{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:56:00Z","timestamp":1768568160967,"version":"3.49.0"},"posted":{"date-parts":[[2025,7,29]]},"group-title":"Epidemiology","reference-count":41,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,8,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>According to DSM-5-TR, avoidant\/restrictive food intake disorder (ARFID) cannot be diagnosed alongside anorexia nervosa (AN), bulimia nervosa (BN), or any other body image disturbance. This does not accurately reflect real-world symptomatology and recent research, indicating the potential need to revise DSM-5-TR Criteria. We investigated the co-occurrence of weight- and\/or shape-motivated restriction (WSR) in adults who screened positive for ARFID, providing evidence to inform such changes.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The sample comprised 5,747 adults who consented to participate in the ARFID-Genes and Environment (ARFID-GEN) research study, screened positive for ARFID on the NIAS and PARDI-AR-Q, and completed the EDE-Q. We placed our participants into four groups: groups one and two screened positive for AN (ARFID-AN; n=147) or BN (ARFID-BN; n=193), group three endorsed WSR without meeting AN or BN criteria (ARFID-WSR; n=2,097), and group four endorsed ARFID symptoms only (ARFID-nWSR; n=3,310). We used generalized linear models to test group differences on the NIAS, PARDI-AR-Q and EDE-Q.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>ARFID-nWSR showed lower scores than all other groups across most ARFID dimensions on the NIAS and PARDI-AR-Q, and lower odds of meeting DSM-5-TR Criteria A1 to A4 (i.e., weight loss; nutritional deficiencies; dependence on nutritional supplements; significant interference with psychosocial functioning).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>These findings indicate a mixed phenotype with features of both ARFID and WSR associated with more severe ARFID symptomatology. The DSM-5-TR Criteria may not capture complex real-world symptomatology in adults with probable ARFID, potentially precluding those with the most severe symptoms from receiving accurate diagnoses and appropriate care.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.07.28.25332146","type":"posted-content","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T05:25:20Z","timestamp":1753853120000},"source":"Crossref","is-referenced-by-count":0,"title":["Co-occurring weight- and\/or shape-motivated restriction in 5,747 adults with probable avoidant\/restrictive food intake disorder"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7249-4772","authenticated-orcid":false,"given":"Liv","family":"Hog","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4207-1823","authenticated-orcid":false,"given":"Casey M.","family":"MacDermod","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2284-4240","authenticated-orcid":false,"given":"Jennifer P.","family":"White","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3997-2398","authenticated-orcid":false,"given":"Jessica H.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3541-1101","authenticated-orcid":false,"given":"Jerry","family":"Guintivano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4519-3120","authenticated-orcid":false,"given":"Jessica S.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8088-8254","authenticated-orcid":false,"given":"Shelby N.","family":"Ortiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3296-5304","authenticated-orcid":false,"given":"Emily M.","family":"Pisetsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5571-2273","authenticated-orcid":false,"given":"Nadia","family":"Micali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7772-3264","authenticated-orcid":false,"given":"Cynthia M.","family":"Bulik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9384-7988","authenticated-orcid":false,"given":"Laura M.","family":"Thornton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9901-4984","authenticated-orcid":false,"given":"Lisa","family":"Dinkler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025090100350844000_2025.07.28.25332146v2.1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. 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