The Association of Avoidant/Restrictive Food Intake Disorder (ARFID) and Neurogastroenterology Disorders (Including Disorders of Gut–Brain Interaction [DGBI]): A Scoping Review
Hiba Mikhael‐Moussa, Valérie Bertrand, Émeline Lejeune, Claire Dupont, Alexandra Aupetit, Najate Achamrah, Chloé Melchior
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.