Picky Eating Research Articles

Creative Omnivores: An Experience Sampling Study of the Variety and Diversity of Everyday Creative Activities

ABSTRACT Studies of everyday creativity suggest that some people are like creative omnivores, dabbling in a broad range of creative pursuits, but others are like picky eaters, focusing on a single creative passion. A week-long experience sampling study examined the breadth vs depth of 125 university students’ everyday creative activities. Several times a day, people were asked if they were doing something creative, and if they were, to describe what they were doing. Diversity statistics quantified the variety (number of distinct domains) and balance (the relative predominance of any domain) of their creative activities. The sample varied widely in both aspects of diversity, reflecting differences in whether people’s creative efforts were relatively broad or focused. Notably, people who were high in openness to experience showed significantly higher variety (they did more kinds of creative activities) yet lower balance (one or two activities predominated), suggesting that they had a broad creative diet but a few favorite foods.

Risk Factors Related to Eating Disorders in a Romanian Children Population

(1) Background: The complex known as avoidant/restrictive food intake disorder (ARFID) is one of the eating disorders that cannot be explained by chronic disease. The aim of this study was to determine the characteristics of patients who were identified as being at risk of developing ARFID and referred to paediatricians, according to their age and duration of symptoms. (2) Methods: Children aged 2–10 years (Group 1) presenting with eating disorders were initially recruited in the “Dr. Victor Gomoiu” Clinical Children Hospital in Bucharest. Group 2 included patients presenting for routine paediatric visits as controls. The study population was given the PARDI questionnaire as well as questions related to demographics, screening growth and development, physical and mental background, and current feeding and eating patterns. Items were scored on a 7-point scale ranging from 0 to 6. (3) Results: A total of 98 individuals were divided equally into the two study groups. There was no difference in terms of sex, living area, mothers’ education level or living standards between the two groups. ARFID children were more likely to be underweight, were unsuccessful at weaning or have irregular feeding habits and a history of allergies. The mean age of onset for chronic symptoms was significantly lower than the onset of acute food refusal—4.24 ± 2.29 vs. 6.25 ± 3.65, p = 0.005. (4) Conclusions: feeding disorders are an important issue among paediatricians, and a proper awareness of them when treating these patients should be included in daily practice.

Avoidant/restrictive food intake disorder, other eating difficulties and compromised growth in 72 children: background and associated factors

This is a study of avoidant/restrictive food intake disorder (ARFID), other feeding disorders, and background factors, including seventy-two children (thirty-one girls, forty-one boys, aged 4–178 months) referred to a secondary/tertiary feeding service for eating difficulties and/or compromised growth. An in-depth review of their medical records was performed. Diagnostic criteria for ARFID were met in 26% of cases. Children with ARFID were older, more nutritionally deficient, and psychosocially impaired, and their feeding difficulties were less likely to go into remission. Most children's onset of feeding difficulties occurred during the first year of life. Several medical and/or psychosocial and/or neurodevelopmental background factors were often recorded in the same child, regardless of the presence of ARFID or not. Neurodevelopmental disorders were significantly more common in children with ARFID. In conclusion, feeding difficulties in children are often complex, with several associated factors. In a clinical setting, such as the present study, ARFID can be expected in about one-fourth of cases. The feeding difficulties in children with ARFID can be expected to be more severe and persistent than other feeding difficulties. Healthcare providers should be aware of possible underlying neurodevelopmental difficulties in children with ARFID.

Body Composition in Fussy-Eating Children, with and without Neurodevelopmental Disorders, and Their Parents, Following a Taste Education Intervention.

Fussy eaters may have an increased risk of becoming overweight or obese as adolescents, with fussy eating and weight status also correlating with neurodevelopmental disorders (NDs) such as autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). Further, maternal and children's weight status relationships are well-established. In this study, we analyzed the body composition of parent-child dyads using bioelectrical impedance analysis (BIA). Fifty-one children aged 8-12 years, with an ND (n = 18) and without (n = 33), and their parents, participated in a 7-week food-based Taste Education intervention with 6-month follow-up. The paired t-test was used to compare differences in body composition based on children's ND status. In logistic regression analysis, odds of children being in the overweight/obese or overfat/obese categories increased by a factor of 9.1 and 10.6, respectively, when having NDs, adjusting for parents' BMI (body mass index) or fat percentage (FAT%). Children with NDs and their parents had significantly higher mean BMI-SDS (BMI standard deviation score) and FAT% at pre-intervention than children without NDs and their parents. Mean BMI-SDS and FAT% lowered significantly between time points for children with NDs and their parents but not for children without NDs or their parents. The findings underline the need for additional exploration into the relationships between children's and parents' body composition based on children's ND status.

