Integrating cognitive-behavioral and medical interventions for ARFID in an adolescent: a case report from Turkiye

This case report presents the comprehensive, multidisciplinary treatment of a 17-year-old male adolescent diagnosed with avoidant/restrictive food intake disorder (ARFID) in Turkiye. The patient developed severe food avoidance, vomiting, and significant weight loss after experiencing traumatic medical interventions, including nasogastric tube placement. His clinical course was further complicated by medical comorbidities such as achalasia, superior mesenteric artery syndrome, and gallstones, which contributed to persistent gastrointestinal discomfort and reinforced his restrictive eating behaviors. Treatment combined with outpatient Cognitive Behavioral Therapy for ARFID (CBT-AR), psychopharmacological support, family-based interventions, and ongoing medical management. CBT-AR was flexibly adapted to address the patient's fear of negative eating consequences, sensory sensitivities, and low appetite, while considering family dynamics and culturally relevant eating practices. Over a 12-month period, the patient's weight increased from 42.6 kg to 55 kg, his dietary variety expanded with the addition of 38 new foods, and his ARFID symptoms showed significant clinical improvement. This is the first documented case of CBT-AR applied in Turkiye, highlighting the feasibility and effectiveness of a combined medical-psychological approach for complex ARFID presentations. The case underscores the necessity of individualized, culturally sensitive treatment strategies and multidisciplinary collaboration in addressing ARFID, particularly in medically compromised patients.