Avoidant/Restrictive Food Intake Disorder in Adult Patients with Gastrointestinal Diseases: A Concept Analysis Using Evolutionary Approach.

Background: Avoidant/restrictive food intake disorder is a recently introduced concept, initially focused on non-adult populations, and encompasses multiple dimensions such as physiological and psychological aspects. Due to symptom overlap, food avoidance and related symptoms in patients with gastrointestinal diseases are often overlooked or rationalized. The confusion and unclear definitions of related concepts have hindered further research and exploration.

Objective: This study aims to clarify the concept of avoidant/restrictive food intake disorder in adults with gastrointestinal diseases and to enhance clinicians' awareness of this phenomenon.

Design: Rodgers' evolutionary concept analysis.

Methods: A systematic literature search targeting avoidant/restrictive food intake disorder in adult patients with gastrointestinal diseases was conducted using keywords and entry terms across seven databases, including PubMed, Web of Science, EBSCO, CINAHL, PsycINFO, EMBASE, and CNKI (up to September 28, 2024). A concept analysis framework was employed to identify the concept's attributes, antecedents, consequences, and other defining characteristics.

Results: A total of 22 articles were included. Four attributes of avoidant/restrictive food intake disorder in adult patients with gastrointestinal diseases were extracted and identified: exclusionary/selective diet status, non-body image-related, negative/fearful response, and mixed/independent motivation. Antecedents include gastrointestinal diseases and symptoms, traumatic events and experiences, dietary adversities history, and nutritional misconceptions. Consequences involved nutritional/psychological consequences, poor overall health, complex disease management, and reduced quality of life.

Conclusion: We found that avoidant/restrictive food intake disorder in the context of gastrointestinal diseases is a state of disordered eating characterized by food exclusion and selectivity, which may progress into a disorder when its impact on physical or psychological functioning exceeds adaptive threshold. This study clarifies the concept, and the findings provide a basis for developing assessment tools, guiding dietary management, and informing the implementation of targeted interventions in GI patients.