Clinical Outcomes in a Large Sample of Youth and Adult Patients Receiving Virtual Evidence-Based Treatment for ARFID: A Naturalistic Study.

Objective: Treatment outcomes research for avoidant/restrictive food intake disorder (ARFID) has been limited to small, mixed-age feasibility trials in face-to-face care settings. This study aims to examine clinical characteristics and treatment outcomes in a large sample of youth and adult patients receiving virtual multidisciplinary team treatment for ARFID.

Method: The sample included N = 783 patients (532 youth and 251 adults) diagnosed with ARFID. Patients received cognitive behavioral therapy for ARFID (CBT-AR) or family-based treatment for ARFID (FBT-ARFID) enhanced by specialized support from a multidisciplinary team. Patients (or caregivers) completed a number of measures assessing ARFID and mood-related symptoms upon admission and throughout treatment.

Results: Youth patients on weight restoration (56%) started treatment around 85% [84%, 86%] of their target weight, and increased to 94% [93%, 96%] by week 35. Adults on weight restoration (47%) started at 85% [84%, 87%] and reached 92% [90%, 94%]. Scores improved for both groups on all PARDI-AR-Q subscales: (sensory sensitivity: b = -0.25 [-0.33, -0.16]; lack of interest: b = -0.08 [-0.16, -0.00]; fear of aversive consequences: b = -0.12 [-0.19, -0.04]). Both youth and adults demonstrated reliable improvements in willingness to try new foods (b = -0.64 [-0.89, -0.37]), anxiety symptoms (b = -0.71 [-0.95, -0.48]), and depression symptoms (b = -0.86 [-1.07, -0.64]).

Discussion: Youth and adult patients demonstrated reliable symptom improvements over the course of treatment across all measures, offering preliminary support for the effectiveness of FBT-ARFID and CBT-AR delivered virtually by a multidisciplinary care team.