Associations Between Avoidant/Restrictive Food Intake Disorder Dimensions and Obsessive-Compulsive Symptomatology

Eur Eat Disord Rev. 2026 Apr 26. doi: 10.1002/erv.70122. Online ahead of print.

ABSTRACT

OBJECTIVE: Although obsessive-compulsive disorder (OCD) commonly co-occurs with anorexia nervosa and bulimia nervosa, less is known about its relationship with avoidant/restrictive food intake disorder (ARFID) dimensions. Whether associations between ARFID dimensions and OCD differ by sex is also unclear. We examined associations between ARFID dimensions and OCD symptoms by sex, accounting for depression and anxiety.

METHODS: Data from 3120 participants ages 15+ in the ARFID Genes and Environment (ARFID-GEN) study were analyzed. ARFID dimensions (i.e., sensory sensitivity; low appetite/lack of interest in food; and fear of aversive consequences), OCD symptoms, anxiety, and depression were assessed using validated self-report measures. We evaluated associations between ARFID dimensions and OCD symptoms using general linear models, adjusting for depression and anxiety.

RESULTS: ARFID dimensions were significantly associated with OCD symptoms. After adjusting for depression and anxiety, these associations were attenuated but remained significant for all ARFID dimensions. Associations between ARFID dimensions and OCD symptoms varied by sex.

CONCLUSION: The relation between ARFID symptomatology and OCD warrants further exploration across the developmental spectrum in which ARFID appears. Clinically, bidirectional screening may improve diagnostic clarity and be informative to tailor interventions appropriately.

TRIAL REGISTRATION: ARFID-GEN is registered in clinicaltrials.gov (NCT05605067).

PMID:42037051 | DOI:10.1002/erv.70122