Winten Copeland G, Ross Lynda J, Strodl Esben, Heruc Gabriella, Thomas Jennifer J
School of Exercise and Nutrition Science, Faculty of Health, Queensland University of Technology, Kelvin, Grove, Australia.
School of Counselling and Psychology, Faculty of Health, Queensland University of Technology, Kelvin, Grove, Australia.
J Hum Nutr Diet. 2025 Aug;38(4):e70087. doi: 10.1111/jhn.70087.
Cognitive-behavioral therapy for avoidant/restrictive food intake disorder (CBT-AR) is an emerging treatment for adults with avoidant/restrictive food intake disorder (ARFID). This article explores how CBT-AR can be integrated with and enhanced by the dietetics skillset and presents two case studies in which a dietitian primarily provided treatment within a multidisciplinary team.
The dietetic-led CBT-AR treatment journeys are described for two patients. We utilised dietetic and psychological assessments to measure change, including: nutrient pathology; weight; Pica, ARFID and Rumination Disorder Interview scores; Australian Core Food Score; and Structured Assessment of Gastrointestinal Symptoms. We describe the stages of CBT-AR with examples of how a dietitian's skillset might be utilised within this treatment approach.
Both patients demonstrated significant improvements in ARFID psychopathology and dietetic measures after completing dietitian-led CBT-AR. These findings provide preliminary evidence that dietitians with specialised expertise in eating disorders could effectively deliver CBT-AR as part of a multidisciplinary team.
These case studies highlight the potential for dietitians to act as primary clinicians in delivering CBT-AR and provide preliminary evidence on how their skillset could lead to clinically meaningful improvements for adults living with ARFID. Future research trials are required to confirm that dietitian-led CBT-AR could be a viable treatment option for ARFID.
针对回避/限制性食物摄入障碍（CBT-AR）的认知行为疗法是一种针对患有回避/限制性食物摄入障碍（ARFID）的成年人的新兴治疗方法。本文探讨了CBT-AR如何与饮食技能相结合并通过饮食技能得到强化，并介绍了两个案例研究，其中营养师主要在多学科团队中提供治疗。
描述了两名患者由营养师主导的CBT-AR治疗过程。我们利用饮食和心理评估来衡量变化，包括：营养病理学；体重；异食癖、ARFID和反刍障碍访谈评分；澳大利亚核心食物评分；以及胃肠道症状结构化评估。我们描述了CBT-AR的各个阶段，并举例说明在这种治疗方法中如何运用营养师的技能。
两名患者在完成由营养师主导的CBT-AR治疗后，ARFID精神病理学和饮食指标均有显著改善。这些发现提供了初步证据，表明在饮食失调方面具有专业知识的营养师可以作为多学科团队的一部分有效地提供CBT-AR。
这些案例研究突出了营养师作为主要临床医生提供CBT-AR的潜力，并提供了初步证据，证明他们的技能如何能够为患有ARFID的成年人带来具有临床意义的改善。未来需要进行研究试验，以确认由营养师主导的CBT-AR是否可能成为ARFID的一种可行治疗选择。
