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Updated: Dec 12, 2025

A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Cognitive-behavioral therapy for avoidant/restrictive food intake disorder: Feasibility, acceptability, and
Jennifer J Thomas1,2, Kendra R Becker1,2, Megan C Kuhnle1,3
1Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
Objective:
Little is known about the optimal treatment of avoidant/restrictive food intake disorder (ARFID). The purpose of this study was to evaluate feasibility, acceptability, and proof-of-concept for cognitive-behavioral therapy for ARFID (CBT-AR) in children and adolescents.
Method:
Males and females (ages 10-17 years) were offered 20-30 sessions of CBT-AR delivered in a family-based or individual format.
Results:
Of 25 eligible individuals, 20 initiated treatment, including 17 completers and 3 dropouts. Using intent-to-treat analyses, clinicians rated 17 patients (85%) as "much improved" or "very much improved." ARFID severity scores (on the Pica, ARFID, and Rumination Disorder Interview) significantly decreased per both patient and parent report. Patients incorporated a mean of 16.7 (SD = 12.1) new foods from pre- to post-treatment. The underweight subgroup showed a significant weight gain of 11.5 (SD = 6.0) pounds, moving from the 10th to the 20th percentile for body mass index. At post-treatment, 70% of patients no longer met criteria for ARFID.
Discussion:
This is the first study of an outpatient manualized psychosocial treatment for ARFID in older adolescents. Findings provide evidence of feasibility, acceptability, and proof-of-concept for CBT-AR. Randomized controlled trials are needed.
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