Abstract
BackgroundIndividuals with Avoidant/Restrictive Food Intake Disorder (ARFID) experience eating problems that cause persistent failure to meet appropriate nutritional and/or energy needs. These eating problems are not driven by body image concerns but rather by persistent low appetite, sensory sensitivity, or fear of aversive consequences of eating (e.g., choking or vomiting). Although increasing numbers of youth are being referred for treatment of ARFID, no evidence-based treatments yet exist for the disorder. Given family-based treatment (FBT) has demonstrated effectiveness with other pediatric eating disorders (anorexia nervosa, bulimia nervosa), a manualized version of FBT adapted for use with ARFID patients has been developed and is currently under study.Case PresentationThe following case report demonstrates how FBT was used to treat a 9-year-old patient with ARFID characterized by sensory sensitivity. Similarities and differences with FBT for anorexia nervosa are illustrated. After 17 sessions across 6 months, the patient no longer met DSM criteria for ARFID, she demonstrated major declines in measures of clinical symptoms, and she gained 2.1 kg.ConclusionsFBT for ARFID relies upon the same key interventions as FBT for AN. However, we discuss critical differences in the application of these interventions given the unique challenges of ARFID, particularly when characterized by sensory sensitivity.
Highlights
Avoidant/Restrictive Food Intake Disorder (ARFID) is a feeding and eating disorder introduced in the DSM-5 that describes a wide range of eating difficulties which often onset in childhood [1]
Given family-based treatment (FBT) has demonstrated effectiveness with other pediatric eating disorders, an initial description of how FBT could be applied to sensory sensitive presentations of ARFID was published [3], followed by the development of a broader manual to treat all presentations of ARFID and the first randomized treatment study for this condition [4]
This case report illustrates a detailed application of this novel manualized treatment (FBT-ARFID) and highlights its similarities and differences from more well-known forms of FBT
Summary
Individuals with Avoidant/Restrictive Food Intake Disorder (ARFID) experience eating problems that cause persistent failure to meet appropriate nutritional and/or energy needs. These eating problems are not driven by body image concerns but rather by persistent low appetite, sensory sensitivity, or fear of aversive consequences of eating (e.g., choking or vomiting). Given family-based treatment (FBT) has demonstrated effectiveness with other pediatric eating disorders (anorexia nervosa, bulimia nervosa), a manualized version of FBT adapted for use with ARFID patients has been developed and is currently under study. Case Presentation: The following case report demonstrates how FBT was used to treat a 9-year-old patient with ARFID characterized by sensory sensitivity. After 17 sessions across 6 months, the patient no longer met DSM criteria for ARFID, she demonstrated major declines in measures of clinical symptoms, and she gained 2.1 kg
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