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In most cases, treatment starts with a psychological assessment and often goes hand in hand with somatic medical examinations. This is important because there may be underlying physical conditions such as reflux disease, food allergies or sensitivities, digestive problems, which may play an important role in the development and maintenance of the disease. Identifying and treating these is of paramount importance in improving the quality of life of the patient and their family, and restoring a sense of control as much as possible.  

In many cases, therapy requires the collaboration of several professionals, from doctors, psychologists and psychiatrists to dieticians and behavioural therapists. Research so far shows that complex therapy that takes into account individual differences can be successful. However, in the case of ARFID, there is always a question of what is considered to be successful, as it makes a big difference where the treatment starts. In the case of a child who is only willing to eat one type of pudding at the start of treatment, an increase in the number of foods accepted by one or two may be considered a success. If weight is very low, the focus of treatment should be on increasing it at the beginning. Likewise, if the weight is normal and there are no nutritional deficiencies, but the family feel that feeding the child is a huge difficulty, the focus of therapy will be elsewhere. 

Treatment can take the form of individual and/or family therapy, and psychoeducation and support groups for parents of children with eating disorders are also very effective. 

Among the treatment options, behavioural therapy can play an important role, e.g. systematic desensitisation, where the patient is introduced to different foods in a playful way, not centred around eating, or operant conditioning, where verbal or physical rewards are given for trying new foods. However, results so far are mixed, and we are not sure which method is most effective. Interestingly, in many cases, children who had previously been forced to eat new foods by their parents chose individual therapy rather than family therapy when given a choice.

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