ARFID and neurogastroenterology disorders is prevalent and affects patients' mental health and quality of life.
• Patients with an ARFID-neurogastroenterology disorder overlap are more likely to be female, to have lower BMI, higher anxiety and depression levels, and poorer quality of life.
• Validated ARFID screening tools in neurogastroenterology and standardized research are needed to improve management.

Open access

 

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