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TOPLINE:

Nearly 18% of patients with inflammatory bowel disease (IBD), including 16.3% of those with inactive disease, met the criteria for avoidant/restrictive food intake disorder (ARFID). Among patients with inactive IBD, gastrointestinal (GI) symptom–specific anxiety was the only significant predictor of ARFID.

METHODOLOGY:

• Patients with IBD are at increased risk for ARFID due to food avoidance and GI symptom–related anxiety. Previous studies reported prevalence rates of 10%-53% but relied on self-report surveys rather than the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.
• In this cross-sectional study conducted at two US academic medical centers, researchers assessed ARFID prevalence in patients with confirmed IBD using a validated screening tool aligned with DSM-5 criteria and explored associated risk factors.
• Participants completed the Pica, ARFID, and Rumination Disorder Interview, a 32-item DSM-5-aligned self-report tool.
• Participants completed additional assessments, including the Nine Item ARFID Screen for symptom severity, Visceral Sensitivity Index for GI-specific anxiety, and Patient Health Questionnaire-4 for psychological distress.
• Objective disease activity was analyzed within 90 days of survey completion, with active disease defined as a fecal calprotectin level > 250 µg/g, a C-reactive protein level > 5 mg/L, or active inflammation identified on colonoscopy.

TAKEAWAY:

• Questionnaires were completed by 325 adults with confirmed IBD (mean age, 49.14 years; 56% women), with 17.8% of patients screening positive for ARFID, including 16.3% with inactive IBD.
• ARFID prevalence did not differ significantly between patients with Crohn’s disease and those with ulcerative colitis.
• Patients who screened positive for ARFID were younger (P < .001), had a shorter disease duration (P = .02), and had worse psychosocial functioning (P < .001) compared with those who screened negative.
• GI symptom–specific anxiety was the only significant predictor of ARFID in patients with inactive IBD (P < .001).

IN PRACTICE:

“The results from this study should raise awareness of the prevalence of ARFID in IBD and prompt clinicians to include questions about eating behaviors and symptom anxiety to appropriately recognize and treat patients with suspected disordered eating,” the authors wrote.

SOURCE:

This study, led by Laurie B. Grossberg, MD, of Beth Israel Deaconess Medical Center in Boston, and Kajali Mishra, MD, of Loyola University Medical Center in Maywood, Illinois, was published online in Inflammatory Bowel Diseases.

LIMITATIONS:

The retrospective collection of objective disease data, rather than concurrent assessment with questionnaires, may have affected accuracy. Both study sites were in urban settings, which may limit generalizability. Several survey measures used in this study had not been previously validated in patients with IBD.

DISCLOSURES:

This study received no specific funding. One author was supported by the National Institutes of Health. Several authors reported serving as a consultant, speaker, or advisor; receiving lecture fees or scientific advisory board fees; and having other financial ties with various pharmaceutical, healthcare, and other companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.