A scoping review of enteral and parenteral nutrition use in adolescents and adults with avoidant/restrictive food intake disorder.

Evidence to support enteral/parenteral nutrition (EN/PN) use in non-pediatric settings for avoidant/restrictive food intake disorder (ARFID) is lacking. We conducted a scoping review to identify the frequency, characteristics, and outcomes of EN/PN use in adolescents and adults with ARFID; identify gaps in the literature; and offer suggestions for clinical practice and research. We searched 4 databases until August 1, 2024, for studies reporting current or historical use of EN/PN in individuals aged ≥ 15 years with ARFID. Of the 24 studies included, 12 (50%) were retrospective cohort studies. Sixteen studies (67%) reported EN use during treatment, primarily via nasogastric (NG) tube, all during inpatient admissions. Six studies (25%) reported on prior or current EN and/or PN at the time of evaluation. Details regarding the criteria for EN/PN placement were reported by 14 studies, with variable details on EN use. Studies generally described placing/using EN when a patient was unable to complete meals orally, with two studies reporting on protocol modifications intended to increase flexibility with meal/supplement selection. Six of the 17 non-case studies (35%) and n = 6/7 case studies (85%) reported clinical outcomes associated with EN/PN in patients with ARFID. EN, particularly via NG tube, is relatively common for adolescents and adults with ARFID in the inpatient setting, but data concerning EN/PN use and its effects on ARFID treatment outcomes are lacking. Prospective research is needed, but clinicians might consider more flexibility than standard nutrition rehabilitation protocols.