Barriers to Healthy Family Dinners and Preventing Child Obesity: Focus Group Discussions with Parents of 5-to-8-Year-Old Children

Background: Although numerous physical and mental health benefits for children have been linked to family dinners, many families still do not have regular family meals together. This study sought to identify the barriers that keep families from having dinners together. Methods: We interviewed 42 parents of 5-to-8-year-old children in small focus groups to identify barriers and challenges that keep families from having healthy and consistent dinners together. Results: Parents reported the main barriers were time (e.g., time strain and overscheduling, mismatched schedules, long work hours, etc.), lack of meal planning or failure to follow plans, lack of skills (e.g., cooking skills or nutritional awareness), external factors (e.g., daycare, schools, or extended family, and competing with advertising), and food-related challenges (e.g., picky eating, food allergies). Parents also suggested potential solutions to overcome these barriers. Conclusions: Overall, parents had a desire to have family dinners with their children, but they felt that there are many barriers keeping them from establishing or maintaining consistent family mealtimes. Future research, as well as child obesity prevention and intervention efforts, should consider these barriers and suggested solutions in efforts to promote healthy and consistent family meals as a means of lowering the prevalence of childhood obesity.

Distribution and clinical comparison of restrictive feeding and eating disorders using ICD-10 and ICD-11 criteria.

Within the eleventh edition of the International Classification of Diseases (ICD-11), diagnostic criteria for feeding and eating disorders were revised and new diagnoses including avoidant/restrictive food intake disorder (ARFID) are classifiable; however, nothing is known about how these changes affect the prevalence of feeding and eating disorders. This study compared the distribution and clinical characteristics of restrictive feeding and eating disorders between ICD-10 and ICD-11. The Eating Disorder Examination (EDE), its child version, and the EDE ARFID module were administered to N = 82 patients (0-17 years) seeking treatment for restrictive feeding and eating disorders and their parents. Clinical characteristics were derived from medical records, questionnaires, and objective anthropometrics. The number of residual restrictive eating disorders (rrED) significantly decreased from ICD-10 to ICD-11 due to a crossover to full-threshold disorders, especially anorexia nervosa (AN) or ARFID. Patients reclassified to ICD-11 ARFID were younger, had an earlier age of illness onset, more restrictive eating behaviors, and tended to have more somatic comorbidities compared to those reclassified to ICD-11 AN. Patients with rrED according to both ICD-10 and ICD-11 were younger, had an earlier age of illness onset, less shape concern, and more somatic comorbidities than patients who were reclassified from ICD-10 rrED to ICD-11 AN or ARFID. This study highlights the inclusive approach of ICD-11 criteria, paving the way for more targeted treatment, and ARFID's high clinical relevance. Future studies considering nonrestrictive feeding and eating disorders across the life span may allow further analyses on diagnostic crossover. Changes in diagnostic criteria for restrictive eating disorders within the newly published ICD-11 led to an increase in full-threshold disorders, while the number of rrED was significantly lowered compared to ICD-10 criteria. The results thus highlight the diagnostic utility of ICD-11 criteria and may help providing adequate treatment to children and adolescents with rrED.

Prevalence and Characterization of Avoidant Restrictive Food Intake Disorder in a Pediatric Population

Prevalence and Characterization of Avoidant Restrictive Food Intake Disorder in a Pediatric Population

Picky eating is associated with lower life satisfaction and elevated psychological distress and psychosocial impairment in Chinese pregnant women.

