Applying the disgust conditioning model of food avoidance: A case study of acceptance-based interoceptive exposure

Objective: The current case report details the treatment of a 16-year-old adolescent with anorexia nervosa utilizing a novel adjunct, acceptance-based interoceptive exposure, prior to family-based treatment (FBT) for eating disorders. Method: The exposure-based module focused particularly on the tolerance of disgust. For six sessions, the clinician taught the client skills that could be used to tolerate distress to visceral sensations associated with disgust. These skills were to be used during in- and between-session exposures. Each session included exposure to physical sensations that occurred while drinking a milkshake. Results: Across six sessions, the client reported improvement in symptoms in addition to gaining weight. Additionally, she consumed more calories of a test meal following the intervention. Within broader FBT, the client reached an established weight goal, was able to return to physical activity, and reported an increased ability to manage distress. Discussion: Given the client's improvement on the Eating Disorders Examination-Questionnaire (EDE-Q) within six sessions, we believe IE may be a useful adjunct to FBT. Interoceptive exposure may augment the efficacy of FBT for anorexia nervosa as it provides clients with skills to utilize during the refeeding phase of treatment.