Shared and Distinct Clinical Features in Treatment-Seeking Adults With Avoidant/Restrictive Food Intake Disorder or Anorexia Nervosa Subtypes

Int J Eat Disord. 2026 Jul 6. doi: 10.1002/eat.70167. Online ahead of print.

ABSTRACT

OBJECTIVE: Available studies comparing clinical features in treatment-seeking adults with avoidant/restrictive food intake disorder (ARFID) to anorexia nervosa (AN) often do not distinguish between AN-restricting (AN-R) and AN-binge-eating/purging (AN-B/P) subtypes, rely on retrospective ARFID diagnoses, and include unequal group sizes. Across relatively balanced study groups, we compared eating disorder symptoms, concurrent psychiatric symptoms, and Big Five personality traits in treatment-seeking adults with ARFID, AN-R, or AN-B/P to identify unique and shared features.

METHODS: Participants were adults (29 ARFID, 39 AN-R, 45 AN-B/P) diagnosed via semi-structured clinical interviews at the start of outpatient treatment. Data were analyzed with general linear models.

RESULTS: On measures of shape-/weight-centered eating pathology and depression, individuals with ARFID scored lower than did those with AN-R (ps < 0.05) or AN-B/P (ps < 0.001). On measures of anxiety, individuals with ARFID scored lower than did those with AN-B/P (p < 0.001) but not AN-R (p = 0.075). Compared with AN groups, the ARFID group had less total emotion-regulation difficulties (p < 0.001). There were no group differences on Big Five personality traits (p = 0.173), including neuroticism.

DISCUSSION: Treatment-seeking adults with ARFID reported less shape-/weight-centered eating pathology, depression, anxiety, and emotion-regulation difficulties than did individuals with AN but did not differ on endorsement of Big Five personality traits. Findings suggest that individuals with ARFID display less pronounced psychopathology on assessed domains than do those with AN and highlight potential directions for future ARFID research.

PMID:42410482 | DOI:10.1002/eat.70167