A clinical trial led by researchers at Stanford Medicine has found that both family-based therapy and individual, child-focused therapy can help children with Avoidant Restrictive Food Intake Disorder (ARFID). The findings add to the growing evidence base for supporting children experiencing significant food restriction.
What is ARFID?
Avoidant Restrictive Food Intake Disorder (ARFID) is an eating disorder that can make it difficult for someone to eat enough food or maintain a varied diet. Unlike some other eating disorders, ARFID is not driven by a desire to lose weight or change body shape. People may experience ARFID for different reasons. These can include limited interest in food, strong sensory responses to particular tastes or textures, or fear of unpleasant consequences such as choking, vomiting, or an allergic reaction. ARFID is more than ordinary fussy eating. For some people, restricted eating can affect nutritional intake, physical health, growth, and everyday activities such as eating in social settings.
Recognising the difficulties a person is experiencing is an important step towards accessing appropriate assessment and support.
What did the Stanford Medicine study find?
Researchers at Stanford Medicine investigated two psychological approaches for children with ARFID, in a randomised controlled trial involving 98 children, aged between six and twelve. All the children met the diagnostic criteria for ARFID and were underweight. The study compared two treatments, each delivered over four months through 14 one-hour therapy sessions. Both approaches were delivered online.
The researchers found that both treatments significantly improved ARFID symptoms. However, the outcomes differed in relation to weight gain: children receiving family-based treatment experienced statistically significant weight gain by the end of the study, while those receiving the individual treatment did not. Children with more sever ARFID symptoms also appeared to benefit more from family-based treatment in this respect.
These findings suggest that different psychological approaches may help address ARFID, while highlighting the importance of considering a person’s individual needs and treatment goals.
Understanding the two treatment approaches
- Family-based treatment
Family-based treatment involves parents or carers in supporting a child’s progress with eating. The therapist helps the family understand ARFID and develop strategies to address restrictive eating behaviours, with children gradually taking on responsibility appropriate to their age and development.
The approach also recognises the importance of responding to a child with compassion. ARFID is not a choice, and support should avoid blame or shame. The study found that this approach was associated with greater weight gain over the treatment period, particularly among children experiencing more sever symptoms.
- Individual, child-focused therapy
The second approach, known as Psychoeducational Motivational Therapy, focused on helping children understand their difficulties and identify their own motivations for making changes. Sessions were tailored to the child’s age and interests, using activities and discussion to explore food-related concerns and encourage progress. Parents also received sessions to help them understand ARFID, reduce conflict around mealtimes, and support changes their child felt ready to make.
Children receiving this treatment experienced significant improvements in ARFID symptoms, although the study did not find statistically significant weight gain in this group by the end of the trial.
The results reinforce that progress should be considered across more than one outcome, and that the most appropriate approach depends on a person’s circumstances and clinical needs.
What do these findings mean for people affected by ARFID?
The research is an encouraging development for treating ARFID, particularly in children. It highlights the value of psychological support that takes account of the individual’s experiences and, where appropriate, involves their family.
ARFID can affect people in different ways, and treatment should be guided by an appropriate clinical assessment. Depending on individual needs, support may involve psychological therapy alongside nutritional input and medical monitoring.
If you or someone you care for is struggling with restricted eating, you do not need to wait until difficulties become severe before seeking advice. A healthcare professional can help assess the concerns and identify appropriate next steps.
ARFID support at Lilac Tree Clinic
At Lilac Tree Clinic, we recognise that people may need different forms of support. Our specialist eating disorder services include a dedicated ARFID pathway, with assessment and psychological support tailored to the person’s needs.
We provide evidence-based, multidisciplinary eating disorder care for people aged 16 and over, with services in Sheffield and online individual therapy. The appropriate support will depend on the individual’s assessment and clinical circumstances.
If you would like to find out more about our ARFID services or discuss whether our support may be suitable, please contact our team.
Contact Lilac Tree Clinic
Email: contact@lilactreeclinic.co.uk
Telephone: 0114 204 1540
Website: www.lilactreeclinic.co.uk
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This article is intended for general information and does not replace professional medical advice or an individual clinical assessment.
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