Disorders of gut–brain interaction common among outpatients with eating disorders including avoidant/restrictive food intake disorder
Open accessAbstract
Objective: Little research exists on Rome IV disorders of gut–brain interaction (DGBI; formerly called functional gastrointestinal disorders) in outpatients with eating disorders (EDs). These data are particularly lacking for avoidant/restrictive food intake disorder (ARFID), which shares core features with DGBI. We aimed to identify the frequency and nature of DGBI symptoms among outpatients with EDs. Method: Consecutively referred pediatric and adult patients diagnosed with an ED (n = 168, 71% female, ages 8–76 years) in our tertiary care ED program between March 2017 and July 2019 completed a modified Rome IV Questionnaire for DGBI and psychopathology measure battery. Results: The majority (n = 122, 72%) of participants reported at least one bothersome gastrointestinal symptom. Sixty‐six (39%) met criteria for a DBGI, most frequently functional dyspepsia—post‐prandial distress syndrome subtype (31%). DGBI were surprisingly less frequent among patients with ARFID (30%) versus EDs that are associated with shape or weight concerns (45%; X2[1] = 3.61, p = .058, Cramer's V = .147). Among those with ARFID, DGBI presence was associated with the fear of aversive consequences prototype and multiple comorbid prototype presence. Discussion: We demonstrated notable overlap between DGBI and EDs, particularly post‐prandial distress symptoms. Further research is needed to examine if gastrointestinal symptoms predict or are a result of greater ED pathology, including ARFID prototypes.
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Anxiety is associated with eating pathology among individuals with chronic constipation.
“High illness anxiety has been associated with the maintenance of gastrointestinal symptoms over treatment (Salvioli et al., 2013) and anxiety is associated with eating pathology among individuals with chronic constipation (Burton Murray et al., 2020).”
From Preliminary data that psychological treatment and baseline anxiety are associated with a decrease in postprandial fullness and early satiation for individuals with bulimia nervosa and related other specified feeding or eating disorder. (2023) · cites this paper as Burton Murray et al., 2020
The Results report functional constipation in a small subset of eating-disorder outpatients, but do not test whether anxiety is associated with eating pathology among people with chronic constipation. The Discussion suggests a possible role for anxiety around GI symptoms, while the References list a separate study on chronic constipation and gastrointestinal-specific anxiety; neither passage establishes the claimed association in this paper. Searched for chronic constipation, gastrointestinal-specific anxiety, and eating-disorder pathology. (LLM, conf=0.73)
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Orthorexia Nervosa Is a Concern in Gastroenterology: A Scoping Review
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Self-citation
- Authors
- Murray, H. B., Kuo, B., Eddy, K. T., Breithaupt, L., Becker, K. R., Dreier, M. J., Thomas, J. J., & Staller, K.
- Affiliations
- Harvard University (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Murray, Helen Burton
- ORCID
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2020-11-26
- Volume
- 54
- Issue
- 6
- Pages
- 952-958
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- PMC
- PMC9116271
- OpenAlex
- W3109061588
- Cited by
- 74
- References
- 4
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 15 · 2023: 13 · 2022: 10 · 2021: 11
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Gastroenterological Association
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- functional gastrointestinal disorders, eating disorders, avoidant/restrictive food intake disorder, Rome IV criteria, functional dyspepsia, postprandial distress syndrome, gastrointestinal symptoms, comorbidities
- MeSH terms
- Avoidant Restrictive Food Intake Disorder, Adult, Feeding and Eating Disorders, Brain, Child, Eating, Female, Humans, Male, Outpatients
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