Healthcare (Commonwealth Union) – For years, individuals with Avoidant/Restrictive Food Intake Disorder (ARFID) have often been dismissed as simply being extremely “picky eaters.”
This condition involves avoiding specific foods or entire food groups, severely limiting the overall quantity of food consumed, or both—making it difficult for affected individuals to meet their nutritional requirements. ARFID can significantly impact both physical health and mental wellbeing. However, it wasn’t until 2013 that the condition was officially recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Now, an international team of researchers from the Netherlands, Australia, the USA, and the UK, led by the University of Aberdeen, has discovered structural differences in the brains of children displaying ARFID symptoms.
Dr. Michelle Sader, a postdoctoral research fellow at the University of Aberdeen and a member of the Eating Disorders and Autism Collaborative (EDACResearch.co.uk), indicated that while many people may go through phases of fussy eating, those with ARFID face serious health and psychological challenges caused by their disordered eating.
“There are three main underlying drivers behind food restriction associated with ARFID, which include sensory sensitivities in relation to food, lack of interest in food and fear of aversive consequences associated with eating, such as choking or vomiting.
“Some symptoms associated with ARFID may include an individual struggling to identify when they are hungry, consistently eating the same meals, having low dietary diversity, anxiety during mealtimes, or needing supplements to meet nutritional needs. Importantly, food restriction associated with ARFID is not due to lack of food availability or cultural practice, and it is not attributed to another mental disorder or other eating disorders such as anorexia nervosa or bulimia nervosa. ARFID can present on its own, or it can co-occur with other conditions – most commonly with autism, ADHD and anxiety.
“Previous research has highlighted that ARFID exhibits adverse physiological effects similar to restrictive eating disorders such as anorexia nervosa, but it is regarded as far less dangerous and thus less important to tackle.”
Researchers examined the brain scans of 1,977 ten-year-old children participating in Generation R, a large population-based cohort study in the Netherlands. Among these children, 121 (6%) exhibited symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID).
The study, published in the Journal of Child Psychology and Psychiatry, revealed that children with ARFID symptoms had significantly greater cortical thickness—referring to the depth of the brain’s outer layer—in specific areas compared to those without such symptoms.
These differences were particularly pronounced in the frontal and superior frontal regions, which are linked to executive functions. These include cognitive flexibility (adaptable thinking) and inhibition control, the ability to regulate thoughts, emotions, and actions.
Dr. Sader pointed out that since ARFID was introduced as a diagnosis in 2013, no structural neuroimaging studies have been conducted on populations with ARFID or ARFID-like symptoms.
She indicated that their research reveals that children exhibiting ARFID symptoms have significantly greater cortical thickness in specific areas of the brain compared to those without these symptoms, particularly in the frontal and superior frontal regions. These areas are crucial for executive functions, such as anticipating conflict and controlling inhibition.
Dr. Sader further indicated that this study enhances our understanding of ARFID by identifying key brain regions linked to the disorder. It also offers valuable insights that could inform strategies for its treatment, management, and support.
Dr. Gordon Waiter, Director of the Biomedical Imaging Centre at the University of Aberdeen, highlighted the fact that the University of Aberdeen has a proud history of leveraging neuroimaging to tackle complex clinical questions, and they hope this study will inspire further research into ARFID.
To the best of their knowledge, this is the first structural imaging study associated with ARFID, according to Dr. Waiter. The findings serve as a crucial foundation for future imaging-focused research on this condition.
