What question did this study set out to answer?

This research aims to assess the risk of avoidant/restrictive food intake disorder (ARFID) in patients with inflammatory bowel disease (IBD) compared to healthy controls.

January 23, 2026

P1291 Risk of Avoidant/Restrictive Food Intake Disorders in patients with Inflammatory Bowel Disease: a Matched Cross-sectional Case-control Study

Key Points

This research aims to assess the risk of avoidant/restrictive food intake disorder (ARFID) in patients with inflammatory bowel disease (IBD) compared to healthy controls.
Matched cross-sectional study design
Participants included adults with IBD and healthy controls
ARFID risk assessed using the Nine-Item ARFID Screen (NIAS-9)
Eating disorder risk measured with the Eating Attitudes Test-26 (EAT-26)
Nutritional status evaluated using the Patient-Generated Subjective Global Assessment (PG-SGA)
ARFID risk in IBD patients was 13.5%, nearly double the 5.7% in healthy controls
Overall eating disorder rates did not differ significantly between IBD (11.3%) and healthy controls (10.8%)
Significant higher 'Fear of adverse consequences' scores in IBD patients
Independent risk factors for ARFID include clinical disease activity and malnutrition risk

Abstract

Abstract Background Individuals with inflammatory bowel disease (IBD) often modify their diet to manage symptoms; however, these behaviours may evolve into eating disorders, including avoidant/restrictive food intake disorder (ARFID). We assessed the risk of eating disorders and ARFID in patients with IBD compared with healthy controls (HC), explored differences by age at diagnosis, and examined associations with malnutrition and disability. Methods In this cross-sectional study, adult patients with confirmed IBD, stratified by paediatric- vs adult-onset, were matched with HC. ARFID risk was assessed using the Nine-Item ARFID Screen (NIAS-9) and eating disorder risk with the Eating Attitudes Test-26 (EAT-26). Nutritional status was evaluated with the Patient-Generated Subjective Global Assessment (PG-SGA) and disability with the IBD-Disk and modified IBD-Disk Results A total of 706 participants completed questionnaires (355 IBD, 351 HC). The risk of eating disorders (11.3% vs 10.8%) and median EAT-26 scores (6 IQR 3–12 vs 6 IQR 2–13) did not differ between IBD and HC (both p = 0.91). In constrast, the ARFID risk in the IBD population was 13.5% (n = 48), nearly double that observed in HC (5.7%, n = 20, p 0.001). Similar findings were confirmed even in patients with IBD in clinical remission with an increased risk of ARFID compared to HC (10.1% vs 5.7%; p = 0.03). In addition, we observed significant differences across NIAS-9 subdomains: ‘Fear of adverse consequences’ was rated higher in IBD patients compared to HC (3 IQR 0–7 vs 2 IQR 0–3, p 0.001). Conversely, ‘Picky eating’ scores were lower in IBD patients compared with controls (3 0-7 vs 4 2-7, p 0.001), as well as ‘Low appetite’ (2 IQR 0–5 vs 3 IQR 1–4, p = 0.03) (Figure 1).Taken together, these findings indicate that IBD patients are more likely to meet the threshold for ARFID risk, yet the overall prevalence of general eating disorders does not differ significantly from HC (Figure 2). When stratifying patients according to age at diagnosis, ARFID risk did not differ by age at onset (p = 0.39). At multivariable logistic regression, independent predictors of ARFID risk included clinical disease activity (OR 2.34, 95% CI 1.10–5.01, p = 0.03), dietary impairment based on mDISK Q11 (OR 4.32, 95% CI 1.92–9.74, p 0.001), concomitant eating disorders risk (OR 7.47, 95% CI 2.95–18.90, p 0.001), and malnutrition risk (OR 2.31, 95% CI 1.04–5.13, p = 0.04) Conclusion ARFID risk in IBD is nearly twice that of HC and strongly associated with disease activity, malnutrition, and disability, supporting the importance of ARFID screening into routine IBD care Conflict of interest: Dr. Nardone, Olga Maria: Advisory board fees from Eli Lilly, Nestlè, Janssen Speaker fees from AbbVie, Janssen, Eli Lilly, Ferring, Alfa Sigma, Recordati, Noòs, and Pfizer D’Amico, Ferdinando: Grant: ECCO fellowship grant 2020 ECCO grant 2021 Personal Fees: F D’Amico has served as a speaker for Abbvie, Alfasigma, Ferring, Lilly, Sandoz, Janssen, Fresenius Kabi, Galapagos, Giuliani, MSD, Pfizer, Takeda, Tillotts, and Omega Pharma he also served as an advisory board member for Abbvie, AnaptysBio, Ferring, Fresenius Kabi, Galapagos, Janssen, Lilly, MSD, Takeda, and Nestlè. Calabrese, Giulio: Travel grant by Johnson and Johnson Speaker fee by Celltrion Parigi, Tommaso Lorenzo: Tommaso L Parigi declares no relevant conflicts of interest Bencardino, Sarah: None Imoletti, Felice: No conflict of interest D’Orsi, Francesca: No conflict of interest Rispo, Antonio: None Testa, Anna: Consultant /Advisory board for Abbvie, J&J, Takeda, Ferring Danese, Silvio: Personal Fees: AbbVie, Alimentiv, Allergan, Amgen, Applied Molecular Transport, AstraZeneca, Athos Therapeutics, Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Dr Falk Pharma, Eli Lilly, Enthera, Ferring Pharmaceuticals Inc., Gilead, Hospira, Inotrem, Janssen, Johnson & Johnson, Morphic, MSD, Mundipharma, Mylan, Pfizer, Roche, Sandoz, Sublimity Therapeutics, Takeda, Teladoc Health, TiGenix, UCB Inc., Vial, Vifor Lecture fees from Abbvie, Amgen, Ferring Pharmaceuticals Inc., Gilead, Janssen, Mylan, Pfizer, Takeda Castiglione, Fabiana: Honoraria from: Takeda, AbbVie, Celltrion, Johnsson Johnsson, Cadigroup, Sandoz, Pfizer, Lilly, Lionhealth, Nestlè

Mark Helpful

Bookmark

Relay