This study assessed picky eating in pregnant women by exploring whether picky eating is associated with pregnant women's well-being, including life satisfaction, psychological distress, and psychosocial impairment. Data collected were from 345 Chinese pregnant women ( = 29.95 years, SD = 5.58). Pearson correlation analyses were conducted to examine zero-order correlations between picky eating and well-being variables (i.e., life satisfaction, psychological distress, and psychosocial impairment). Hierarchical multiple regressions were conducted to examine the unique associations of picky eating with well-being variables, adjusting for demographic and pregnancy-related characteristics and thinness-oriented disordered eating. Picky eating was significantly and negatively correlated with life satisfaction (r = -.24, p < .001) and positively correlated with psychological distress (r = .37, p < .001) and psychosocial impairment (r = .50, p < .001). When adjusting for covariates and thinness-oriented disordered eating, picky eating was still significantly associated with lower life satisfaction, higher psychological distress, and higher psychosocial impairment. The findings suggest that picky eating may be a significant correlate of pregnant women's poorer well-being. Future research with longitudinal designs is warranted to further examine the temporal associations between picky eating and pregnant women's well-being. Picky eating behaviors are poorly understood in pregnant women. Our results revealed that higher picky eating behaviors were associated with lower life satisfaction and higher psychological distress and psychosocial impairment in Chinese pregnant women. Researchers and clinicians may consider picky eating in the assessment and treatment of mental health and disordered eating in pregnant women.

Advancements in Inpatient Medical Management of Malnutrition in Children and Adolescents with Restrictive Eating Disorders

There is an urgent need to identify best practices for hospital treatment of youth with malnutrition secondary to restrictive eating disorders, including anorexia nervosa (AN) and avoidant/restrictive food intake disorder (ARFID). Certain physical health complications of malnutrition, such as bradycardia, hypotension, and hypothermia, often lead to hospitalization. These acute medical complications improve with refeeding, or short-term nutritional rehabilitation, and will resolve with ongoing recovery. Historically, refeeding was approached with extreme caution, with lower calorie protocols that advanced slowly and required weeks to restore medical stability.( 1 Shamim T. Golden N.H. Arden M. Filiberto L. Shenker I.R. Resolution of vital sign instability: an objective measure of medical stability in anorexia nervosa. J Adolesc Health. 2003; 32: 73-77 Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar , 2 Garber A.K. Mauldin K. Michihata N. Buckelew S.M. Shafer M.A. Moscicki A.B. Higher calorie diets increase rate of weight gain and shorten hospital stay in hospitalized adolescents with anorexia nervosa. J Adolesc Health. 2013; 53: 579-584 Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar , 3 Golden N.H. Keane-Miller C. Sainani K.L. Kapphahn C.J. Higher caloric intake in hospitalized adolescents with anorexia nervosa is associated with reduced length of stay and no increased rate of refeeding syndrome. J Adolesc Health. 2013; 53: 573-578 Abstract Full Text Full Text PDF PubMed Scopus (100) Google Scholar ) Prolonged hospitalizations place eating disorders among the top 6 most “common and costly” pediatric mental health diagnoses.( 4 Bardach N.S. Coker T.R. Zima B.T. Murphy J.M. Knapp P. Richardson L.P. Edwall G. Mangione-Smith R. Common and costly hospitalizations for pediatric mental health disorders. Pediatrics. 2014; 133: 602-609 Crossref PubMed Scopus (150) Google Scholar ) This paper reviews current evidence on refeeding approaches for hospitalized youth with eating disorders. Recent findings suggest that high calorie refeeding is a clinically safe method of inpatient management and, more importantly, improves clinical outcomes.

Brief Report: Decreased Bone Health in Children with Autism Spectrum Disorder and Avoidant Restrictive Food Intake Disorder.

Children with autism spectrum disorder (ASD) and food selectivity are at increased risk for nutritional deficiencies which could affect bone health. We report on four male patients with ASD and avoidant restrictive food intake disorder (ARFID) with significant bone conditions including rickets, vertebral compression fractures, osteopenia, and slipped capital femoral epiphyses. Each patient was at risk for at least one nutritional deficiency. Two out of four patients had deficiencies in Vitamins A, B12, E, and zinc. Calcium and Vitamin D deficiency were noted in all four. Two out of four patients with Vitamin D deficiency developed rickets. Provisional evidence suggests that children with ASD and ARFID are at elevated risk for serious adverse bone health outcomes.

Comparison of Adiponectin Levels in Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, Obesity, Constitutional Thinness, and Healthy Controls: A Network Meta-Analysis.

