Understanding ARFID- Interview with GNC’s researchers Katarzyna Brimo and Helena Holmäng
An interview featuring GNC ARFID researchers Katarzyna Brimo and Helena Holmäng, exploring their research on ARFID, their academic interests, and the professional trajectories that led them to this area of study.
Avoidant/Restrictive Food Intake Disorder (ARFID) is often mistaken for ordinary picky eating. In reality, it can be a severe and persistent condition that affects children’s health, development, and family life. At the Gillberg Neuropsychiatry Centre (GNC) in Gothenburg, researchers Katarzyna Brimo and Helena Holmäng have spent several years studying ARFID from multiple perspectives—from early identification and epidemiology to family experiences and intervention outcomes. GNC’s Communications Officer, Anna Spyrou has recently met up with the duo to get an overview of their recently published work, what they are currently working on, and research in the pipeline.
Two varying paths that lead into research, united by a shared focus
Katarzyna’s academic journey spans countries, disciplines, and professional fields. Originally from Poland, she has lived in Sweden for over 20 years. Her early studies focused on economics and human resource management, but her interests gradually shifted toward child psychology and psychiatry. She now holds a master’s degree in psychology from the University of Gothenburg and a bachelor’s degree in business administration from National Louis University in the USA.
After moving to Sweden in 2003, Katarzyna worked for several years at the Port of Gothenburg in administration, logistics, and customs control. Later, she returned to academia, completing psychology courses that led to a bachelor’s degree. In 2019, while writing her master’s thesis on dyslexia and comorbidities, she became affiliated with the Gillberg Neuropsychiatry Centre through her supervisors, Professor Jakob Åsberg Johnels and Dr. Lisa Dinkler. Since then, her work has focused on neurodevelopmental conditions (ESSENCE) and their overlap.
Helena’s path into research began during medical school at the University of Gothenburg. After her first semester, she worked on a summer research project on the hormone adiponectin in metabolic disease. That experience sparked her interest in research, but it was in 2020—when she joined the GNC—that her focus truly took shape. There, she became involved in research on ARFID in preschool children and its neurodevelopmental comorbidities.
Halfway through medical school, Helena chose to change direction academically and pursued studies in statistics at the Gothenburg School of Business, Economics and Law—an area she finds enjoyable. Alongside completing a bachelor’s degree in medicine, she also worked on a research project on Paediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Her thesis examined how OCD symptom severity relates to performance on a reaction-time task and was recently published.
More recently, Helena completed a master’s degree (Magister) in Public Health, focusing her thesis on the expectations of students in the introductory programmes regarding a mental health intervention.
The ESSENCE of their interests
Helena’s research interests are broad and rooted in her background in medicine and neuropsychiatry. Through her work at the Gillberg Neuropsychiatry Centre (GNC), she has developed a particular interest in avoidant/restrictive food intake disorder (ARFID) and paediatric acute-onset neuropsychiatric syndrome (PANS). More generally, she is engaged in research within the ESSENCE framework and child and adolescent mental health, with a growing focus on how societal factors, such as digitalisation, may influence development and wellbeing. Her medical training has shaped a strong interest in questions of etiology, pathophysiology, and treatment mechanisms. This is especially evident in neuropsychiatry, a field where clinical practice often relies heavily on symptom descriptions rather than well-defined biological mechanisms. Exploring these knowledge gaps and contributing to a deeper mechanistic understanding are central motivations for her research.
Katarzyna’s research interests also lie within neuropsychiatry, with a particular focus on neurodevelopmental conditions such as autism, ADHD, developmental coordination disorder (DCD), intellectual disability, selective mutism, and ARFID, as well as the overlap between these conditions. A key area of interest is sensorimotor rehabilitation, or sensory re-education, and its potential to improve neurological function and support cognitive, behavioural, and physical development. Sensorimotor re-education relies on a process called neuroplasticity, the brain’s capacity to reorganise and develop new pathways—and she is especially interested in how sensorimotor therapies can facilitate this process. In addition, her background in nutritional science has led to a strong interest in the relationship between nutrition, gut microbiota, and mental health, an area she aims to explore further in future research.
ARFID research
Over the past four years, Katarzyna and Helena have been closely involved in a large, multi-layered research project focused on avoidant/restrictive food intake disorder (ARFID). Their work spans epidemiology, assessment, intervention, and family experiences, with the shared goal of improving early identification and treatment for young children with ARFID.
