Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: A Treatment Development and Pilot Study

This study is designed to pilot the CBT-AR treatment in youth with ARFID to determine
treatment acceptability and efficacy.This includes evaluating the efficacy and acceptability
of CBT-AR in reducing primary ARFID symptoms from pre- to post-treatment, and to assess
whether improvement in individual symptoms is related to the timing of relevant
interventions. The investigators hypothesize that from pre-treatment to post-treatment,
subjects with ARFID will increase percentage of calories coming from fruits, vegetables, and
protein; and decrease severity of self-reported ARFID symptoms, decrease self-reported
anxiety and depression, and improve psychosocial functioning. The investigators further
hypothesize that overall, subjects with ARFID will have reduced phobic avoidance, sensory
sensitivity, and/or low appetite in comparison to their pre-treatment symptoms.

Inclusion Criteria:

- Males and females; ages 10-22 with avoidant/restrictive eating disorder or
avoidant/restrictive eating patterns, characterized by either (i) Eating Disorder
Assessment-5 (EDA-5) (ii) Kiddie Schedule for Affective Disorders and Schizophrenia
for School Age Children-Present and Lifetime Version (KSADS-PL)

Exclusion Criteria:

- Use of systemic hormones, pregnancy or breastfeeding within eight weeks

- History of psychosis by KSADS-PL

- Substance or Alcohol Use Disorder active within the past month by KSADS-PL

- Active suicidal ideation

- Gastrointestinal tract surgery (including gastrectomy, gastric bypass surgery, and
small or large bowel resection)

- Any feeding or eating disorder other than ARFID determined by EDA-5

- Any clinically significant disordered eating as evidenced by EDE-Q global > 4.0 or
self-induced vomiting, laxatives, diuretics, purposeful fasting, or compensatory
exercise in past 28 days

- Medical history of intellectual disability (IQ< 70)

- Has previously received more than 4 hours of CBT for ARFID in the past

- Is currently receiving another form of psychosocial treatment for ARFID (e.g.,
occupational therapy, speech therapy, another form of psychotherapy) and is unable to
discontinue that treatment for the duration of this study.