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When a GI disorder is present, the DSM\u20105 states that Avoidant\/Restrictive Food Intake Disorder (ARFID) can be diagnosed only when eating disturbance exceeds that expected. There is limited guidance to make this determination. This study attempts to address this gap by characterizing the presentation of ARFID in adults with and without a self\u2010reported GI disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Participants were 2,610 adults ages 18\u201344 who self\u2010identified as \u201cpicky eaters.\u201d Participants reported on motivations for food avoidance, affective experiences towards food, and perceived impairment. Responses were compared across four groups: GI issues and likely ARFID (L\u2010ARFID\/GI), L\u2010ARFID\u2010only, GI\u2010only, and No\u2010ARFID\/No\u2010GI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Groups with a GI disorder (L\u2010ARFID\/GI, GI\u2010only) reported more fear of aversive consequences of eating than those without a GI disorder, while groups with L\u2010ARFID (L\u2010ARFID, L\u2010ARFID\/GI) evidenced significantly greater sensory aversion to food and indifference to food or eating, negative emotional reactions to food and overall disgust sensitivity, and eating related impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Consideration of the interplay of a GI disorder with ARFID can add precision to case conceptualization. Food avoidance may be attempts to manage fears of aversive consequences that are augmented by a history of GI symptoms, while sensory aversions and negative emotional reactions towards foods may be more elevated in ARFID. These findings emphasize the need to consider an ARFID diagnosis in patients with GI disorders to optimize care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23536","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T14:25:51Z","timestamp":1621866351000},"page":"995-1008","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["The diagnosis of avoidant restrictive food intake disorder in the presence of gastrointestinal disorders: Opportunities to define shared mechanisms of symptom expression"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7218-5719","authenticated-orcid":false,"given":"Julia K.","family":"Nicholas","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda A. 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