Beyond Weight Gain in Family-Based Treatment for Avoidant/Restrictive Food Intake Disorder: A Response to Lock et al. (2026)
Year: 2026
Type: preprint
Abstract: Family-based treatment for avoidant/restrictive food intake disorder (FBT-ARFID) has recently been defended as addressing more than weight gain. This Commentary argues that therapeutic intent should be distinguished from demonstrated comparative benefit. In the primary randomized trial, FBT-ARFID showed its clearest advantage for weight restoration, while broader domains of ARFID symptomatology and psychological functioning did not consistently show between-group superiority. High treatment completion and absence of serious adverse events likewise cannot establish psychological, relational, sensory, or autonomy-related safety when these outcomes are not systematically assessed. These limitations are particularly consequential in ARFID, where sensory processing differences, fear of aversive consequences, low interest in eating, and neurodivergence may shape treatment needs and experiences. Future trials should incorporate direct child-reported outcomes, treatment burden, agency and participation, sensory distress, psychosocial functioning, adverse effects, reasons for discontinuation, and durability of change. If FBT-ARFID is to be understood as more than weight gain, its evaluation should be broader than weight gain too.
Source: PsyArXiv (OSF Preprints)
Author: Laurence Cobbaert
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7221098306