Adiponectin is a protein hormone that is produced and secreted primarily by adipose tissue. The levels of adiponectin in those with eating disorders, obesity, and healthy controls have been extensively studied. However, the general picture of the differences in adiponectin levels across the mentioned conditions is still unclear and fragmented. In this study, we pooled previous studies and performed a network meta-analysis to gain a global picture of comparisons of adiponectin levels across eating disorders, obesity, constitutional thinness, and healthy controls. Electronic databases were searched for anorexia nervosa, avoidant restrictive food intake disorder, binge-eating disorder, bulimia nervosa, healthy controls, night eating syndrome, obesity, and constitutional thinness in studies where adiponectin levels were measured. A total of 4262 participants from 50 published studies were included in the network meta-analysis. Adiponectin levels were significantly higher in participants with anorexia nervosa than in healthy controls (Hedges' g = 0.701, p < 0.001). However, adiponectin levels in constitutionally thin participants were not significantly different from those of healthy controls (Hedges' g = 0.470, p = 0.187). Obesity and binge-eating disorder were associated with significantly lower adiponectin levels compared to those of healthy controls (Hedges' g = -0.852, p < 0.001 and Hedges' g = -0.756, p = 0.024, respectively). The disorders characterized by excessive increases or decreases in BMI were associated with significant changes in adiponectin levels. These results suggest that adiponectin may be an important marker of severely disequilibrated homeostasis, especially in fat, glucose, and bone metabolisms. Nonetheless, an increase in adiponectin may not simply be associated with a decrease in BMI, as constitutional thinness is not associated with a significant increase in adiponectin.

Eating disorders - what the gastroenterologist needs to know

Eating disorders are potentially life-threatening disorders that go along with severe psychiatric and somatic comorbidities. It is expected that the number of patients will dramatically increase in the post COVID-19 pandemic era.Four main eating disorders are mentioned in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) and the International Classification of Diseases 11 (ICD-11): anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) und avoidant restrictive food intake disorder (ARFID). Many traditional assumptions in eating disorders are currently challenged due to recent research results. The gastroenterologist is usually not the first point of contact for patients with eating disorders. However, he is crucial, especially in the management of gastroenterologic complications of eating disorders.Focus of the overview will be on relevant gastroenterologic aspects and less on the psychiatric treatment. Basics of the most common eating disorders will be repeated, opportunities in diagnosing an eating disorder and the most relevant gastroenterologic complications will be described. Obesity and its management, an entity that often goes along with an eating disorder, is not in the spotlight of the review.

Interrelated development of autism spectrum disorder symptoms and eating problems in childhood: a population-based cohort.

Eating problems, such as food selectivity or picky eating, are thought to be an epiphenomenon of autism spectrum disorders (ASD). Yet eating problems are also common in the general pediatric population and overlap with ASD symptoms. However, the temporal association between ASD symptoms and eating problems is poorly understood. This study examines the bidirectional association between ASD symptoms and eating problems across child development, and investigates whether these associations differ by child sex. Participants (N = 4,930) were from the population-based Generation R Study. Parents reported their child's ASD symptoms and eating problems using the Child Behavior Checklist at 5 assessments from toddlerhood to adolescence (1.5 to 14 years, 50% girls). A Random Intercept Cross-Lagged Panel Model was used to examine the lagged associations between ASD symptoms and eating problems at the within-person level, controlling for stable, trait-like differences at the between-person level. At the between-person level, there was a strong correlation between ASD symptoms and eating problems (β = .48, 95% CI: 0.38 to 0.57). Controlling for these between-person effects, there was limited evidence for consistent, predictive effects of ASD symptoms and eating problems at the within-person level. Associations did not differ by child sex. Findings suggest that ASD symptoms and eating problems may represent a cluster of traits that are highly stable from early childhood to adolescence, which have a minimal reciprocal effect at the individual-level. Future research could focus on these trait-like qualities to inform the development of supportive, family-focused interventions.

Picky eating in children: Current clinical trends, practices, and observations within the Australian health-care context.

Childhood picky eating occurs when there is limited intake or variety of food and/or unwillingness to try new foods. Within research settings, standardised assessments are used to describe picky eating behaviours in children. However, little is known about assessment practices of occupational therapists. Similarly, occupational therapy interventions for picky eating in the literature focus on; providing strategies for parents, and working with the child on self-feeding skills. Despite this, interventions and strategies utilised by occupational therapists in clinical practice within an Australian health-care context are unknown. This study examines Australian health professionals' observations of picky eating behaviours, the use of childhood picky eating assessments and interventions, and differences between occupational therapists and other professionals. Health professionals (n= 179) were recruited through professional organisations, such as Occupational Therapy Australia. Participants completed an online survey between March and May 2021. Independent variables were reported using descriptive statistics, with logistic regression used to consider differences between occupational therapists and other health professionals. Conventional content analysis was used to analyse responses to open-ended questions. The final sample included 109 eligible participants, with an average of 8.5 years working with picky eaters. Results indicated picky eating behaviours aligned with those reported in the literature. Participants relied on clinical observations and workplace designed assessments. The most common interventions were education, coaching, and the sequential oral sensory approach to feeding. Occupational therapy participants were significantly more likely than other health professional participants to report always using coaching and education. Although few health professionals used standardised or validated assessments, the use of education and coaching by occupational therapists aligned with the literature. Results highlight the need for more rigorous investigation to determine the sensitivity of current assessments to differentiate between clinical and typical picky eating, and the effectiveness of interventions for childhood picky eating.

