Association between gastroesophageal reflux disease and avoidant/restrictive food intake disorder-related eating behaviors in young adults

Objective: Avoidant/restrictive food intake disorder (ARFID) is marked by picky eating behaviors due to sensory aversions, fear of adverse effects, or low interest in food. It shares a bidirectional link with gastroesophageal reflux disease (GERD), where each can aggravate the other. This study aims to assess the association between picky eating behaviors and GERD symptoms in young adults in Saudi Arabia. Methodology: A cross-sectional study conducted at a tertiary hospital from November 2023 to August 2024, examining young adults (aged 18–40 years) with GERD. Data were collected using a structured questionnaire covering demographics, GERD symptoms (GERD Questionnaire [GERDQ]), and ARFID behaviors (ARFID questionnaire). Results: A total of 279 participants participated, most of whom were female (62%) and students (58.1%). The most commonly reported GERD symptoms were heartburn (53.8%), reflux (53.4%), upper abdominal pain (57%), and nausea (55.6%). Based on the GERDQ score, 33% of participants were classified as having a possibility of GERD (score >8), while 67% were not (score 0–7). The majority of participants identified as picky eaters (65.3%) or were labeled as selective eaters by others (55.9%). Despite these behaviors, most participants reported that picky eating had not significantly impacted their socialization (78.1%) or health (59.5%). Conclusion: This study demonstrates a notable association between ARFID eating behaviors and increased likelihood of GERD symptoms among young adults. Selective eating patterns, particularly those driven by sensory sensitivities or anticipated discomfort, were significantly linked to higher GERDQ scores.