Screening and ARFID
The project began between 2021 and 2023 with an epidemiological study led by their research colleague Lisa Dinkler, now Associate Professor at Karolinska Institutet in Stockholm. During this phase, the research group developed and validated the ARFID-Brief Screener, a new screening instrument designed to identify ARFID early in young children. The tool was tested in a population-based sample of Swedish preschoolers, with data collected through child healthcare centres in the Fyrbodal region. The resulting article, “Avoidant restrictive food intake disorder (ARFID) in Swedish preschool children: a screening study”, was published in August 2025, with both Katarzyna and Helena as co-authors. This study provided prevalence estimates and demonstrated the feasibility of early identification of ARFID in routine healthcare settings.
Families and ARFID
Building on this foundation, the project expanded to examine the clinical complexity and lived experience of ARFID. One strand of this work focused on families’ perspectives. In a qualitative semi-structured interview study led by Katarzyna and published in December in the Journal of Eating Disorders, six Swedish parents were interviewed while their children were receiving treatment for ARFID. “The analysis identified three main themes, (1) "It's hard work": ARFID dominating life, (2) "It's not about forcing": Seeking balance, and (3) "You feel questioned": Feeling different,” explains Katarzyna. The study, entitled “‘It’s about survival, love and care’ – parents’ experiences of living with a child with ARFID”, showed that life with ARFID is often exhausting and all-consuming. Parents described daily routines dominated by meal planning, managing unpredictable eating behaviours, and persistent concern about their child’s health. They struggled to balance encouragement and acceptance, felt misunderstood or judged by others, and often experienced difficulties accessing adequate healthcare support. The findings highlight the need for earlier recognition of ARFID, clearer clinical guidelines, and better family-centred support.
Intervention and ARFID
In parallel, Helena’s recent work has focused on evaluating an intensive multidisciplinary intervention for young children with severe ARFID. This intervention was delivered at the Folke Bernadotte Regional Habilitation Centre in Uppsala and targeted children aged 2–8 years with longstanding and complex eating difficulties, often alongside medical and neurodevelopmental conditions. Unlike many directive behavioural models described in the literature, the intervention was based on a non-directive, low-pressure approach. It emphasised play-based sensory exploration, guided mealtimes, and caregiver learning through modelling, descriptive language, and close attention to the child’s cues.
Over eight intensive days, families worked with a multidisciplinary team to develop supportive interaction strategies, explore food in positive ways, receive nutritional guidance, and establish less pressured mealtime routines. In a prospective cohort of 28 children, the team observed significant reductions in ARFID symptom severity at follow-up, alongside high parental satisfaction and increased confidence in supporting their child’s eating at home. “These findings, published recently in the International Journal of Eating Disorders contribute to a limited evidence base for young children with ARFID and suggest that intensive, caregiver-focused interventions may offer an important alternative for families with complex and persistent difficulties,” explains Helena.
Notably, the specialist unit that developed the intervention accepted nationwide referrals but closed in 2023 due to organisational restructuring, underscoring the importance of documenting and disseminating this work.
Clinical presentation and ARFID
Finally, Katarzyna is currently finalising a manuscript that further characterises the clinical profiles of the same children who participated in the intervention. The forthcoming paper, “Young children with avoidant restrictive food intake disorder (ARFID): Clinical presentation, co-occurring conditions, and symptoms”, describes early-onset and persistent feeding difficulties, frequent comorbidities, reliance on medical nutritional support, and substantial psychosocial impairment. The findings point to early neurodevelopmental difficulties, prematurity, and low birth weight as potential risk factors, and reinforce the need for increased clinical awareness, early screening, and access to multidisciplinary care.
Together, these projects form a coherent research project addressing ARFID from early identification and family experience through intervention and clinical characterisation, with the overarching goal of improving outcomes for young children and their families.
What is next?
Katarzyna and Helena are currently busy planning doctoral studies and are writing their research proposals.
When it comes to ARFID, Katarzyna aims to delve deeper into the underlying mechanisms behind disgust, fear, and lack of interest in eating. Her goal is to investigate sensory and motor processing in children with eating disorders across different populations and cultural backgrounds. To this end, she will collaborate with a research colleague at the Medical School in Kochi, Japan, Kahoko Yasoumitsu. It is also Katarzyna’s ambition to engage fellow researchers across our international GNC hubs in data collection, for example, our South African counterparts.
And away from the world of research….
While Helena is rooted in daily life in Gothenburg, where she spends time with friends, family, and her Shetland Sheepdog, Tindra, Katarzyna enjoys her free time with her family and her dog, Daisy, as well as exploring big cities, taking walks in parks and forests, biking, and picking mushrooms.
Text by Anna Spyrou, Communications Officer
Links to articles
Avoidant restrictive food intake disorder (ARFID) in Swedish preschool children: a screening study.
