Treatment Options for Avoidant Restrictive Food Intake Disorder: A Systematic Review

Avoidant Restrictive Food Intake Disorder (ARFID) is an emerging eating disorder characterized by restrictive eating associated with sensory sensitivities, limited interest in eating, or fear of aversive consequences. Although research on ARFID treatment has expanded since its recognition in the DSM-5, the evidence remains fragmented across treatment approaches, developmental stages, and comorbid conditions. Small samples, heterogenous methodologies, limited adult research, and inconsistent outcome measures further limit the development of evidence-informed treatment options. This systematic review examined psychosocial treatment approaches for ARFID across the lifespan, with particular attention to Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy, (DBT), Family-Based Therapy (FBT), Eye Movement Desensitization and Reprocessing (EMDR), behavioural interventions and examined treatment considerations for individuals with comorbid anxiety and autism spectrum disorder (ASD). A systematic review was conducted in accordance with PRISMA 2020 guidelines. Quantitative and qualitative findings were synthesized descriptively, and methodological quality was assessed using Joanna Briggs Institute critical appraisal tools. CBT and exposure-based interventions demonstrated the most consistent evidence for reducing food avoidance, increasing food variety and intake, and reducing eating-related anxiety. Family and caregiver involvement was especially beneficial for children and adolescents. Multidisciplinary and higher levels of care supported nutritional rehabilitation and medical stabilization. Treatment outcomes were influenced by developmental stage, comorbidities and individual clinical needs. Findings support an individualized, flexible, and multidisciplinary approach to ARFID treatment rather than a standardized intervention. Larger controlled and longitudinal studies are needed to establish comparative and long-term treatment effectiveness.