ARFID Symptoms Common in Patients With DGBI, Population Study Finds
A population-based survey of adults in the United States and United Kingdom has identified a significant association between disorders of gut-brain interaction (DGBI) and avoidant/restrictive food intake disorder (ARFID) symptoms, expanding prior findings from specialty clinics to the general population.
Among 4,002 respondents (median age 46), 42.6% met criteria for at least one DGBI based on the Rome IV diagnostic questionnaire. The prevalence of positive ARFID screens was significantly higher in those with DGBI compared to those without (34.6% vs 19.4%; adjusted OR 1.67, 95% CI 1.43–1.94).
“Positive ARFID screens are common in DGBI and associated with increased general health burden,” the authors reported.
Common ARFID symptom subtypes among patients with DGBI included lack of interest in eating (21.5%), sensory-based avoidance (18.1%), and fear of aversive consequences (9.9%). The likelihood of ARFID increased with DGBI symptom burden, affecting 61.4% of individuals with DGBI in four anatomic regions compared to 19.4% in those without DGBI (P < .001).
Patients with both DGBI and ARFID symptoms were more likely to be underweight (7.9% vs 1.5%) and had greater psychological distress, more nongastrointestinal symptoms, lower quality of life, and higher health care utilization than those with DGBI alone.
The findings support incorporating ARFID screening into routine evaluation of patients with DGBI to better guide integrated care. “Routine screening for ARFID in DGBI will inform the multi-integrated care plan provided by clinicians, dietitians, and psychologists,” the authors concluded.
For gastroenterologists, this study underscores the importance of recognizing restrictive eating patterns in DGBI and coordinating multidisciplinary management to address both GI and psychosocial factors.
Reference
Flack R, Brownlow G, Burton-Murray H, Palsson O, Aziz I. The prevalence and burden of avoidant/restrictive food intake disorder (ARFID) symptoms in adults with disorders of gut-brain interaction: a population-based study. Gastroenterology. Published online August 20, 2025. doi:10.1053/j.gastro.2025.07.043
