Assessing Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms Using the Nine Item ARFID Screen in >9000 Swedish Adults With and Without Eating Disorders

Emily K Presseller; Gabrielle E Cooper; Laura M Thornton; Andreas Birgegård; Afrouz Abbaspour; Cynthia M Bulik; Emma Forsén Mantilla; Lisa Dinkler

doi:10.1002/eat.24274

Assessing Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms Using the Nine Item ARFID Screen in >9000 Swedish Adults With and Without Eating Disorders

Int J Eat Disord. 2024 Aug 8. doi: 10.1002/eat.24274. Online ahead of print.

Authors

Emily K Presseller^{1

2

3

4}, Gabrielle E Cooper^{3

5}, Laura M Thornton³, Andreas Birgegård⁴, Afrouz Abbaspour⁴, Cynthia M Bulik^{3

4

6}, Emma Forsén Mantilla^{4

7}, Lisa Dinkler⁴

Affiliations

¹ Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA.
² Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA.
³ Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
⁵ School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁶ Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁷ Department of Physical Activity and Health, Swedish School of Sport and Health Sciences, Stockholm, Sweden.

PMID: 39115175
DOI: 10.1002/eat.24274

Abstract

Objective: The Nine Item ARFID Scale (NIAS) is a widely used measure assessing symptoms of avoidant/restrictive food intake disorder (ARFID). Previous studies suggest that individuals with eating disorders driven by shape/weight concerns also have elevated scores on the NIAS. To further describe NIAS scores among individuals with diverse current and previous eating disorders, we characterized NIAS scores in a large sample of individuals with eating disorders and evaluated overlap in symptoms measured by the NIAS and the Eating Disorder Examination-Questionnaire (EDE-Q) version 6.0.

Method: Our sample comprised 9148 participants from the Eating Disorders Genetics Initiative Sweden (EDGI-SE), who completed surveys including NIAS and EDE-Q. NIAS scores were calculated and compared by eating disorder diagnostic group using descriptive statistics and linear models.

Results: Participants with current anorexia nervosa demonstrated the highest mean NIAS scores and had the greatest proportion (57.0%) of individuals scoring above a clinical cutoff on at least one of the NIAS subscales. Individuals with bulimia nervosa, binge-eating disorder, and other specified feeding or eating disorder also demonstrated elevated NIAS scores compared to individuals with no lifetime history of an eating disorder (ps < 0.05). All subscales of the NIAS showed small to moderate correlations with all subscales of the EDE-Q (rs = 0.26-0.40).

Discussion: Our results substantiate that individuals with eating disorders other than ARFID demonstrate elevated scores on the NIAS, suggesting that this tool is inadequate on its own for differentiating ARFID from shape/weight-motivated eating disorders. Further research is needed to inform clinical interventions addressing the co-occurrence of ARFID-related drivers and shape/weight-related motivation for dietary restriction.

Keywords: adults; anorexia nervosa; assessment; avoidant/restrictive food intake disorder; binge‐eating disorder; bulimia nervosa; screening.

Abstract

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