Examining Avoidant/Restrictive Food Intake Disorder and Food Selectivity Across the Body Mass Index Spectrum in...

For children with avoidant/restrictive food intake disorder (ARFID), research on factors contributing to elevated BMI is lacking. Using a sample of children diagnosed with ARFID through an outpatient, multidisciplinary feeding clinic, this study aimed to identify the proportion of children within each BMI category, compare fruit and vegetable (FV) intake between children with sensory sensitivity and non-sensory sensitivity ARFID, and determine whether FV intake was associated with BMI.

Data were collected retrospectively from an outpatient, multidisciplinary feeding clinic. The sample included 271 children (2-18 years; Mage = 6.71, SD = 3.05) and one parent/legal guardian per child who completed a feeding evaluation. Child height/weight, demographics, FV checklist, and two items assessing FV intake from the Behavioral Pediatrics Feeding Assessment Scale were collected. A pediatric psychologist established ARFID diagnosis using a multi-method approach.

Classifications of underweight, healthy weight, overweight, and obesity were 9.6%, 64.9%, 11.4%, and 14.0%, respectively. No differences were found in average FV intake between children with sensory sensitivity ARFID versus those with non-sensory sensitivity ARFID. Accounting for relevant covariates, lower FV intake (number of accepted FVs but not frequency of FV intake) was significantly associated with higher BMI z-score.

Findings support the existence of ARFID across the BMI spectrum and suggest that among children with ARFID, those with fewer accepted FVs may present with higher BMI. Food selectivity may be a valuable intervention target, particularly among youth with higher BMI. Further research is needed to elucidate factors relevant to BMI in children with ARFID.