DSM-V describes three eating disorders (anorexia nervosa, bulimia nervosa, and binge eating disorder), three feeding disorders (avoidant/restrictive food intake disorder, pica, and rumination disorder), and two residual feeding and eating disorder categories (APA, 2013). Although these disorders contain some overlapping features, an individual can receive just one feeding or eating disorder diagnosis at a time. The only exception is pica, which can be diagnosed concurrently with another feeding or eating disorder if the pica behavior is severe enough to warrant additional clinical attention.

This chapter describes the primary interventions for the lack of interest presentation of ARFID, including:

• Step-by-step instructions for interoceptive exposures to habituate to feelings of nausea, fullness, or bloating to support eating enough for adequate nutritional intake

• Self-monitoring to increase awareness of hunger cues

• Reconnecting to the pleasure of eating by using the five steps with highly preferred foods

This chapter provides a basic introduction to the relationship between thoughts, feelings, and behaviors, and introduces our cognitive-behavioral model of ARFID. We return to the case examples from Chapter 1 to illustrate a cognitive-behavioral understanding of sensory sensitivity, fear of aversive consequences, and lack of interest in eating or food.

This chapter explains what avoidant/restrictive food intake disorder (ARFID) is and provides diverse and relatable case examples of each of the three prototypical ARFID presentations, including sensory sensitivity, fear of aversive consequences, and lack of interest in eating or food.

This chapter describes the primary interventions for the sensory sensitivity presentation of ARFID, including:

• Choosing five new foods to learn about each week

• Setting aside a dedicated time to learn about these five foods using theFive Steps of learning (see, touch, smell, taste, chew)

• Identifying at least some of these new foods for repeated practice in the upcoming week

• Strategies for incorporating larger portions new foods into regular meals and snacks after small portions have been tasted several times

This chapter describes the evidence for cognitive-behavioral therapy for ARFID and highlights exciting future directions in ARFID treatment and research.

This chapter will help the reader assess the adequacy of his of her current diet and determine which module(s) (described in chapters 6, 7, and 8) is/are most appropriate to complete as next steps. Key components of this chapter will include:

• Information about common nutrition deficiencies observed in ARFID

• The five basic food groups (from US MyPlate schematic) and the importance of eating a varied diet

• Strategically selecting fruits, vegetables, proteins, dairy, and grains to learn about that will support resolution of nutrition deficiencies, encourage further weight gain (if needed), and/or reduce psychosocial impairment

• Selecting whether to tackle sensory sensitivity, fear of aversive consequences, and/or lack of interest in eating or food, and in what order

This chapter will help the reader evaluate his or her progress with CBT-AR and maintain their gains by:

• Identifying all of the foods that have been incorporated as part of CBT-AR

• Identifying new foods still to learn about in the future

• Adopting a mindset of lifelong learning about new foods and eating situations

• Creating a formal relapse prevention plan