Approach Considerations
Further investigation is necessary to determine the most effective treatment for avoidant-restrictive food intake disorder (ARFID). In its acute stages, however, re-feeding and behavioral interventions are often necessary to ameliorate the effects of semi-starvation and achieve medical stability. Like anorexia nervosa and bulimia nervosa patients, underweight ARFID patients should abide by a calorie prescription that promotes weight gain and facilitates attaining a minimally appropriate weight for their age and height. Behavioral modification such as expanding the variety of foods consumed and learning how to manage anxiety around new foods can help achieve weight gain. Refeeding and anxiety management are tenets of successful recovery, and they should be encouraged even in patients who may not require weight gain, but who are unable to reach developmental benchmarks or are dependent on enteral feeding.
Regardless of one’s weight status, cognitive behavioral therapy (CBT) can be employed to help ARFID patients change the thought patterns that underlie their eating disturbance. [17] Exposure therapy may also help patients tolerate anxiety-provoking foods or the physical process of consuming feared foods. Family-based approaches may also be helpful if resistance or avoidance arises during family meals. [9] Such psychological interventions coupled with nutritional education and medical monitoring can help eliminate avoidant and restrictive behaviors and promote recovery from ARFID, just as they promote recovery from anorexia nervosa and bulimia nervosa.
