Avoidant/restrictive food intake disorder (ARFID) is characterized in part by limited dietary variety, but dietary characteristics of this disorder have not yet been systematically studied. Our objective was to examine dietary intake defined by diet variety, macronutrient intake, and micronutrient intake in children and adolescents with full or subthreshold ARFID in comparison to healthy controls. We collected and analyzed four-day food record data for 52 participants with full or subthreshold ARFID, and 52 healthy controls, aged 9–22 years. We examined frequency of commonly reported foods by logistic regression and intake by food groups, macronutrients, and micronutrients between groups with repeated-measures ANOVA. Participants with full or subthreshold ARFID did not report any fruit or vegetable category in their top five most commonly reported food categories, whereas these food groups occupied three of the top five groups for healthy controls. Vegetable and protein intake were significantly lower in full or subthreshold ARFID compared to healthy controls. Intakes of added sugars and total carbohydrates were significantly higher in full or subthreshold ARFID compared to healthy controls. Individuals with full or subthreshold ARFID had lower intake of vitamins K and B12, consistent with limited vegetable and protein intake compared to healthy controls. Our results support the need for diet diversification as part of therapeutic interventions for ARFID to reduce risk for nutrient insufficiencies and related complications.

Objective The majority of individuals with anorexia nervosa (AN) have a fat‐phobic (FP‐AN) presentation in which they explicitly endorse fear of weight gain, but a minority present as non‐fat‐phobic (NFP‐AN). Diagnostic criteria for avoidant/restrictive food intake disorder (ARFID) specifically exclude fear of weight gain. Differential diagnosis between NFP‐AN and ARFID can be challenging and explicit endorsements do not necessarily match internal beliefs. Method Ninety‐four adolescent females (39 FP‐AN, 13 NFP‐AN, 10 low‐weight ARFID, 32 healthy controls [HC]) completed implicit association tests (IATs) categorizing statements as pro‐dieting or non‐dieting and true or false (questionnaire‐based IAT), and images of female models as underweight or normal‐weight and words as positive or negative (picture‐based IAT). We used the Eating Disorder Examination to categorize FP‐ versus NFP‐AN presentations. Results Individuals with FP‐AN and NFP‐AN demonstrated a stronger association between pro‐dieting and true statements, whereas those with ARFID and HCs demonstrated a stronger association between pro‐dieting and false statements. Furthermore, while all groups demonstrated a negative implicit association with underweight models, HC participants had a significantly stronger negative association than individuals with FP‐AN and NFP‐AN. Discussion Individuals with NFP‐AN exhibited a mixed pattern in which some of their implicit associations were consistent with their explicit endorsements, whereas others were not, possibly reflecting a minimizing response style on explicit measures. In contrast, individuals with ARFID demonstrated implicit associations consistent with explicit endorsements. Replication studies are needed to confirm whether the questionnaire‐based IAT is a promising method of differentiating between restrictive eating disorders that share similar clinical characteristics.

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Objective This study examined the relationship between eating‐disorder behaviors—including restrictive eating, binge eating, and purging—and suicidal ideation. We hypothesized that restrictive eating would significantly predict suicidal ideation, beyond the effects of binge eating/purging. Methods Participants were 82 adolescents and young adults with low‐weight eating disorders. We conducted a hierarchical logistic regression, with binge eating and purging in Step 1 and restrictive eating in Step 2, to predict suicidal ideation. Results Step 1 was significant (p = .01) and explained 20% variance in suicidal ideation; neither binge eating nor purging significantly predicted suicidal ideation. Adding restrictive eating in Step 2 significantly improved the model (ΔR2 = .07, p = .009). This final model explained 27% of the variance, and restrictive eating (but not binge eating/purging) significantly predicted suicidal ideation (p = .02). Discussion Restrictive eating is associated with suicidal ideation in youth with low‐weight eating disorders, beyond the effects of other eating‐disorder behaviors. Although healthcare providers may be more likely to screen for suicidality in patients with binge eating and purging, our findings indicate clinicians should regularly assess suicide and self‐injury in patients with restrictive eating. Future research examining how individuals progress from suicidal ideation to suicidal attempts can further enhance our understanding of suicide in eating disorders.