Category: Eating Disorders
Jessie Menzel, Ph.D.
Equip Health
Carlsbad, California
Jennifer Thomas, Ph.D.
Psychologist
Massachusetts General Hospital
Boston, Massachusetts
Irina Vanzhula, Ph.D.
Johns Hopkins School of Medicine
Baltimore, Maryland
Jessie Menzel, Ph.D.
Equip Health
Carlsbad, California
Kendra Becker, Ph.D.
Massachusetts General Hospital/Harvard Medical School
Boston, Massachusetts
Avoidant/restrictive food intake disorder (ARFID) is a feeding and eating disorder newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. ARFID is characterized by significantly restricted food intake that is not related to body weight or shape concerns, which results in the failure to meet nutritional needs. Consequences of ARFID are severe including curtailed growth in children and adolescents, substantial nutritional deficiencies, significant psychosocial impairment, and dependence on nutritional supplements. Prevalence estimates for ARFID approximate 5%, yet large-scale epidemiological studies are lacking. ARFID is often considered a childhood disorder; however, ARFID can present at any age and continue well throughout adulthood. In a retrospective chart review of adult patients presenting to a neurogastroenterology clinic, 6.3% met full criteria for ARFID and 17.3% had clinically significant ARFID-related eating behaviors, but there was insufficient information for a diagnosis. Currently, very little is known about the presentation and treatment of adult ARFID as empirical studies have almost exclusively focused on children. Elucidating the presentation and treatment of ARFID in young adults is critical to developing effective treatment efforts for this overlooked population. This symposium will discuss current research on the presentation and treatment of ARFID in transition age youth (TAY) and young adults.
This symposium highlights three studies that present research on the symptom presentation, etiology, and treatment outcomes of ARFID in TAY and young adults serving to expand our understanding of ARFID across the lifespan. First, Dr. Irina Vanzhula will outline the symptom presentation and clinical course of adult patients receiving inpatient-based care for ARFID. Symptom presentation and clinical course will also be compared with a matched sample of patients with anorexia nervosa. Second, Dr. Jessie Menzel will present initial treatment outcomes for young adult patients with ARFID receiving an enhanced version of family based treatment (FBT) that includes treatment from a multidisciplinary team. Preliminary outcomes suggest that FBT results in a reduction of ARFID-related symptoms. Consistent with the conference theme to expand reach, treatment was delivered via telehealth, which can be successfully leveraged and continued without interruption during a public health emergency. Third, Dr. Kendra Becker will present on potential neurobiological mechanisms of change implicated in CBT in both children and young adults with ARFID. Findings suggest that a reduction in the hyperactive saliency circuitry and appetite regulating hormones may be candidate mechanisms through which CBT exerts its effects. As discussant, Dr. Jennifer Thomas integrates these presentations and discusses the importance and implications of addressing adult ARFID. These presentations will highlight recent research efforts to understand ARFID in young adults in order to better understand and address the needs of this underserved population. An improved understanding of ARFID in adults can inform the development and implementation of effective treatments for this population.
Presenter: Irina Vanzhula, Ph.D. – Johns Hopkins School of Medicine
Co-author: Colleen Schreyer, PhD – Johns Hopkins School of Medicine
Co-author: Angela Guarda, MD – Johns Hopkins School of Medicine
Presenter: Jessie Menzel, Ph.D. – Equip Health
Co-author: Jessica Baker, PhD – Equip Health
Co-author: Kelly Cai, MS – Equip Health
Co-author: David Freestone, PhD – Equip Health
Co-author: Cara Bohon, PhD – Equip Health
Co-author: Dori Steinberg, PhD – Equip Health
Presenter: Kendra R. Becker, Ph.D. – Massachusetts General Hospital/Harvard Medical School
Co-author: Avery Van De Water, BS – Brigham and Women's Hospital
Co-author: Katie Rozzell, BS – University of Hawai'i at Manoa
Co-author: Nassim Tabri, PhD – Carleton University
Co-author: Lauren Breithaupt, PhD – Massachusetts General Hospital/Harvard Medical School
Co-author: Helen Burton Murray, PhD – Massachusetts General Hospital/Harvard Medical School
Co-author: Casey M. Stern, PhD – Massachusetts General Hospital
Co-author: Madhusmita Misra, MD, MPH – Massachusetts General Hospital/Harvard Medical School
Co-author: Lawson Elizabeth, MD – Massachusetts General Hospital/Harvard Medical School
Co-author: Laura Holsen, PhD – Brigham and Women's Hospital
Co-author: Kamryn Eddy, PhD – Massachusetts General Hospital/Harvard Medical School
Co-author: Jennifer J. Thomas, Ph.D. – Massachusetts General Hospital
