Prevalence of Avoidant/Restrictive Food Intake Disorder (ARFID) in Undergraduate DPT Students: Avoidant/Restrictive Food Intake Disorder in DPT Students

Kiran Arshad; . Sawera; Mouiza Munir; Ghulam Fatima; Abdullah Mohammad Alyami

doi:10.54393/tt.v6i2.278

Authors

Kiran Arshad Isra Institute of Rehabilitation Sciences, Karachi, Pakistan
. Sawera Department of Physical Therapy, Al-Tibri Medical College and Hospital, Karachi, Pakistan
Mouiza Munir Department of Physical Therapy, Al-Tibri Medical College and Hospital, Karachi, Pakistan
Ghulam Fatima Isra Institute of Rehabilitation Sciences, Karachi, Pakistan
Abdullah Mohammad Alyami Department of Medical Rehabilitation Sciences, Applied Medical Sciences College, Najran University, Saudi Arabia

DOI:

https://doi.org/10.54393/tt.v6i2.278

Keywords:

Prevalence, Avoidant/Restrictive Food Intake Disorder, DPT, Undergraduate Students

Abstract

Avoidant/Restrictive Food Intake Disorder (ARFID) is a relatively new eating disorder diagnosis characterized by limited food intake due to lack of interest, sensory-based avoidance, or concern about aversive consequences, which can negatively impact nutritional health and quality of life. University students, such as those pursuing a Doctor of Physical Therapy (DPT), may be at risk due to stress and lifestyle factors. Objectives: To determine the prevalence of ARFID in undergraduate DPT students. Methods: A cross-sectional study was conducted on 377 students from different universities in Karachi using the PARDI-AR-Q-Self-14+ questionnaire. SPSS version 22 was used for data analysis, including frequencies and percentages. Results: The findings revealed that out of 377 participants, 28% responded “YES” while 72% responded “NO” to ARFID prediction. Participants’ ages ranged from 18 to 26 years, with a female majority (72%) compared to males (27%). The highest prevalence was observed in lack of interest in food, with 53.3% at level 1, 18.3% at level 2, 15.1% at level 3, 8.5% at level 4, 4.0% at level 5, and 1.1% at level 6, whereas sensory-based avoidance showed the lowest prevalence. Most participants fell within a healthy BMI range, while the least were classified as obesity class I. Conclusions: Undergraduate DPT students demonstrated low prediction of ARFID but highlighted a notable lack of interest in food or eating as the most prevalent pattern. The overall findings suggest limited awareness about ARFID among students, indicating a need for educational programs, seminars, and webinars to increase awareness and promote a better quality of life.

References

Breiner CE. Acceptability and Feasibility of ARFID-PTP: A Brief, Virtual, Parent-Training Intervention for Avoidant/Restrictive Food Intake Disorder in Children. State University of New York at Albany. 2023.

Sanchez‐Cerezo J, Nagularaj L, Gledhill J, Nicholls D. What Do We Know About the Epidemiology of Avoidant/Restrictive Food Intake Disorder in Children and Adolescents? A Systematic Review of the Literature. European Eating Disorders Review. 2023 Mar; 31(2): 226-46. doi: 10.1002/erv.2964.

Chiong TX, Tan ML, Lim TS, Quak SH, Aw MM. Selective Feeding—An Under-Recognized Contributor to Picky Eating. Nutrients. 2024 Oct; 16(21): 3608. doi: 10.3390/nu16213608.

Chatoor I, Lucarelli L. Feeding and Eating Disorders of Infancy and Early Childhood. In Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, (Robert Boland, Marcia L. Verduin Eds), Eleventh Edition. 2025; 2: 3761-3773.

Norris ML, Robinson A, Obeid N, Harrison M, Spettigue W, Henderson K. Exploring Avoidant/Restrictive Food Intake Disorder in Eating Disordered Patients: A Descriptive Study. International Journal of Eating Disorders. 2014 Jul; 47(5): 495-9. doi: 10.1002/eat.22217.

Thomas JJ, Lawson EA, Micali N, Misra M, Deckersbach T, Eddy KT. Avoidant/Restrictive Food Intake Disorder: A Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment. Current Psychiatry Reports. 2017 Aug; 19(8): 54. doi: 10.1007/s11920-017-0795-5.

