Avoidant and Restrictive Food Intake Disorder: Outcomes for 16 Inpatient Cases to Target Oral Consumption Using a Medical and Behavioral Treatment Model

• Published in: Clinical pediatrics Vol. 61; no. 4; pp. 362 - 369
• Main Authors: Lesser, Aaron D., Mathis, Emily S., Melicosta, Michelle E.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-05-2022; Westminster Publications, Inc
• Subjects: Anxiety; Behavior Therapy; Body image; Diagnosis; Eating; Enteral feeding; Feeding and Eating Disorders; Food intake; Humans; Inpatients; Nutritional status; Pediatrics; Retrospective Studies; anxiety; feeding disorders; ARFID; food refusal; behavioral therapy
• ISSN: 0009-9228; 1938-2707
• DOI: 10.1177/00099228221078419

Introduction
Avoidant and restrictive food intake disorder (ARFID) is characterized by restrictions in oral intake and does not include concerns related to body image. Despite the evidence-based medical and behavioral treatments, there is limited research as they apply to ARFID, but the extant research supports hospital-based behavioral therapy. Individuals with ARFID may have comorbidities that can affect treatment, which requires multidisciplinary treatment to provide effective care. Supplementary sources of nutrition may be required for individuals with this diagnosis to ensure they maintain proper nutritional status (eg, enteral feeding).
Methods
A record review from 2015 to 2019 identified 16 participants admitted to an inpatient hospital. Of the sample, 75% of participants had a psychiatric diagnosis and 88% of participants experienced an acute event that preceded their feeding difficulties. Each participant received medical oversight, and instead of a standard treatment approach, behavioral treatment components were individualized based on each participants’ presentation.
Results
All participants met at least 80% of their admission treatment goals, and 92% of participants who completed their admission consumed 100% of their nutritional needs orally. Follow-up data indicate sustained progress for several months following discharge.
Conclusion
Our results suggest that a multidisciplinary, medical, and behavioral treatment model is effective for a variety of clinical presentations of ARFID. More research is needed on triggering events that precede restricted food and liquid intake. In addition, the extent to which these treatment components are preferred should be assessed in an effort to maintain treatment gains after discharge.