Abstract
Avoidant/restrictive food intake disorder (ARFID) is a complex, phenotypically heterogenous, and often severe feeding and eating disorder. Genetic studies suggest that ARFID is highly heritable, and that genes involved in taste perception and neurodevelopmental disorders may confer increased risk for the disorder. Neuroimaging studies are limited but point toward greater activation in reward circuitry among individuals with ARFID who are also overweight or obese, compared to those of normal weight. Endocrine studies have identified maladaptively high satiety-promoting (Peptide YY, cholecystokinin, oxytocin) and low hunger-promoting (ghrelin) hormone levels among individuals with ARFID, which may contribute to disease etiology and/or maintenance. Although research is limited, emerging insights into the pathophysiology of this common and impairing disorder may pave the way for the development of novel biological and pharmacological treatments. [Psychiatr Ann. 2024;54(2):e47–e50.]
- 1. . Evaluation and treatment of avoidant/restrictive food intake disorder (ARFID) in adolescents. Curr Pediatr Rep. 2018; 6(2):107–113.
10.1007/s40124-018-0162-y PMID:31134139 > CrossrefGoogle Scholar - 2. . Avoidant/restrictive food intake disorder: a three-dimensional model of neurobiology with implications for etiology and treatment. Curr Psychiatry Rep. 2017; 19(8):54.
10.1007/s11920-017-0795-5 PMID:28714048 > CrossrefGoogle Scholar - 3. . Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder. 1st edition. Cambridge University Press; 2019. > Google Scholar
- 4. . Differential diagnosis between avoidant/restrictive food intake disorder and anorexia nervosa. Psychiatr Annals. 2024; 54(2) :e37–e41. > LinkGoogle Scholar
- 5. . Diagnostic and Statistical Manual of Mental Disorders . 5th ed. American Psychiatric Publishing;2013. > CrossrefGoogle Scholar
- 6. . International Classification of Diseases. 11th Revision (ICD-11).World Health Organization; 2018. > Google Scholar
- 7. . Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nat Genet. 2019; 51(8) :1207–1214.
10.1038/s41588-019-0439-2 PMID:31308545 > CrossrefGoogle Scholar - 8. . How genetic analysis may contribute to the understanding of avoidant/restrictive food intake disorder (ARFID). J Eat Disord. 2022; 10(1) :53.
10.1186/s40337-022-00578-x PMID:35428338 > CrossrefGoogle Scholar - 9. . Dietary patterns and heritability of food choice in a UK female twin cohort. Twin Res Hum Genet. 2007 ; 10(5) :734–748.
10.1375/twin.10.5.734 PMID:17903115 > CrossrefGoogle Scholar - 10. . Food fussiness and food neophobia share a common etiology in early childhood. J Child Psychol Psychiatry. 2017; 58(2) :189–196.
10.1111/jcpp.12647 PMID:27739065 > CrossrefGoogle Scholar - 11. . Associations between the ability to detect a bitter taste, dietary behavior, and growth: a preliminary report. Ann N Y Acad Sci. 2009 ; 1170(1) :553–557.
10.1111/j.1749-6632.2009.04482.x PMID:19686192 > CrossrefGoogle Scholar - 12. . Etiology of the broad avoidant restrictive food intake disorder phenotype in Swedish twins aged 6 to 12 years . JAMA Psychiatry. 2023; 80(3 ):260–269 .
10.1001/jamapsychiatry.2022.4612 PMID:36723946 > CrossrefGoogle Scholar - 13. . Estimating the prevalence and genetic risk mechanisms of ARFID in a large autism cohort. Front Psychiatry. 2021; 12:668297.
10.3389/fpsyt.2021.668297 PMID:34177659 > CrossrefGoogle Scholar - 14. . Medical comorbidities and endocrine dysfunction in low-weight females with avoidant/restrictive food intake disorder compared to anorexia nervosa and healthy controls. Int J Eat Disord. 2020; 53 (4):631–636.
10.1002/eat.23261 PMID:32198943 > CrossrefGoogle Scholar - 15. . Ghrelin and PYY in low-weight females with avoidant/restrictive food intake disorder compared to anorexia nervosa and healthy controls. Psychoneuroendocrinology. 2021; 129:105243.
10.1016/j.psyneuen.2021.105243 PMID:34049199 > CrossrefGoogle Scholar - 16. . Elevated fasting satiety-promoting cholecystokinin (CCK) in avoidant/restrictive food intake disorder compared to healthy controls. J Clin Psychiatry. 2022; 83(5):21m14111.
10.4088/JCP.21m14111 > CrossrefGoogle Scholar - 17. . Low bone mineral density is found in low weight female youth with avoidant/restrictive food intake disorder and associated with higher PYY levels. J Eat Disord. 2023; 11(1):106.
10.1186/s40337-023-00822-y PMID:37393263 > CrossrefGoogle Scholar - 18. . Oxytocin response to food intake in avoidant/restrictive food intake disorder. Eur J Endocrinol. 2023; 189(2):149–155.
10.1093/ejendo/lvad087 PMID:37474111 > CrossrefGoogle Scholar - 19. . Neurobiology of avoidant/restrictive food intake disorder in youth with overweight/obesity versus healthy weight. J Clin Child Adolesc Psychol. 2022; 51(5):701–714.
10.1080/15374416.2021.1894944 > CrossrefGoogle Scholar - 20. . Hungry brains: a meta-analytical review of brain activation imaging studies on food perception and appetite in obese individuals. Neurosci Biobehav Rev. 2018; 94:271–285.
10.1016/j.neubiorev.2018.07.017 PMID:30071209 > CrossrefGoogle Scholar - 21. . Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls. Pediatrics. 2004; 114(6):1574–1583.
10.1542/peds.2004-0540 PMID:15574617 > CrossrefGoogle Scholar - 22. . The endocrine manifestations of anorexia nervosa: mechanisms and management. Nat Rev Endocrinol. 2017; 13(3):174–186.
10.1038/nrendo.2016.175 PMID:27811940 > CrossrefGoogle Scholar - 23. . Ghrelin regulates the hypothalamic-pituitary-adrenal axis and restricts anxiety after acute stress. Biol Psychiatry. 2012; 72(6):457–465.
10.1016/j.biopsych.2012.03.010 PMID:22521145 > CrossrefGoogle Scholar - 24. . Lower ghrelin levels are associated with higher anxiety symptoms in adolescents and young adults with avoidant/restrictive food intake disorder. J Clin Psychiatry. 2023; 84(3):22m14482.
10.4088/JCP.22m14482 > CrossrefGoogle Scholar