Stanford Medicine scientists conducted a randomized, controlled trial involving 98 children ages 6 to 12 with avoidant restrictive food intake disorder (ARFID). The study found that both family-based and individual psychoeducational motivational therapies improved ARFID symptoms in children within this age group, with family-based therapy leading to greater weight gain.

The study's findings were published online in the Journal of the American Academy of Child & Adolescent Psychiatry. James Lock, lead study author and professor of psychiatry and behavioral sciences, said, "This is the first study, worldwide, to take a systematic, randomized, adequately powered approach to testing treatments for this disorder." He added, "We now have an evidence base for how to help children with ARFID, at the age when they often present for treatment."

ARFID affects an estimated 2% to 6% of children and adolescents. Individuals with ARFID consume insufficient amounts of food due to reasons such as a low interest in eating or a fear of eating. Unlike other eating disorders like anorexia or bulimia, those with ARFID do not struggle with poor body image or attempts to alter their body shape. Lock said, "Some ARFID patients are young people who don't like to eat very much - they have a low appetite, or they are highly selective because they worry about feeling disgusted by foods." He added, "Another group of patients have had a traumatic experience like a choking incident or allergic reaction and became afraid to eat."

The study evaluated two distinct treatments, each consisting of 14 one-hour therapy sessions conducted online over four months. Family-based therapy focused on empowering parents to manage their child's food and nutrition by guiding them in changing ARFID behaviors. These sessions involved the child, parents, siblings, and therapists collaborating. Brittany Matheson, a study coauthor and clinical associate professor of psychiatry and behavioral sciences, said, "The therapist guides and consults them, but parents are the experts on their child, their family's food culture and their family systems."

The second approach, psychoeducational motivational therapy, was an individualized, play-based method where children attended nine sessions with a therapist, and parents attended five separate sessions. In this therapy, children learned about ARFID and why their parents might be concerned. "A 6-year-old doesn't always have that insight," Matheson said. At the study's conclusion, children who received family-based therapy showed a statistically notable increase in weight. While children in the individual psychoeducational motivational therapy group did not achieve a statistically notable weight gain, both treatment methods improved ARFID symptoms.

Matheson stated that both treatments proved effective in improving ARFID symptoms. "We now have two treatments that work for children aged 6 to 12 with ARFID," she said. "Family-based treatment seems to help kids gain weight more quickly, but both family and individual treatment can be helpful." The ARFID diagnosis was added to the Diagnostic and Statistical Manual of Mental Disorders in 2013. The disorder can lead to long-term health issues, including poor growth, short stature, impaired fertility, and deficiencies such as low vitamin A levels, which can endanger vision, and vitamin C deficiency, also known as scurvy.