Avoidant restrictive food intake disorder: First do no harm. Issue 4 (24th January 2019)

• Record Type: Journal Article
• Authors: Katzman, Debra K.; Norris, Mark L.; Zucker, Nancy
• Other Names: Eddy Kamryn T. guestEditor.; Thomas Jennifer J. guestEditor.
• Is Part Of: International journal of eating disorders. Volume 52:Issue 4(2019)
• Page Start: 459
• Page End: 461
• Publication Date: 2019-01-24
• Subjects: adolescent -- ARFID -- avoidant restrictive food intake disorder -- children -- conditioned taste aversion -- nasogastric tube feeding -- sensory aversion; Appetite disorders -- Periodicals; Ingestion disorders -- Periodicals; Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/eat.23021
• Languages: English
• ISSNs: 0276-3478

Abstract

Abstract: Objective: This opinion piece offers some considerations, both medical and psychological, for the use of nasogastric tube (NGT) feedings in the treatment of avoidant restrictive food intake disorder (ARFID) in children and adolescents. Method: Although there is empirical support for the use of NGT feedings in the treatment of anorexia nervosa, this evidence base does not exist for the treatment of ARFID. As such, there is need to delineate pragmatic considerations in the use of this procedure. Results: Issues of medical necessity notwithstanding, we advise that the use of this procedure be considered more cautiously due to the oral sensitivities inherent in many individuals with ARFID and the potential psychological consequences. These sensitivities may make the experience of NGT feedings particularly aversive, with the potential of creating iatrogenic conditioned food aversions. Discussion: This article encourages clinicians to give careful thought and attention when considering NGT feedings in children and adolescents with ARFID.