Prevalence, Phenotype, and Correlates of Avoidant/Restrictive Food Intake Disorder Symptoms in the Gulf Cooperation Council: An Underserved Region

Abstract

Introduction: Prevalence estimates and correlates of ARFID in non-Western samples are lacking. This study aims to estimate the prevalence of ARFID symptoms, identify its phenotypes, and explore its correlates in a community sample from the Gulf Cooperation Council (GCC). Method: Participants were parents of children aged 4–13 years (n = 87) and individuals of ≥ 14 years old (n = 433). They completed the Pica, ARFID, and Rumination Disorder Interview-ARFID-Questionnaire (PARDI-AR-Q), the Nine Item ARFID Screen (NIAS) and the Eating Disorder Examination-Questionnaire (EDE-Q). Multiple regression analyses were performed with body mass index or its standard deviation score, comorbid psychopathology, EDE-Q global score, sex, and age as independent variables; the dependent variable was ARFID psychopathology. Results: Among individuals not reporting eating disorder symptoms driven by overvaluation of shape and weight, the PARDI-AR-Q diagnostic prediction suggested that approximately 23.4% of those aged ≥ 14 exhibited ARFID symptoms. Based on the NIAS, sensory-based food avoidance was the most reported phenotype expression, with approximately 29.4% of children (4–13 years) and 12.8% of adolescents/adults (≥ 14-years) reporting ARFID symptoms. In adolescents and adults, ARFID psychopathology was positively associated with eating disorder pathology driven by overvaluation of shape and weight, with female sex and negatively associated with age. Discussion: This study is the first to identify a subset of individuals in GCC countries with ARFID symptoms across sexes and a broad age range, with sensory sensitivity as the most common symptom.