Cognitive-behavioral Therapy vs. Nutrition Counseling for Avoidant/Restrictive Food Intake Disorder

This study is a randomized controlledlinical trial, assessing the efficacy of cognitive- behavioral therapy (CBT-AR) and nutrition counseling for avoidant/restrictive food intake disorder (ARFID) for children and adolescents (ages 10-18 years).

Inclusion Criteria: * Males and Females ages 10-18 years old * Current ARFID * Normal TSH or free T4 levels to rule out thyroid disease as cause of symptoms * Negative celiac screening panel indicating no active celiac disease as cause of symptoms * Fluency and literacy in English Exclusion Criteria: * BMI \< 5th percentile for sex and age * Pregnancy, breastfeeding, or recent initiation/cessation of oral contraceptive pills within 8 weeks of the pre-treatment study visit * Current/history of psychosis * Substance/alcohol use disorder (active within the past month) * Medical instability requiring inpatient care according to the American Psychiatric Association 2023 treatment guidelines for eating disorders * Laboratory abnormalities indicating a need for higher level of care * Complete lack of oral intake (suggesting a need for inpatient care) * Tube feeding (suggesting a need for tube weaning) * Active suicidal/homicidal ideation with intent or plan * Contraindications to MRI * History of major gastrointestinal tract surgery or serious medical condition (e.g., cancer) * Medical history of intellectual disability * Illiteracy