ARFID Eating Disorder Highly Heritable

Topic: Eating Disorders
Author: Karolinska Institutet
Published: 2023/02/01 - Peer-Reviewed: Yes
Contents: Summary - Definition - Introduction - Main Item - Related Topics

Synopsis: ARFID is a serious eating disorder that leads to malnutrition and nutritional deficiencies. Between one to five percent of the population is affected by the eating disorder. ARFID is not about the patient's experience of their body and fear of gaining weight. Instead, the disease is characterized by the avoidance of certain types of food due to a sensory discomfort because of the characteristics or appearance of food, for example, the fear of choking, a food poisoning phobia, or lack of appetite.

Defining Avoidant/Restrictive Food Intake Disorder

Avoidant/Restrictive Food Intake Disorder: Avoidant/restrictive food intake disorder (ARFID) is an eating disorder in which people eat only within an extremely narrow repertoire of foods. ARFID is a serious mental health condition that causes the individual to restrict food intake by volume or variety. This avoidance may be based on appearance, smell, taste, texture (because of sensory sensitivity), brand, presentation, fear of adverse consequences, lack of interest in food, or a past negative experience with the food, to the point that may lead to nutritional deficiencies, failure to thrive, or other negative health outcomes. Individuals with the condition will sometimes exclude whole food groups, such as fruit or vegetables. Sometimes excluded foods can be refused based on color. Some may only like very hot or icy foods, very crunchy or hard-to-chew foods, very soft foods, or avoid sauces. Most people with ARFID will still maintain a healthy or typical body weight. There are no specific outward appearances associated with ARFID.

Introduction

Etiology of the Broad Avoidant Restrictive Food Intake Disorder Phenotype in Swedish Twins Aged 6 to 12 Years - JAMA Psychiatry

ARFID is strongly influenced by genetic factors, according to a twin study examining this relatively new type of eating disorder. The study has been published in the journal JAMA Psychiatry by researchers at Karolinska Institutet.

Main Item

ARFID is a serious eating disorder that leads to malnutrition and nutritional deficiencies. Researchers estimate that between one to five percent of the population is affected by the eating disorder.

Unlike anorexia nervosa, ARFID is not about the patient's experience of their own body and fear of gaining weight. Instead, the disease is characterised by the avoidance of certain types of food due to a sensory discomfort because of the characteristics or appearance of food, or for example, the fear of choking, a food poisoning phobia, or lack of appetite.

Researchers at Karolinska Institutet have now investigated the importance of genetic factors for developing ARFID. A cohort of almost 17,000 pairs of twins in Sweden born between 1992 and 2010 participated in the study. A total of 682 children with ARFID between the ages of six and twelve years could be identified.

The researchers used the twin method to determine the influence of genes and the environment on the onset of the disease.

"We know that identical twins share all genes and that fraternal twins share about half of the genes that make people different. When we then see that a certain trait is more common in both members of identical twin pairs than in fraternal twin pairs, it is an indication that there is a genetic influence. We can then estimate the degree to which a trait is influenced by genetic factors", says Lisa Dinkler.

The researchers discovered that the genetic component for developing ARFID was high, 79 per cent. This means that 79 per cent of the risk of developing ARFID can be explained by genetic factors.

"This study suggests that ARFID is highly heritable. The genetic component is higher than that of other eating disorders and on par with that of neuropsychiatric disorders such as autism and ADHD," says Lisa Dinkler, a postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet

ARFID is a Relatively New Diagnosis

In 2013, the disorder was included in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, and this year it was included in the World Health Organization's diagnostic manual ICD. The latest edition, ICD-11, will be introduced to the Swedish healthcare system in a couple of years, consequently, the diagnosis is not an official part of Swedish health and medical care yet.

The next step in Dr. Dinkler's research is to study the extent to which ARFID is associated with other psychiatric diagnoses, such as anxiety and depression, neurodevelopmental disorders, and gastrointestinal problems.

"We will use twin studies to test the extent to which ARFID shares underlying genetic and environmental factors with these conditions," says Dr. Dinkler.

The study was mainly funded by the Swedish Research Council, the Swedish Mental Health Fund, Fredrik and Ingrid Thuring Foundation, Lundbeckfonden, NIMH and Brain and Behavior Research Foundation. Many of the researchers have received fees from private companies for work done outside this study, see the scientific article for more information.

Publication:

"Etiology of the broad avoidant restrictive food intake disorder phenotype in Swedish twins aged 6 to 12 years", Lisa Dinkler, Marie-Louis Wronski, Paul Lichtenstein, Sebastian Lundström, Henrik Larsson, Nadia Micali, Mark J. Taylor, Cynthia M. Bulik, JAMA Psychiatry.

Attribution/Source(s):

This peer reviewed publication was selected for publishing by the editors of Disabled World due to its significant relevance to the disability community. Originally authored by Karolinska Institutet, and published on 2023/02/01, the content may have been edited for style, clarity, or brevity. For further details or clarifications, Karolinska Institutet can be contacted at ki.se/en. NOTE: Disabled World does not provide any warranties or endorsements related to this article.

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