ARFID - A Lesser Known ED

When we think of eating disorders, conditions like anorexia or bulimia often come to mind. But there’s another lesser-known eating disorder that can significantly impact daily life: ARFID, or Avoidant/Restrictive Food Intake Disorder.

Unlike other eating disorders, ARFID isn’t driven by body image concerns. Instead, individuals with ARFID avoid or restrict food intake due to other reasons, such as:

• Sensory sensitivities (texture, smell, taste)

• Fear of negative consequences (choking, vomiting, or allergic reactions)

• Low interest in food or eating

For someone with ARFID, eating can be a source of stress rather than nourishment or enjoyment. This can lead to nutritional deficiencies, suppressed weight, or reliance on supplements, as well as emotional distress and social difficulties.

How Does Treatment Differ From Other EDs?

• The function of the eating disorder differs:

  • In eating disorder treatment, we’re not just addressing the behaviors; we’re addressing the underlying causes behind them. In anorexia, those root causes might include body image distress, perfectionism, or difficulty expressing emotional needs. In ARFID, the drivers are often quite different, such as sensory processing challenges, food-related trauma, or a lack of internal hunger cues. Effective care means understanding the why behind the eating patterns, not just focusing on what or how much is being eaten.

• Different cognitive and emotional targets:

  • In other eating disorders, treatment often centers around disordered beliefs related to body image, perfectionism, shame, or emotional regulation. While some of these areas may also be relevant for individuals with ARFID, treatment for ARFID typically requires a different focus. For many, the work is centered on increasing food flexibility, reducing fear-based responses, and addressing sensory sensitivities. As a result, treatment tends to be more behavioral and exposure-based, rather than centered on body image reprocessing.

• Different nutritional goals and strategies:

  • In ARFID treatment, weight restoration may be necessary in some cases, but the goals often go beyond weight alone. A primary focus is on expanding food variety, meeting nutritional needs, and reducing avoidant eating patterns, even when weight is not a clinical concern. To support these goals, feeding therapy and structured food exposures are often central components of care. While treatment across eating disorders often involves challenging rigid food-related patterns, the nature of those patterns (and the process for addressing them) looks quite different in ARFID than in anorexia or bulimia. Whereas anorexia or bulimia may involve confronting distorted beliefs about food and body image, ARFID work often centers on tolerating discomfort, building sensory tolerance, and gradually increasing food acceptance.

• Greater involvement of occupational therapists or feeding specialists:

  • Given that some individuals with ARFID may benefit from sensory integration work, support from occupational therapists can be incredibly helpful.

• Exposure process and engagement:

  • For some individuals with anorexia, bulimia, or binge eating disorder, the eating disorder can serve as a protective mechanism or become closely tied to identity. This dynamic often requires treatment to address deeper emotional themes such as self-worth, control, or belonging. In contrast, this is typically less prominent in ARFID. While identity or protective elements may be present to some degree, they are usually not as central. As a result, the tone and focus of treatment often shifts, leaning more toward curiosity, cognitive flexibility, and skill-building rather than intensive emotional reprocessing. Language matters here, and a more collaborative, exploratory approach is often most effective in helping clients with ARFID gradually shift rigid patterns and expand their capacity to engage with food.

Recovery With ARFID

ARFID is a legitimate and complex diagnosis—not just “picky eating.” While it commonly begins in childhood, it can persist into adolescence or adulthood, and in some cases, may even emerge later in life. Effective treatment typically involves a multidisciplinary team, including therapy, nutrition support, and medical care, all tailored to the individual’s specific needs.

That said, recovery from ARFID varies widely. When food avoidance stems from biological sensory sensitivities or lack of hunger cues, that aspect may not fully resolve. In those cases, recovery doesn’t mean becoming a “normal” or “adventurous” eater. Instead, it means finding ways to nourish the body consistently, safely, and with less distress. And truly—that’s okay. Recovery should be defined by what is sustainable and supportive for the individual, not by comparison to others.

Final Thoughts

Let’s be clear, it’s important to recognize that eating disorder treatment should always be individualized. While there are evidence-based tools and therapeutic approaches that can be helpful across various eating disorder diagnoses, each person’s needs are unique and should guide the course of care. At the same time, there are key differences in how treatment should be approached for ARFID compared to other eating disorders. Although some interventions may overlap, addressing ARFID often requires distinct strategies that reflect the specific drivers of the disorder.

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If you or someone you love is struggling with an eating disorder, help is available. Contact a professional, reach out to The Alliance for Eating Disorders, or talk to your healthcare provider. You are not alone.