Eating Disorders and Avoidant/Restrictive Food Intake Disorder

  • Kevin K. TsangEmail author
  • Lillian C. Hayes
  • Chrissy Cammarata
Part of the Issues in Clinical Child Psychology book series (ICCP)


Pediatric eating and feeding disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder, affect many children and teens throughout the United States. In the treatment of eating and feeding disorders, pediatric consultation-liaison psychologists are often involved in diagnostic evaluation, treatment planning, and coordination of care with the patient, family, and other multidisciplinary providers. This chapter summarizes evidence-based approaches to engaging patients with eating and feeding disorders and their families in evaluation, formulation, treatment, and disposition planning. The chapter providers review of levels of care and models for empirically supported treatment as well as considerations for adaptation based on factors commonly experienced in consultation-liaison practice. Case examples and other resources for the consultation-liaison psychologist are also provided.


ARFID Anorexia nervosa Bulimia nervosa Binge eating Consultation-liaison Adolescents Weight restoration DSM-5 


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.CrossRefGoogle Scholar
  2. Boachie, A., Goldfield, G. S., & Spettigue, W. (2003). Olanzapine use as an adjunctive treatment for hospitalized children with anorexia nervosa. International Journal of Eating Disorders, 33, 98–103.CrossRefGoogle Scholar
  3. Brewerton, T. D., & D’Agostino, M. (2017). Adjunctive use of olanzapine in the treatment of avoidant restrictive food intake disorder in children and adolescents in an eating disorders program. Journal of Child and Adolescent Psychopharmacology, 27, 920–922.CrossRefGoogle Scholar
  4. Couturier, J., & Mahmood, A. (2009). Meal support therapy reduces the use of nasogastric feeding for adolescents hospitalized with anorexia nervosa. Eating Disorders, 17, 327–332.CrossRefGoogle Scholar
  5. Espie, J., & Eisler, I. (2015). Focus on anorexia nervosa: Modern psychological treatment and guidelines for the adolescent patient. Adolescent Health, Medicine and Therapeutics, 6, 9–16. Scholar
  6. Fisher, M. M., Rosen, D. S., Ornstein, R. M., Mammel, K. A., Katzman, D. K., Rome, E. S., … Walsh, B. T. (2014). Characteristics of avoidant/restrictive food intake disorder in children and adolescents: A “new disorder” in DSM-5. Journal of Adolescent Health, 55, 49–52.CrossRefGoogle Scholar
  7. Forman, S. F., McKenzie, N., Hehn, R., Monge, M. C., Kapphahn, C. J., Mammel, K. A., … Woods, E. R. (2014). Predictors of outcome at 1 year in adolescents with DSM-5 restrictive eating disorders: Report of the National Eating Disorders Quality Improvement Collaborative. Journal of Adolescent Health, 55, 750–756.CrossRefGoogle Scholar
  8. Garber, A. K., Sawyer, S. M., Golden, N. H., Guarda, A. S., Katzman, D. K., Kohn, M. R., … Redgrave, G. W. (2016). A systematic review of approaches to refeeding in patients with anorexia nervosa. International Journal of Eating Disorders, 49, 293–310.CrossRefGoogle Scholar
  9. Golden, N. H., & Attia, E. (2011). Psychopharmacology of eating disorders in children and adolescents. Pediatric Clinics of North America, 58, 121–138.CrossRefGoogle Scholar
  10. Katzman, D. K., Peebles, R., Sawyer, S. M., Lock, J., & Le Grange, D. (2013). The role of the pediatrician in family-based treatment for adolescent eating disorders: Opportunities and challenges. Journal of Adolescent Health, 53, 433–440.CrossRefGoogle Scholar
  11. Lock, J., Le Grange, D., Agras, S., Moye, A., Bryson, S. W., & Jo, B. (2010). Treatment of adolescent eating disorders: Progress and challenges. Minerva Psichiatrica, 51, 207–216.PubMedPubMedCentralGoogle Scholar
  12. Madden, S., Hay, P., & Touyz, S. (2015). Systematic review of evidence for different treatment settings in anorexia nervosa. World Journal of Psychiatry, 5, 147–153.CrossRefGoogle Scholar
  13. Mairs, R., & Nicholls, D. (2016). Assessment and treatment of eating disorders in children and adolescents. Archives of Disease in Childhood, 101, 1168–1175.CrossRefGoogle Scholar
  14. Makino, M., Tsuboi, K., & Dennerstein, L. (2004). Prevalence of eating disorders: A comparison of western and non-western countries. Medscape General Medicine, 6, 49. Retrieved from Scholar
  15. Manikam, R., & Perman, J. A. (2000). Pediatric feeding disorders. Journal of Clinical Gastroenterology, 30, 34–45.CrossRefGoogle Scholar
