Avoidant/Restrictive food intake disorder in adults within the community: A mixed-method study on individual impairment and progression

Abstract Background While avoidant/restrictive food intake disorder (ARFID) occurs across the lifespan, most previous research focused on children and adolescents. Particularly, individual impairment and progression patterns in adults remain largely unknown. Therefore, this study aimed to explore individual impairment and to identify progression patterns and associated psychological and sociodemographic characteristics in adults with ARFID. Methods Data from N = 97 adults from the community with an interview-based diagnosis of ARFID were utilized. Participants took part in an online study on ARFID and answered open-ended questions on personal impairment and disorder progression, which were analyzed based on a qualitative content-thematic approach. In addition, ARFID symptoms, obsessive-compulsive personality traits, temperament, and sensory sensitivity were assessed via established questionnaires. Quantitative analyses included comparisons of progression groups in sociodemographic and clinical variables. Results Qualitatively, seven main themes of impairment emerged: (1) health-related impairment, (2) impairment of lifestyle, (3) impairment by the eating behavior itself, (4) impairment due to responses of the social environment, (5) partnership, (6) parenthood, and (7) impairment due to experiences with practitioners. Higher education and age were more often seen in individuals with improved compared to individuals with deteriorated progression patterns, while greater fear of aversive consequences was associated with deteriorated progression. Conclusion This is the first study to comprehensively capture the impact of ARFID based on experienced impairments and to highlight the heterogeneity of disorder progression, with educational level, age, and ARFID symptoms emerging as potentially associated factors. Longitudinal studies are needed to prospectively identify risk and protective factors on ARFID’s progression and persistence.