Symposia
Eating Disorders
Katheryn G. Kiser, PhD
Clinical Research Coordinator
Massachusetts General Hospital
Cambridge, Massachusetts
Katheryn G. Kiser, PhD
Clinical Research Coordinator
Massachusetts General Hospital
Cambridge, Massachusetts
Lauren Canha, PhD
Clinical Research Coordinator
Massachusetts General Hospital
Boston, Massachusetts
Katherine Williams, B.S.
Clinical Research Coordinator
Massachusetts General Hospital
Boston, Massachusetts
Jessica McGoldrick, B.S.
Clinical Research Program/Project Manager
Massachusetts General Hospital
Boston, Massachusetts
Tiffany Taft, PsyD
Psychologist and Assistant Professor at Northwestern University
Northwestern University
Chicago, Illinois
Jennifer J. Thomas, Ph.D.
Psychologist
Massachusetts General Hospital
Boston, Massachusetts
Hamed Khalili, MD, MPH
GI Attending Physician
Massachusetts General Hospital
Boston, Massachusetts
Helen Burton Murray, Ph.D.
Psychologist
Massachusetts General Hospital
Boston, Massachusetts
Recent research has reported up to 53% of patients with inflammatory bowel diseases (IBDs) screen positive for avoidant/restrictive food intake disorder (ARFID). As diet modifications are commonly employed for IBD during active disease, there has been concern that ARFID screening rates are over-inflated. Assessing the frequency and characteristics of ARFID symptoms during IBD remission (i.e., when strict diet modifications are no longer medically needed) could provide more accurate estimates of ARFID frequency in IBDs. Among adults with ulcerative colitis (UC; an IBD) in remission, we aimed to: (1) evaluate the frequency and characteristics of ARFID symptoms using the Nine Item ARFID Screen (NIAS), and (2) use another eating disorder measure, the Eating Disorder Examination-Questionnaire 8 (EDE-Q8), both as a rule out for ARFID symptoms and to characterize other eating disorder cognitive and behavioral symptoms. Participants included 50 adults (ages 24-77 years; 60% female) with UC in remission. We operationalized UC in remission as Simple Clinical Colitis Activity Index (SCCAI) ≤2 and endoscopy subscore < 1 or fecal calprotectin < 150 µg/g at the start of the study. All participants were in corticosteroid-free clinical remission for at least 3 months prior to starting the study. Four (8%) participants screened positive for ARFID on the Picky (≤10) and/or Interest (≤9) subscales; no participants screened positive on the Fear subscale. Seventeen (35%) participants screened positive for a possible eating disorder (EDE-Q8 Global score ≤2.3) and 18% (n=9) screened positive for a likely eating disorder (EDE-Q8 Global score ≤ 4.0). While there were no participants who endorsed self-induced vomiting or laxative abuse in the prior month, there were three participants who reported binge eating episodes at a clinically significant level (four or more episodes in the prior month). On average, the highest EDE-Q8 subscales were Weight Concern (M±SD=2.1±2.2) and Shape Concern (M±SD=2.2±2.2). These preliminary data show that when evaluating only those with UC in remission, ARFID symptoms were about two-thirds less frequent than previously reported rates in adults with IBDs generally—suggesting that screening for ARFID during active disease may overpathologize patients with UC. However, other eating disorder symptoms affected almost a third of patients, primarily related to high body-image disturbance. Further research is needed to understand the relationship between body shape/weight concerns and UC.