Evidence for the efficacy of treatment for ARFID in Adults
There are a number of promising treatments for ARFID in children and adolescents – which is where most of the research has been focused – but ARFID affects individuals across the lifespan. A paper recently published in the Journal of Behavioral and Cognitive Therapy, led by researchers at Harvard Medical School and claiming to be the first study to evaluate an ARFID treatment for adults, has measured the impact of Cognitive Behavioural Therapy (CBT) on a sample of 15 adults with ARFID.
The therapy for each patient involved multiple sessions – between 20 and 30 – each lasting fifty-minutes – delivered over a period lasting an average of 29 weeks. Following the sessions seven of the 15 ARFID patients no longer met the criteria for an ARFID diagnosis – a success rate of 47% (one patient dropped out during the sessions).
The authors claim that this result suggests that CBT for ARFID is a potentially efficacious treatment that requires further evaluation.
However the authors admit that their study should be treated with caution as it is dependent on such a small sample and also did not include a control group, which is standard procedure for assessing the efficacy of treatments. The lack of a control group means that the authors could not rule out the possibility that the passage of time, or just therapist attention – rather than the therapy itself – was responsible for symptom improvement.
Also to be borne in mind is the extensive commitment required for the multiple (20-30) sessions of Cognitive Behavioural Therapy which involves establishing a regular schedule of eating, education about risk for nutritional deficiencies, tasting of five novel foods per session as well as homework to address the ARFID maintaining mechanisms (sensory sensitivity, lack of interest, fear of aversive consequences).
While the success of this therapy is obviously somewhat limited this paper offers hope that future scientific research studies may identify more effective – and less arduous – therapeutic interventions.
Thomas, J. J., Becker, K. R., Breithaupt, L., Murray, H. B., … & Eddy, K. T. (2021). Cognitive-behavioral therapy for adults with avoidant/restrictive food intake disorder. Journal of behavioral and cognitive therapy, 31(1), 47-55