‘Fussy eating’ disorder linked to differences in brain structure, study shows

Children who suffer from a “fussy eating” disorder have differences in brain structure, a study has revealed.

The research, led by the University of Aberdeen, was the first to use neuroimaging to study the brains of children with avoidant/restrictive food intake disorder (Arfid).

The condition, which was officially classified as a disorder in 2013, is characterised by a person avoiding certain foods or types of food or restricting how much they eat, to the extent they cannot meet their nutritional needs – and it can have a significant impact on physical and psychological wellbeing.

The researchers analysed the brain scans of 1,977 10-year-old children in the Netherlands, 121 (6%) of whom had symptoms of Arfid.

They found that those with symptoms of Arfid showed significantly greater cortical thickness – a measurement of the depth of the outer layer of the brain – in certain areas compared with those without symptoms.

Dr Michelle Sader, a post-doctoral research fellow at the University of Aberdeen, said: “Many people may experience fussy eating at some point in their lives, while individuals with Arfid experience severe health and psychological consequences resulting from their disordered eating.

“There are three main underlying drivers behind food restriction associated with Arfid, which include sensory sensitivities in relation to food, lack of interest in food and fear of aversive consequences associated with eating, such as choking or vomiting.

“Some symptoms associated with Arfid may include an individual struggling to identify when they are hungry, consistently eating the same meals, having low dietary diversity, anxiety during mealtimes, or needing supplements to meet nutritional needs.”

She said previous studies have shown Arfid exhibits similar “adverse physiological effects” to restrictive eating disorders such as anorexia but that it is regarded as far less dangerous.

She explained that the study found those with Arfid symptoms had differences in areas of the brain associated with “executive function”.

“Since the introduction of the Arfid diagnosis in 2013, no structural neuroimaging studies have been conducted in Arfid or Arfid-like populations,” she said.

“Our findings demonstrate that children presenting with symptoms of Arfid showed significantly greater cortical thickness in certain areas of the brain compared to those without Arfid symptoms, specifically in the frontal and superior frontal regions.

“These brain regions are associated with executive function and are particularly important for anticipation of conflict and inhibition control.”

She added that she hoped the study, called Far From Fussy Eaters, would help researchers and clinicians better understand the condition, and “inform on approaches for Arfid treatment, management and support”.

The research was welcomed by Tom Quinn, chief executive of eating disorder charity Beat.

“Arfid can sometimes be downplayed as a phase, which is incredibly unfair considering the real impact the disorder has on those who experience it,” he said.

“There can be devastating impacts on nutrition, quality of life and overall physical and mental health.

“Although the condition can develop at any age, some children experiencing the disorder may not enter puberty because they aren’t able to eat a wide enough range of foods to meet their nutritional needs.”

He said more research into the condition was needed to “fully understand how best to treat and ultimately prevent Arfid and other eating disorders.”

The study was was undertaken by an international team of scientists from the Netherlands, Australia, the US and the UK, led by the University of Aberdeen.

The findings were published in the Journal of Child Psychology and Psychiatry.