Howard M, Hembry P, Rhind C, Siddall A, Uddin MF, Bryant-Waugh R. Cognitive Behaviour Therapy (CBT) as A Psychological Intervention in the Treatment of ARFID for Children and Young People. The Cognitive Behaviour Therapist. 2023 Jan; 16: e5. doi: 10.1017/S1754470X22000629.

Graf MD, Lutenbacher M, Wasser H, Dietrich MS, Karp SM. Choking, Allergic Reactions, and Pickiness: A Qualitative Study of Maternal Perceived Threats and Risk Avoidance Strategies During Complementary Feeding. Appetite. 2022 Apr; 171: 105914. doi: 10.1016/j.appet.2022.105914.

Delaney CB, Eddy KT, Hartmann AS, Becker AE, Murray HB, Thomas JJ. Pica and Rumination Behavior Among Individuals Seeking Treatment for Eating Disorders or Obesity. International Journal of Eating Disorders. 2015 Mar; 48(2): 238-48. doi: 10.1002/eat.22279.

Leung AK, Hon KL. Pica: A Common Condition That Is Commonly Missed-An Update Review. Current Pediatric Reviews. 2019 Aug; 15(3): 164-9. doi: 10.2174/1573396315666190313163530.

Mallick H and Dalia S. Pica Syndromes and Iron Deficiency Anemia Treatment: A Mini Review. Hemato. 2025 Aug; 6(3): 26. doi: 10.3390/hemato6030026.

James RM, O’Shea J, Micali N, Russell SJ, Hudson LD. Physical Health Complications in Children and Young People with Avoidant Restrictive Food Intake Disorder (ARFID): A Systematic Review and Meta-Analysis. British Medical Journal Pediatrics Open. 2024 Jul; 8(1): e002595. doi: 10.1136/bmjpo-2024-002595.

Miao D, Young SL, Golden CD. A Meta‐Analysis of Pica and Micronutrient Status. American Journal of Human Biology. 2015 Jan; 27(1): 84-93. doi: 10.1002/ajhb.22598.

Abu BA, Morrissey A, Wu Y, Castillo DA, Becker R, Wu T et al. Pica Practices, Anemia, and Oral Health Outcomes: A Systemic Review. BioMed Central Oral Health. 2025 Jan; 25(1): 13. doi: 10.1186/s12903-025-06429-w.

Katzman DK, Spettigue W, Agostino H, Couturier J, Dominic A, Findlay SM et al. Incidence and Age-And Sex-Specific Differences in the Clinical Presentation of Children and Adolescents with Avoidant Restrictive Food Intake Disorder. Journal of the American Medical Association Pediatrics. 2021 Dec; 175(12): e213861-. doi: 10.1001/jamapediatrics.2021.3861.

Murray HB, Kuo B, Eddy KT, Breithaupt L, Becker KR, Dreier MJ et al. Disorders of Gut–Brain Interaction Common among Outpatients with Eating Disorders Including Avoidant/Restrictive Food Intake Disorder. International Journal of Eating Disorders. 2021 Jun; 54(6): 952-8. doi: 10.1002/eat.23414.

Burton Murray H, Jehangir A, Silvernale CJ, Kuo B, Parkman HP. Avoidant/Restrictive Food Intake Disorder Symptoms Are Frequent in Patients Presenting for Symptoms of Gastroparesis. Neurogastroenterology and Motility. 2020 Dec; 32(12): e13931. doi: 10.1111/nmo.13931.

Ortiz SN, White JP, MacDermod CM, Dinkler L, Thornton LM, Johnson J et al. Validating Online Parent‐and Self‐Report Screening Methods for Avoidant/Restrictive Food Intake Disorder. International Journal of Eating Disorders. 2025 May; 58(5): 878-89. doi: 10.1002/eat.24376.

Zickgraf HF, Murray HB, Kratz HE, Franklin ME. Characteristics of Outpatients Diagnosed with the Selective/Neophobic Presentation of Avoidant/Restrictive Food Intake Disorder. International Journal of Eating Disorders. 2019 Apr; 52(4): 367-77. doi: 10.1002/eat.23013.

Bryant-Waugh R, Stern CM, Dreier MJ, Micali N, Cooke LJ, Kuhnle MC et al. Preliminary Validation of the Pica, ARFID and Rumination Disorder Interview ARFID Questionnaire (PARDI-AR-Q). Journal of Eating Disorders. 2022 Nov; 10(1): 179. doi: 10.1186/s40337-022-00706-7.