A NEW nationwide study from Spain has found that nearly half of adults with systemic sclerosis (SSc) screen positive for avoidant or restrictive food intake disorder (ARFID) symptoms, raising concerns about the often-overlooked impact of gastrointestinal symptoms on eating behaviors and overall quality of life in this patient population.
The study surveyed 200 adults with SSc and found that 49.5% screened positive for ARFID, a feeding and eating disorder characterized by avoidance or restriction of food intake that leads to nutritional, psychological, or social impairments.
In many cases, restrictive eating appeared to stem from a fear of gastrointestinal discomfort, such as pain, bloating, or nausea—symptoms commonly experienced by people with SSc. Over half of those who screened positive reported avoiding food due to fears of negative physical consequences, rather than body image concerns typical of more widely recognized eating disorders.
Patients with ARFID symptoms were more likely to report weight loss, self-imposed diet restrictions, and reliance on enteral nutrition. These symptoms were moderately associated with worse gastrointestinal symptom severity and significantly linked to poorer physical and mental health-related quality of life.
“While some level of dietary restriction may be an adaptive response to chronic symptoms, we need to better understand when it crosses into clinically significant disordered eating,” said co-lead author Dr. Luis G. Alcala-Gonzalez.
The researchers stress the importance of screening for ARFID in patients with systemic sclerosis and call for future research to determine when behavioral interventions may be needed.
Reference
Alcala-Gonzalez L et al. Avoidant or Restrictive Food Intake Disorder Symptoms in Adults With Systemic Sclerosis: A Nationwide Study in Spain. Arth Care Res. 2025;DOI: 10.1002/acr.25569.
