Cognitive Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (CBT-AR)

What is cognitive-behavioral therapy for avoidant/restrictive food intake disorder?

Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (CBT-AR) is a 20 to 30 session, four-staged treatment to address food avoidance and restriction in individuals of all ages diagnosed with Avoidant/Restrictive Food Intake Disorder (ARFID). The goal of CBT-AR is to expand an individual's food intake, correct nutritional deficits, and normalize an individual's weight through in and out of session food exposures. For those requiring weight restoration, we would expect a return to the individual’s healthy weight trajectory. 

Individuals with ARFID typically attribute their avoidant or restrictive eating to:

  • Sensory characteristics of food (i.e. texture, smell, appearance)

  • Fear of aversive consequences of eating (e.g. throwing-up or choking)

  • And/or lack of interest in eating or food (e.g., low hunger, lack of enjoyment in eating)

Unlike other eating disorders, such as anorexia nervosa (AN), an individual with ARFID does not restrict their food intake with the goal of changing their body, nor do they experience body image distress.

What does CBT-AR treatment entail?

CBT-AR can be delivered in two ways: family-supported therapy or individual therapy. Family-supported therapy is generally provided for individuals below the age of 15-years-old, young adults residing at home with significant weight to gain, and those with co-occurring Autism Spectrum Disorder or others who require additional support. Individual therapy is generally recommended for those above 15-years of age who are not underweight. In both deliveries, CBT-AR consists of highly structured sessions, assignment of homework between sessions, and review of completed assignments the following session.