Cognitive-behavioral Therapy for Avoidant/restrictive Food Intake Disorder: Feasibility, Acceptability, and Proof-of-concept for Children and Adolescents

Overview

Journal Int J Eat Disord

Publisher Wiley

Specialty Social Sciences

Date 2020 Aug 11

PMID 32776570

Citations 39

Authors

Jennifer J Thomas

Kendra R Becker

Megan C Kuhnle

Jenny H Jo

Stephanie G Harshman

Olivia B Wons

Ani C Keshishian

Kristine Hauser

Lauren Breithaupt

Rachel E Liebman

Madhusmita Misra

Sabine Wilhelm

Elizabeth A Lawson

Kamryn T Eddy

Affiliations

Soon will be listed here.

Abstract

Objective: Little is known about the optimal treatment of avoidant/restrictive food intake disorder (ARFID). The purpose of this study was to evaluate feasibility, acceptability, and proof-of-concept for cognitive-behavioral therapy for ARFID (CBT-AR) in children and adolescents.

Method: Males and females (ages 10-17 years) were offered 20-30 sessions of CBT-AR delivered in a family-based or individual format.

Results: Of 25 eligible individuals, 20 initiated treatment, including 17 completers and 3 dropouts. Using intent-to-treat analyses, clinicians rated 17 patients (85%) as "much improved" or "very much improved." ARFID severity scores (on the Pica, ARFID, and Rumination Disorder Interview) significantly decreased per both patient and parent report. Patients incorporated a mean of 16.7 (SD = 12.1) new foods from pre- to post-treatment. The underweight subgroup showed a significant weight gain of 11.5 (SD = 6.0) pounds, moving from the 10th to the 20th percentile for body mass index. At post-treatment, 70% of patients no longer met criteria for ARFID.

Discussion: This is the first study of an outpatient manualized psychosocial treatment for ARFID in older adolescents. Findings provide evidence of feasibility, acceptability, and proof-of-concept for CBT-AR. Randomized controlled trials are needed.

Citing Articles

Neural Response to Food Cues in Avoidant/Restrictive Food Intake Disorder.

Thomas J, Holsen L, Van De Water A, Becker K, Breithaupt L, Burton-Murray H JAMA Netw Open. 2025; 8(2):e2460101.

PMID: 39964683 PMC: 11836757. DOI: 10.1001/jamanetworkopen.2024.60101.

An ARFID case report assessment with 18F-FDG PET/MRI and treatment with olanzapine, escitalopram and fluoxetine in adult.

Liu M, Chang Y, Xie X, Liu Y, Tian S, Yang C Front Psychiatry. 2025; 15:1450800.

PMID: 39882163 PMC: 11775632. DOI: 10.3389/fpsyt.2024.1450800.

Do children with a Noonan syndrome-like RASopathy and avoidant/restrictive food intake disorder benefit from behavioral therapy?.

Dumont E, Tiemens D, Draaisma J, Kleimeier L, van Druten D, Mulkens S Eur J Pediatr. 2024; 184(1):100.

PMID: 39710790 DOI: 10.1007/s00431-024-05933-5.

A US-Based Consensus on Diagnostic Overlap and Distinction for Pediatric Feeding Disorder and Avoidant/Restrictive Food Intake Disorder.

Estrem H, Pederson J, Dodrill P, Romeo C, Thompson K, Thomas J Int J Eat Disord. 2024; 58(3):489-499.

PMID: 39679744 PMC: 11891627. DOI: 10.1002/eat.24349.

Development and Management of Avoidant/Restrictive Food Intake Disorder and Food Neophobia in Pediatric Patients with Food Allergy: A Comprehensive Review.

Nocerino R, Mercuri C, Bosco V, Giordano V, Simeone S, Guillari A Nutrients. 2024; 16(17).

PMID: 39275348 PMC: 11397472. DOI: 10.3390/nu16173034.

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