Eating disorder symptoms, including avoidant/restrictive food intake disorder, in patients with disorders of gut-brain interaction.

Background: Previous studies show some patients with functional gastrointestinal disorders (disorders of gut-brain interaction) may be at risk for or already have an eating disorder (ED). Avoidant/restrictive food intake disorder (ARFID) (ED not primarily motivated by body shape/weight concerns) may be particularly relevant but previous studies have been unable to fully apply diagnostic criteria. This study aimed to determine the frequency and nature of the full spectrum of ED symptoms, among adults with disorders of gut-brain interaction.

Methods: Adults with disorders of gut-brain interaction (n = 99, 77.1% female, ages 18-82 years) from academic medical center gastroenterology clinics completed a modified ARFID Canadian Paediatric Surveillance Program Questionnaire, the ED Examination Questionnaire (EDE-Q), and other self-report measures of depression, generalized anxiety, and pain interference.

Key Results: Of the 93 participants who completed the measures, 37 (39.8%) had ARFID symptoms and 12 (12.9%) had clinically significant shape/weight-motivated ED symptoms (EDE-Q-Global ≥4.0). Exploratory comparisons among ARFID, shape/weight-motivated ED, and no-ED groups revealed that ARFID symptom presence was associated with lower body mass index (BMI), and shape/weight-motivated ED presence was associated with higher depression, anxiety, and pain interference. However, the majority (86%) of patients with ARFID symptoms had a BMI >18.5 kg/m .

Conclusions & Inferences: The full spectrum of ED symptoms was frequent among patients with disorders of gut-brain interaction, particularly ARFID symptoms. Further research is needed to understand risk and maintenance factors to inform prevention and intervention efforts.