A striking finding was that across the 50 studies, there was little consistency on how to measure change for Avoidant Restrictive Food Intake Disorder patients. This means that it is hard to compare the treatments. What is needed now is consensus amongst clinicians and researchers about how to best measure change for patients, as well as trials to compare the effectiveness of different treatmentsDr Tom Jewell, Lecturer in Mental Health Nursing in the Faculty of Nursing, Midwifery & Palliative Care
13 November 2023
New review highlights range of treatments for eating disorder
A new review has found that people with Avoidant Restrictive Food Intake Disorder can be supported with a range of psychological treatments.
Avoidant Restrictive Food Intake Disorder (ARFID) is a relatively new eating disorder diagnosis, added to diagnostic manuals 10 years ago. There is currently a lack of research into and clinical guidelines for the disorder.
A new review authored by researchers at King’s College London, Great Ormond Street Hospital, South London and Maudsley NHS Foundation Trust, and University College London, has identified 50 different studies that describe a variety of psychological treatments to support patients with Avoidant Restrictive Food Intake Disorder.
These psychological treatments included behavioural interventions, Cognitive Behavioural Therapy, family interventions, and combinations of these therapeutic approaches.
Those affected by Avoidant Restrictive Food Intake Disorder have limited and restrictive diets often due to a lack of interest in food, the sensory properties of food, and/or due to specific fears affecting eating, such as a fear of choking. Avoidant Restrictive Food Intake Disorder can affect people of any age and can contribute to severe physical complications, nutritional compromise, and psychosocial distress.
Dr Kathryn Bradley, Specialist Clinical Psychologist at Derby Hospital, commented: ‘As the chair of the Avoidant Restrictive Food Intake Disorder special interest group for psychologists working with children and young people, this review is extremely welcome, marking the tenth anniversary of Avoidant Restrictive Food Intake Disorder as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders.’
Dr Bradley added 'UK clinical guidance for Avoidant Restrictive Food Intake Disorder is yet to be published and, as a relatively new umbrella term for many complex feeding difficulties, we are pleased to see the publication of this comprehensive and up to date review that corroborates much of our collective clinical experience.'
First author Dr Emma Willmott, Senior Clinical Psychologist at South London and Maudsley NHS Foundation Trust, said 'In the absence of clinical guidance, professionals can feel uncertain as to how to best support patients with Avoidant Restrictive Food Intake Disorder. Our review has identified that a range of psychological interventions, drawing upon different therapeutic modalities, can be applied for those with the eating disorder.'
However, the researchers noted that much more research needs to be conducted into Avoidant Restrictive Food Intake Disorder. Currently, most intervention studies focus on children and adolescents rather than adults with Avoidant Restrictive Food Intake Disorder.
From the studies included in the review, the authors recommend that the most appropriate choice of psychological treatment should be guided by a range of factors including patient age and developmental stage, the specific presentation of Avoidant Restrictive Food Intake Disorder for patients, and patient preferences and goals. Additionally, they note that a multidisciplinary approach to care is often required. The authors call for further research in adults with Avoidant Restrictive Food Intake Disorder.