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Family vs Individual Treatment for Children With Avoidant/Restrictive Food Intake Disorder: A Randomized Clinical

James Lock1, Brittany Matheson1, Booil Jo1

  • 1Stanford University School of Medicine, Stanford, California.

Journal of the American Academy of Child and Adolescent Psychiatry
|April 22, 2026
PubMed
Summary

Family-based Treatment for Avoidant/Restrictive Food Intake Disorder (FBT-ARFID) significantly improved weight gain in underweight children compared to Psychoeducational Motivational Therapy (PMT). FBT-ARFID was especially effective for children with more severe ARFID symptoms.

Keywords:
avoidant/restrictive food intake disorder (ARFID)childrenfamily-based treatment (FBT)low-weightpsychoeducational motivational therapy

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Area of Science:

  • Pediatric Gastroenterology
  • Child Psychiatry
  • Clinical Psychology

Background:

  • Avoidant/Restrictive Food Intake Disorder (ARFID) affects children, leading to underweight status.
  • Effective treatments are crucial for improving health outcomes in pediatric ARFID.
  • Comparative efficacy of different therapeutic approaches requires investigation.

Purpose of the Study:

  • To compare the efficacy of Family-based Treatment for ARFID (FBT-ARFID) against individual Psychoeducational Motivational Therapy (PMT).
  • To evaluate treatment effectiveness in underweight children aged 6-12 years with ARFID.
  • To assess changes in percent estimated body weight (%EBW) from baseline to end of treatment.

Main Methods:

  • Ninety-eight children with ARFID were randomized into two telehealth treatment groups: FBT-ARFID and PMT.
  • Both treatments consisted of 14 sessions over 4 months.
  • Assessments included weight/height, eating cognitions, and behaviors at multiple time points.

Main Results:

  • FBT-ARFID demonstrated superior efficacy in increasing %EBW compared to PMT at the end of treatment.
  • No significant differences were found between groups for overall ARFID symptom severity.
  • Baseline ARFID symptom severity moderated treatment effects, with more symptomatic children showing greater improvement with FBT-ARFID.

Conclusions:

  • FBT-ARFID is a more effective treatment than PMT for promoting weight gain in underweight children with ARFID.
  • The benefits of FBT-ARFID are particularly pronounced in children presenting with greater ARFID symptom severity.