Neurobiology of Avoidant/Restrictive Food Intake Disorder

Avoidant/restrictive food intake disorder (ARFID) is a complex, phenotypically heterogenous, and often severe feeding and eating disorder. Genetic studies suggest that ARFID is highly heritable, and that genes involved in taste perception and neurodevelopmental disorders may confer increased risk for the disorder. Neuroimaging studies are limited but point toward greater activation in reward circuitry among individuals with ARFID who are also overweight or obese, compared to those of normal weight. Endocrine studies have identified maladaptively high satiety-promoting (Peptide YY, cholecystokinin, oxytocin) and low hunger-promoting (ghrelin) hormone levels among individuals with ARFID, which may contribute to disease etiology and/or maintenance. Although research is limited, emerging insights into the pathophysiology of this common and impairing disorder may pave the way for the development of novel biological and pharmacological treatments. [ Psychiatr Ann. 2024;54(2):e47–e50.]