  16. Marques, L., Alegria, M., Becker, A. E., Chen, C., Fang, A., Chosak, A., & Belo Diniz, J. (2011). Comparative prevalence, correlates of impairment, and service utilization for eating disorders across U.S. ethnic groups: Implications for reducing ethnic disparities in health care access for eating disorders. International Journal of Eating Disorders, 44, 412–420.CrossRefGoogle Scholar
  17. Misra, M., Prabhakaran, R., Miller, K. K., Goldstein, M. A., Mickley, D., Clauss, L., … Klibanski, A. (2008). Weight gain and restoration of menses as predictors of bone mineral density change in adolescent girls with anorexia nervosa-1. The Journal of Clinical Endocrinology & Metabolism, 93, 1231–1237.CrossRefGoogle Scholar
  18. Mitchison, D., & Hay, P. J. (2014). The epidemiology of eating disorders: Genetic, environmental, and societal factors. Clinical Epidemiology, 6, 89–97.PubMedPubMedCentralGoogle Scholar
  19. Moser, D. J., Benjamin, M. L., Bayless, J. D., McDowell, B. D., Paulsen, J. S., Bowers, W. A., … Andersen, A. E. (2003). Neuropsychological functioning pretreatment and posttreatment in an inpatient eating disorders program. International Journal of Eating Disorders, 33, 64–70.CrossRefGoogle Scholar
  20. Muise, A. M., Stein, D. G., & Arbess, G. (2003). Eating disorders in adolescent boys: A review of the adolescent and young adult literature. Journal of Adolescent Health, 33, 427–435.CrossRefGoogle Scholar
  21. Neumark-Sztainer, D. R., Wall, M. W., Haines, J. I., Story, M. T., Sherwood, N. E., & van den Berg, P. A. (2007). Shared risk and protective factors for overweight and disordered eating in adolescents. American Journal of Preventive Medicine, 33, 359–369.CrossRefGoogle Scholar
  22. Norris, M. L., Robinson, A., Obeid, N., Harrison, M., Spettigue, W., & Henderson, K. (2014). Exploring avoidant/restrictive food intake disorder in eating disordered patients: A descriptive study. International Journal of Eating Disorders, 47, 495–499.CrossRefGoogle Scholar
  23. Norris, M. L., Spettigue, W. J., & Katzman, D. K. (2016). Update on eating disorders: Current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatric Disease and Treatment, 12, 213–218.CrossRefGoogle Scholar
  24. Rosen, D. S., & The Committee on Adolescence. (2010). Clinical report: Identification and management of eating disorders in children and adolescents. Pediatrics, 126, 1240–1253.CrossRefGoogle Scholar
  25. Stice, E., Gau, J. M., Rohde, P., & Shaw, H. (2016). Risk factors that predict future onset of each DSM–5 eating disorder: Predictive specificity in high-risk adolescent females. Journal of Abnormal Psychology, 126, 38–51.CrossRefGoogle Scholar
  26. Stice, E., Marti, N. C., & Rohde, P. (2013). Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. Journal of Abnormal Psychology, 122, 445–457.CrossRefGoogle Scholar
  27. Taljemark, J., Rastam, M., Lichtenstein, P., Anckarsater, H., & Kerekes, N. (2017). The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study. Journal of Eating Disorders, 5, 1–11.CrossRefGoogle Scholar
  28. The Society of Adolescent Health and Medicine. (2015). Position paper of the society for adolescent health and medicine: Medical management of restrictive eating disorders in adolescents and young adults. Journal of Adolescent Health, 56, 121–125.CrossRefGoogle Scholar
  29. Thornton, L. M., Mazzeo, S. E., & Bulik, C. M. (2013). The heritability of eating disorders: Methods and current findings. Current Topics in Behavioral Neurosciences, 6, 141–156.CrossRefGoogle Scholar
  30. Wolfe, B. E., Metzger, E. D., Levine, J. M., & Jimerson, D. C. (2001). Laboratory screening for electrolyte abnormalities and anemia in bulimia nervosa: A controlled study. International Journal of Eating Disorders, 30, 288–293.CrossRefGoogle Scholar
  31. Zeeck, A., Weber, S., Sandholz, A., Wetzler-Burmeister, E., Wirsching, M., & Hartmann, A. (2009). Inpatient versus day clinic treatment for bulimia nervosa: A randomized trial. Psychotherapy and Psychosomatics, 78, 152–160.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Kevin K. Tsang
    • 1
    Email author
  • Lillian C. Hayes
    • 1
  • Chrissy Cammarata
    • 2
  1. 1.Department of PsychiatryBoston Children’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Department of Pediatrics, Nemours Alfred I. duPont Hospital for Children, Sidney Kimmel Medical CollegeThomas Jefferson UniversityWilmingtonUSA

Personalised recommendations