Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;53(4):631-636.
doi: 10.1002/eat.23261. Epub 2020 Mar 21.

Medical comorbidities and endocrine dysfunction in low-weight females with avoidant/restrictive food intake disorder compared to anorexia nervosa and healthy controls

Anna Aulinas  1   2   3 , Dean A Marengi  1 , Francesca Galbiati  1   2 , Elisa Asanza  1 , Meghan Slattery  1 , Christopher J Mancuso  1 , Olivia Wons  1 , Nadia Micali  4   5 , Elana Bern  6 , Kamryn T Eddy  7   8 , Jennifer J Thomas  7   8 , Madhusmita Misra  1   2   9 , Elizabeth A Lawson  1   2
Affiliations

Medical comorbidities and endocrine dysfunction in low-weight females with avoidant/restrictive food intake disorder compared to anorexia nervosa and healthy controls

Anna Aulinas et al. Int J Eat Disord. 2020 Apr.

Abstract

Objective: To improve our understanding of medical complications and endocrine alterations in patients with low-weight avoidant/restrictive food intake disorder (ARFID) and how they may differ from those in anorexia nervosa (AN) and healthy controls (HC).

Method: We performed an exploratory cross-sectional study comparing low-weight females with ARFID (n = 20) with females with AN (n = 42) and HC (n = 49) with no history of an eating disorder.

Results: We found substantial overlap in medical comorbidities and endocrine features in ARFID and AN, but with earlier onset of aberrant eating behaviors in ARFID. We also observed distinct medical and endocrine alterations in ARFID compared to AN, such as a greater prevalence of asthma, a lower number of menses missed in the preceding 9 months, higher total T3 levels, and lower total T4 : total T3 ratio; these differences persisted after adjusting for age and might reflect differences in pathophysiology, acuity of weight fluctuations, and/or nutritional composition of food consumed.

Conclusion: These results highlight the need for prompt diagnosis and intensive therapeutic intervention from disease onset in ARFID.

Keywords: anorexia nervosa; avoidant/restrictive food intake disorder; hormone evaluation; low weight; medical comorbidities.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest. EAL has a financial interest in OXT Therapeutics, a company developing an intranasal oxytocin and long-acting analogs of oxytocin to treat obesity and metabolic disease. EAL’s interests were reviewed and are managed by Massachusetts General Hospital and Partners HealthCare in accordance with their conflict of interest policies. Other authors have no financial interests to declare.

References

    1. AP A. (2013). Diagnostic and statistical manual of mental disorders fifth edition DSM-5. Washington, DC: American Psychiatric Association
    1. Breithaupt L, Kohler-Forsberg O, Larsen JT, Benros ME, Thornton LM, Bulik CM, & Petersen L. (2019). Association of Exposure to Infections in Childhood With Risk of Eating Disorders in Adolescent Girls. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2019.0297 - DOI - PMC - PubMed
    1. Fazeli PK, & Klibanski A. (2012). Neuroendocrine dysregulation and the growth hormone-IGF-1 axis in anorexia nervosa. Expert Rev Endocrinol Metab, 7(2), 223–231. doi:10.1586/eem.12.5 - DOI - PubMed
    1. Fisher MM, Rosen DS, Ornstein RM, Mammel KA, Katzman DK, Rome ES, … Walsh BT. (2014). Characteristics of avoidant/restrictive food intake disorder in children and adolescents: a “new disorder” in DSM-5. J Adolesc Health, 55(1), 49–52. doi:10.1016/j.jadohealth.2013.11.013 - DOI - PubMed
    1. Harshman SG, Wons O, Rogers MS, Izquierdo AM, Holmes TM, Pulumo RL, … Thomas JJ. (2019). A Diet High in Processed Foods, Total Carbohydrates and Added Sugars, and Low in Vegetables and Protein Is Characteristic of Youth with Avoidant/Restrictive Food Intake Disorder. Nutrients, 11(9). doi:10.3390/nu11092013 - DOI - PMC - PubMed

Publication types