Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by persistent insufficient nutritional and/or energy intake. ARFID, before referred to as “selective eating disorder”, was introduced recently in the DSM-5 as a replacement for and expansion of the previous diagnosis. Individuals with ARFID may limit food variety and intake due to avoidance based on the sensory characteristics of the food or related to any adverse consequences of eating without the intention of losing weight and concerns of body image. The limited understanding of avoidant and restrictive eating poses challenges to effective treatment and management, impacting directly on the growth and development of children and adolescents. The ARFID neurobiological concept has not yet been clearly defined to clinical practice for nutritionists, thereby hindering screening and impeding the development of treatment recommendations. This narrative review provide useful practical information to consult the pathophysiology, the neurobiology, the clinical features, the assessment and the treatment for healthcare professionals seeking to enhance their clinical knowledge and management of this disorder.

Individuals diagnosed with Generalized Anxiety Disorder (GAD) search for pleasurable foods to avoid their negative emotional experiences. An ineffective regulation of negative emotions may be a risk factor for emotional eating, leading to suffering, dysfunctional behaviors and weight gain. The aim of this study is to understand the relationship between emotional dysregulation and emotional eating, investigating potential mediators as the intensity of the worry, avoidance of internal experiences, mindfulness and self-compassion in female anxious patients. Participants from a randomized clinical trial diagnosed with GAD answered the instruments at baseline: Difficulties in Emotion Regulation Scale (DERS), Three Factor Eating Questionnaire (TFEQ-R21), Penn State Worry Questionnaire (PSWQ), Action and Acceptance Questionnaire (AAQ), Five Facet Mindfulness Questionnaire (FFMQ), and Self-Compassion Scale (SCS) in this cross-sectional study. We estimated Pearson correlation coefficients and performed mediation analyses. We evaluated 51 individuals and 34 female participants completed all the questionnaires. Our data showed that emotional eating was positively correlated with emotional dysregulation (r=0.593; p<0.001), worry trait (r=0.402; p=0.018), and avoidance of internal experiences (r=0.565; p<0.001), whereas it was negatively correlated with self-compassion (r=-0.590; p<0.001) and mindful state (r=-0.383; p=0.026). Moreover, we demonstrated that self-compassion mediates the relationship between emotional dysregulation and emotional eating (ab product estimate = 0.043, 95% CI [0.003 to 0.084]). : Our findings could add to the literature by identifying psychological factors that could mediate the association between emotional dysregulation and emotional eating, allowing more effective eating behavior intervention targets in patients with GAD.

Eating behavior is affected by psychological and neurocognitive factors. However, little is known about this relationship in anxious patients. Our aim was to investigate the associations between impulsivity, inhibitory control, energy-dense food consumption, and body mass index (BMI) in women with generalized anxiety disorder (GAD). In this cross-sectional study, 51 adult females with GAD answered the Barratt Impulsiveness Scale (BIS-11) and participated in a go/no-go task using food images. Anthropometric measurements were evaluated. A food frequency questionnaire and a snack test were used to study eating behavior. Pearson correlation and multiple linear regression were performed to analyze the variables of interest, adjusted by age. Impulsivity predicted intake of sugar (p = 0.016, 95%CI 0.67-6.05), total fat (p = 0.007, 95%CI 0.62-3.71), and saturated fat (p = 0.004, 95%CI 0.30-1.48). The snack test showed a positive correlation between presence of impulsivity and intake of biscuits (R = 0.296; p = 0.051). Response inhibition to food images in the go/no-go task paradigm did not predict BMI or food intake. Impulsivity was predictive of higher sugar and saturated fat intake in women diagnosed with GAD. Our findings add to the literature regarding the association between neuropsychological factors and food consumption in this specific population.

Psychiatric disorders are highly prevalent among individuals living with obesity and contribute to treatment resistance, poor adherence, and adverse health outcomes. Yet, obesity management often remains fragmented, with limited integration between endocrinology, psychiatry, and behavioral health. This Perspective advocates for a mental health framework for obesity care. We emphasize the need for future investigations to test the clinical relevance of behavioral phenotyping as a complementary approach to pharmacotherapy, including GLP‐1 receptor agonists, to enhance treatment personalization. By reframing obesity as a disease deeply intertwined with mental health, we emphasize the need for multidisciplinary care models that incorporate psychological assessment, stigma reduction, and patient‐centered nutrition counseling. Advancing this framework will require closer collaboration between medical and mental health disciplines and greater investment in neurobehavioral research to improve long‐term outcomes in obesity care.

There is a high prevalence of people living with obesity (LWO) and mental disorders, which could worsen stigma. Internalized weight stigma (IWS) impairs psychological functioning and eating behaviors. This study, therefore, evaluated the acute effects of a Mindfulness-based Eating (ME) intervention and the feasibility of incorporating IWS assessment into a randomized controlled trial for adults LWO and generalized anxiety disorder (GAD). It also explores associations between IWS, device use, and psychological outcomes. Seventy adults LWO and GAD were randomized to a five-week ME group intervention (n = 36) or an asynchronous health educational video control (n = 34). The inhibitory control measured by the Go/No Go test was the primary RCT outcome. Post hoc feasibility outcomes were attendance and completion of the IWS assessment. The Weight Bias Internalization scale (WBIS) was applied alongside measures of body appreciation (BAS2), self-compassion (SCS), anxiety symptoms (GAD7), depressive symptoms (PHQ9), emotional dysregulation (DERS), shame (OAS), early memories (EMWSS), personality assessment (ER5FP), Mindful Eating (MEQ), binge eating (BES), impulsivity (BIS), and device use (smartphone/tablet). Associations were analyzed using correlation, regression and moderation; analyses of psychological outcomes were considered hypothesis-generating. NCT Number NCT06087185. The ME group showed no clear improvement in inhibitory control on the food Go/No-Go task, but resulted in improvements across several psychological outcomes (p < 0.05). All participants completed the WBIS; retention in the RCT was 58.6%. WBIS was positively associated with GAD7 (B = 0.869, p = 0.005) and negatively with BAS2 (B = -0.619, p = 0.005). Device use moderated the association between BAS2 and WBIS at baseline (B = 0.116, p = 0.021), with body appreciation being more protective against IWS at lower device use. ME shows promise for improving psychological outcomes linked to IWS. This study supports the feasibility of integrating IWS measures in trials examining obesity and GAD. Findings highlight the important effect of device use moderates the BAS2-IWS association. These findings can support clinicians and researchers in developing more effective, stigma-informed interventions for individuals LWO, particularly those with psychiatric disorders. CAPES; CNPq; FIPE-HCPA (ROR: https://ror.org/010we4y38).