Effect of Picky Eating on Adolescent’s Health

Effect of Picky Eating on Adolescent’s Health

HUBUNGAN PERILAKU PICKY EATING DENGAN STATUS GIZI PADA SISWA SDIT BUNAYYA MEDAN

Introduction: Picky eating is a condition in which children are picky about food or only consume certain foods. Picky eating occurs due to a lack of variety in the foods that are introduced to children. If this lasts a relatively long time, it can result in a lack of energy and other nutrients. Purpose : to determine the relationship between picky eating behavior and nutritional status of SDIT Bunayya Medan students. Design : analytic observational using a cross sectional study approach. The population is all students in class IV SDIT Bunayya Medan consisting of 2 classes and a total of 60 people. Sampling in total sampling. Results : The most dominant non picky eating behavior was 51,66% and picky eating was 48,33%. Most of the respondents had normal nutritional status of 53,33% and undernourished 46,66%. Based on the statistical test results, the p-value was 0.002 &lt;? (0.05). Conclusion: There is a significant relationship between picky eating behavior and nutritional status of SDIT Bunayya Medan students.

Dokuz Maddeli Kaçıngan/Kısıtlayıcı Gıda Alım Bozukluğu Tarama Ölçeği (NIAS) Ebeveyn Bildirimi’nin Türkçe Versiyonunun Geçerlik ve Güvenirliği

Background and aims: The current study aimed to evaluate the psychometric properties of a Turkish version of The Nine Item Avoidant/Restrictive Food Intake Disorder Screen Parent Report (NIAS-PR), which measures the avoidant/restrictive food intake disorder (ARFID) symptoms by parents. NIAS-PR includes three subscales picky eating, poor appetite/limited interest in eating, and fear of aversive consequences from eating. Also, our secondary aim was to assess the relationship between ARFID-related eating behaviours and emotional-behavioural symptoms of children and parents' psychological status. Methods: The NIAS-PR was translated into Turkish with standard procedures. Two hundred sixty-eight children (133 girls, 49.6%; mean age 8.62, age range from 2 to 18 years) and parents (175 mothers, 65.2%) were included in the study. The factor structure was confirmed using confirmatory factor analysis (CFA). The results were compared to the validated Turkish Children’s Eating Behavior Questionnaire (CEBQ) to determine the convergent validity. Internal consistency (Cronbach alpha coefficient) analysis was used to determine the reliability of the NIAS-PR. Results: The current study provided evidence for the validity of the translated Turkish version of the NIAS-PR in the pediatric population. The three-factor structure of the NIAS—Picky eating, Appetite, and Fear—was replicated in the Turkish NIAS-PR. The NIAS-PR subscales showed the expected patterns of correlations with the CEBQ subscales. The reliability of the Turkish version of NIAS-PR proved to be satisfactory (total Cronbach's alpha=0.90) in the pediatric population (2-18 years). Conclusions: This study demonstrated a good internal consistency of the Turkish version of the NIAS-PR. We confirmed the three-factor structure of the Turkish version of NIAS-PR. NIAS-PR is a brief, reliable instrument for ARFID research in Turkish children and adolescents. The NIAS-PR is developed as a screening questionnaire, so health professionals should use it to investigate ARFID-related eating behaviours further. It is worth mentioning that deepening these eating symptoms with clinical interviews is necessary.

Treatment of avoidant-restrictive food intake disorder in an older adult: A proof-of-concept case study.

