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Avoidant-Restrictive Food Intake Disorder Is Common in Adults With Cyclic Vomiting Syndrome and Is Associated With
Thangam Venkatesan1, Praveen S Goday2, Saranya Arumugam1
1Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University, Columbus, Ohio, USA.
Neurogastroenterology and Motility
|April 2, 2026
Summary
About a third of cyclic vomiting syndrome (CVS) patients show signs of avoidant/restrictive food intake disorder (ARFID). This is linked to malnutrition and poor micronutrient intake, highlighting the need for screening and nutritional support.
Area of Science:
- Gastroenterology
- Psychiatry
- Nutritional Science
Background:
- Cyclic vomiting syndrome (CVS) affects patients with persistent symptoms between episodes.
- A significant portion of CVS patients may develop avoidant/restrictive food intake disorder (ARFID) due to food trigger avoidance.
- This association may lead to nutritional deficiencies in adults with CVS.
Purpose of the Study:
- To investigate the prevalence of ARFID risk in adults with CVS.
- To explore the relationship between ARFID risk and nutritional status, including malnutrition and food insecurity.
- To identify potential contributing factors and consequences of ARFID in CVS patients.
Main Methods:
- Prospective study of adults diagnosed with CVS.
- Utilized validated questionnaires: Nine-Item ARFID Screen (NIAS), Eating Disorder Questionnaire (EDE-QS), Food Security Questionnaire.
- Assessed nutritional status via a registered dietitian nutritionist (RDN) and food frequency questionnaires.
Main Results:
- 37.5% of CVS participants screened positive for ARFID risk (NIAS+).
- ARFID risk was associated with younger age, moderate-severe CVS, anxiety, depression, and inter-episodic symptoms.
- ARFID-risk group showed higher rates of malnutrition (73% vs. 30%), food insecurity (30% vs. 0%), and deficient micronutrient intake.
Conclusions:
- A substantial proportion of CVS patients are at risk for ARFID.
- ARFID in CVS is linked to significant malnutrition and micronutrient deficiencies.
- Screening for ARFID, disordered eating, and food insecurity is crucial; RDN intervention can improve nutritional outcomes.
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