Avoidant/Restrictive Eating Prevalent in People With and Without Bowel Symptoms
A Swedish population-based survey published in The American Journal of Gastroenterology has found that avoidant/restrictive eating is not only common among individuals with bowel symptoms, but also prevalent in the general population without gastrointestinal complaints. The findings underscore the importance of recognizing maladaptive eating behaviors in clinical evaluations, particularly among patients with overlapping functional GI disorders.
“We aimed to investigate the prevalence of avoidant/restrictive eating in individuals with versus without bowel symptoms in the general population, and identify factors associated with avoidant/restrictive eating,” the researchers wrote.
The study leveraged a large internet-based health survey, enrolling 825 participants with at least one bowel symptom that met Rome IV criteria for functional bowel disorders, and 1806 age- and sex-matched controls without bowel symptoms. The Nine-Item ARFID Screen (NIAS) was used to assess the prevalence of avoidant/restrictive eating, and hierarchical multiple regression was applied to identify independent correlates.
Avoidant/restrictive eating was significantly more common in individuals with bowel symptoms than in those without (22.8% vs 18.2%, p<.001). Among symptomatic individuals, those with avoidant/restrictive eating were more likely to be female, had lower BMI, and more frequently reported coexisting functional dyspepsia. They also experienced greater severity of bowel, psychological, and somatic symptoms, as well as heightened shape and weight concerns, and lower overall quality of life.
Importantly, bowel symptom severity emerged as the strongest predictor of avoidant/restrictive eating severity, according to the multivariable analysis.
“Avoidant/restrictive eating is common in individuals with bowel symptoms and associated with a more severe clinical profile, indicating a need to discuss eating behavior with patients,” the authors noted. “However, avoidant/restrictive eating is also common in individuals in the general population without bowel symptoms.”
Reference
Blomsten A, Trindade IA, Nybacka S, Melchior C, et al. Avoidant/restrictive eating in people with and without bowel symptoms in the general population: Prevalence, Clinical Profile and Associated Factors. Am J Gastroenterol. 2025 Aug 20. doi: 10.14309/ajg.0000000000003735. Epub ahead of print. PMID: 40833462.
