Symposia
Eating Disorders
Jessie Menzel, Ph.D.
Equip Health
Carlsbad, California
Jessica Baker, PhD
Senior Research Manager
Equip Health
Carlsbad, California
Kelly Cai, MS
Data Analyst
Equip Health
Carlsbad, California
David Freestone, PhD
Lead Data Analyst
Equip Health
Carlsbad, California
Cara Bohon, PhD
VP Clinical Programs
Equip Health
Carlsbad, California
Dori Steinberg, PhD
VP of Research
Equip Health
Carlsbad, California
Background: There are no evidence-based treatments for young adults with avoidant/restrictive food intake disorder (ARFID). For children and adolescents with ARFID and other eating disorders, family based treatment (FBT) is effective. FBT focuses on empowering the family to take charge in intervening with the eating disorder symptoms early in treatment, then increasing independence back to the patient. Here, we examine preliminary findings from a virtual treatment delivering enhanced FBT for transition age youth with ARFID.
Methods: We examined outcomes of patients aged 16-24 with ARFID at a virtual eating disorder treatment program. Patients received an enhanced FBT treatment with a multidisciplinary team. Outcomes after 4 months were assessed using validated survey measures to assess ARFID symptoms (Nine Item ARFID Screen [NIAS]), depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and parental self-efficacy (Parent versus Eating Disorder [PVED]). Descriptive analyses and paired t-tests were used to examine changes in symptomatology.
Results: Transition age youth with ARFID (N=36) had a mean (SD) age of 17.6 (3.4) years; 61% were cisgender female, 60% identified as White, and 61% had an a co-occuring illness. The breakdown of ARFID subtypes was 71% lack of interest in food, 79% selective eating, and 29% fear of aversive consequences. At 4 months, patients on weight restoration (n=20) gained on average 0.7 lbs/wk and more than half (56%) reduced ARFID symptoms. There were no significant differences in average NIAS score over time. Significant reductions were seen for GAD-7 [mean difference (95% CI): -5.3 (-1.9, -8.7); p=.007] and PHQ-9 [mean difference (95% CI): -4.0 (-1.6, -6.4); p=.005]. Caregivers saw an increase in parental self-efficacy [mean difference (95% CI): 2.9 (.25, 5.5); p=.034].
Conclusion: Preliminary results indicate that an enhanced FBT treatment model delivered virtually may be effective for transition age youth with ARFID. Within 4-months, there was a reduction in ARFID-related symptomatology. While FBT may be effective for this age group, additional treatment modalities are needed when families are unable to participate. More research is needed for transition age youth across the spectrum of feeding and eating disorders.