Cognitive behavioral therapy for Avoidant Restrictive Food Intake Disorder (ARFID; CBT-AR) is an emerging treatment for ARFID. However, this treatment modality has yet to be examined among older adults (e.g., older than 50 years) or with adults presenting with feeding tubes. To inform future versions of CBT-AR, we present the results of a singular case study (G) of an older male with the sensory sensitivity phenotype of ARFID who presented for treatment with a gastrostomy tube. G was a 71-year-old male who completed eight sessions of CBT-AR in a doctoral training clinic. ARFID symptom severity and comorbid eating pathology changes were examined pre- and post-treatment. Posttreatment, G reported significant decreases in ARFID symptom severity and no longer met diagnostic criteria for ARFID. Furthermore, throughout treatment, G reported significant increases in his oral food consumption (vs. calories being pushed through the feeding tube), solid food consumption, and the feeding tube was ultimately removed. This study provides proof of concept that CBT-AR is potentially effective for older adults and/or those presenting for treatment with feeding tubes. Validation of patient efforts and severity of ARFID symptoms emerged as core to treatment success and should be emphasized when training clinicians in CBT-AR. Cognitive behavior therapy for ARFID (CBT-AR) is the leading treatment for this disorder; however, it has yet to be tested among older adults or those with feeding tubes. This single-patient case study demonstrates that CBT-AR may be efficacious in reducing ARFID symptom severity among older adults with a feeding tube.

Scurvy presenting with difficulties to walk and weakness in pediatric patients; 2 case reports. (P11-9.009)

<h3>Objective:</h3> Vitamin deficiency should be considered during differential diagnosis of neurological symptoms in patients presenting with subacute progressive gait instability and weakness. <h3>Background:</h3> Despite the perception that scurvy is a rare disorder (1,2), clinicians should have a high index of suspicion in patients at risk for nutritional deficiencies including picky eater, behavioral or sensory issues. <h3>Design/Methods:</h3> We report 2 patients of ascorbic acid deficiency who presented with subacute progressive gait instability and weakness. <h3>Results:</h3> Case 1 is a 12-year-old male with autism spectrum disorder who presented with 3 weeks of progressive bilateral lower extremity weakness resulting in wheelchair dependence. Cranial nerves, deep tendon reflexes, and sensory exam were normal. Motor exam notable for proximal &gt; distal lower extremity weakness. Skin and mucosal examination revealed gingival bleeding and corkscrew hair. Detailed dietary history revealed a severely restricted diet. He was found also to have low vitamin D. Patient treated empirically with vitamin C supplementation resulted in marked improvement within 24 hours, so no additional work up was recommended. Ascorbic acid level was extremely low confirming the diagnosis. Case 2 is a 4-year-old with history of mild hypotonia who presented with subacute progressive lower extremities weakness exacerbated by physical activity. Cranial nerves, deep tendon reflexes, and sensory exam were normal. Motor exam notable for proximal &gt; distal lower extremity weakness, waddling gait, and positive Gowers maneuver. Dietary history revealed restricted diet for the last 3 months. CK normal. Supplementation with Vitamin C resulted in minimal symptoms improvement so additional neuroimaging was recommended such as magnetic resonance imaging (MRI) of brain, spine and thigh/leg as well as lumbar puncture (LP) all unremarkable. Ascorbic acid level was low confirming the diagnosis. <h3>Conclusions:</h3> Dietary restriction and subacute progressive weakness should raise concern for nutritional myopathies. Refusal to bear weight is a frequent presentation of ascorbic acid deficiency (3). <b>Disclosure:</b> Dr. Railean has nothing to disclose. Dr. Martindale has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Tourette Association of America. The institution of Dr. Martindale has received research support from Tourette Association of America.

A Narrative Review on Eating Disorders and Disordered Eating in Inflammatory Bowel Diseases: Need for Increased Awareness

Recent evidence suggests a link between Inflammatory Bowel Disease (IBD) and eating disorders, an emerging complex bidirectional association. Indeed, the overlap of symptoms and signs can lead to delayed diagnosis and misdiagnosis of both conditions, but also the fear of food-induced symptoms, commonly observed in patients with IBD, determines dietary restrictions which in predisposed individuals may induce an overt eating disorder. ARFID (Avoidant Restrictive Food Intake Disorder) and anorexia nervosa are the eating disorders more frequently reported, while disordered eating and orthorexia nervosa are emerging conditions. Disease worsening due to refusal of therapies in patients with anorexia is also a matter of concern and an increased awareness of the possible association of these conditions by gastroenterologists and dietitians is strongly warranted in order for patients to receive the appropriate counseling.