Endorsement of Avoidant/Restrictive Eating Motivations Across Restrictive Eating Disorders: A Trait- and State-Level Examination

Abstract

Objective: Research on avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) has emphasised differences between these disorders, but similarities maintaining dietary restriction may be overlooked. ARFID-related eating disturbances may also occur and facilitate egosyntonic restriction in AN.

Method: Using the Nine Item ARFID Screen (NIAS; N = 141) and ecological momentary assessment (N = 76), we examined endorsement of ARFID-related and traditional eating disorder (ED) reasons for restrictive eating in women with ARFID, AN-restrictive subtype (AN-R), AN binge eating/purging subtype (AN-BP), and controls.

Results: Clinical groups scored higher on NIAS subscales than controls. ARFID participants scored higher on NIAS-Picky than AN groups, and higher on NIAS-Fears and NIAS-Appetite than AN-BP, while AN-R did not differ from either. For skipped meals, ARFID and AN-R did not differ on ratings of avoidant/restrictive motivations, while AN-BP did not differ from either on fears of aversive consequences. For restriction at meal/snack, ARFID did not differ from AN-R on endorsement of picky eating nor AN-BP on lack of interest but endorsed stronger fears of aversive consequences.

Conclusions: While sensory sensitivity/picky eating appears unique to primarily-restrictive EDs, lack of interest was common across clinical groups. Results highlight differences and potential transdiagnostic treatment targets.

Keywords: anorexia nervosa; avoidant/restrictive food intake disorder; eating motivation; ecological momentary assessment; restrictive eating.