Living with avoidant/restrictive food intake disorder (ARFID) as an adult can feel isolating. Many people assume it is a childhood problem. But ARFID affects adults too, and it is very treatable.

ARFID is an eating disorder where someone avoids many foods. This happens because of fear of choking, sensory problems with food, or a lack of interest in eating. It is not about body image or wanting to lose weight. That makes it different from other eating disorders.

The good news is that several treatments have strong evidence behind them. This article walks through what those treatments look like, who provides them, and how to take your first step.

What Is ARFID in Adults?

ARFID stands for avoidant/restrictive food intake disorder. Adults with ARFID typically eat a very small range of foods. They may avoid entire food groups, textures, or colors. Some fear they will choke or vomit. Others feel no hunger or interest in eating at all.

ARFID is just as common in adults as it is in children, and is associated with serious medical and psychiatric challenges when left untreated. You can learn more about what ARFID looks like across the lifespan by reading about adults and ARFID specifically.

ARFID can cause serious health problems when left untreated. These include malnutrition, low energy, and difficulty in social situations involving food. Many adults with ARFID feel embarrassed or ashamed at restaurants, work events, or family gatherings.

Treatment can change that. It does not demand you eat everything. It helps you slowly expand what feels safe, at your own pace.

Who Can Treat ARFID in Adults?

Getting the right team in place is the most important first step. ARFID treatment usually involves more than one type of provider. A 2023 review in JCPP Advances found that the best outcomes occur when treatment is multi-modal, meaning it addresses medical, nutritional, and psychological needs together.

Therapists Who Specialize in Eating Disorders

A therapist trained in eating disorders is often the center of your care. They help you understand the thoughts and feelings tied to food avoidance. They can also guide you through the process of trying new foods without forcing anything.

Look for therapists who list ARFID, eating disorders, or anxiety as areas of specialty. Many now offer telehealth sessions, which removes barriers like travel or work schedules.

Registered Dietitians

A registered dietitian (RD) who understands ARFID can help you build nutritional support. They are not there to tell you what to eat. Instead, they work with you to make sure your current foods are providing enough energy and nutrients. They also help you set small, realistic food goals.

Occupational Therapists

For adults who struggle with the sensory side of eating, an occupational therapist (OT) can be very helpful. OTs work on sensory processing, which is how your nervous system responds to textures, smells, and sounds. You can learn more about this through reading about food texture aversion and how to overcome it.

Therapy Options for ARFID in Adults

Several therapeutic approaches have evidence behind them for treating ARFID. Each one works a bit differently. Your treatment team will help you figure out which fits best.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy, or CBT, is one of the most well-studied treatments for ARFID. CBT helps you identify thoughts that keep food avoidance in place. For example, if you believe a food will make you sick, CBT helps you examine that belief and test it gradually.

A 2021 proof-of-concept study published in Journal of Behavioral and Cognitive Therapy found that CBT-AR for adults produced large, significant decreases in ARFID severity. Therapists rated 80% of participants as 'much improved' or 'very much improved' after treatment. Progress is usually slow and steady, not sudden. That is by design.

ARFID Exposure Therapy

Exposure therapy is a specific type of CBT. It involves getting closer to feared foods in very small steps. You might start by just looking at a food. Then smelling it. Then touching it. Eating it comes much later, only when you are ready.

Acceptance and Commitment Therapy (ACT)

ACT helps you reduce the struggle with difficult thoughts and feelings about food. Rather than trying to get rid of anxiety, ACT teaches you to make room for it while still moving toward your goals. Some people find this feels more manageable than traditional exposure methods.

Medical and Nutritional Support

Before or alongside therapy, your physical health needs attention. Malnutrition can affect your mood, energy, and ability to engage in treatment. A doctor or nurse practitioner can check your bloodwork and identify any deficiencies.

Research found that people with ARFID commonly meet only 20 to 30 percent of their recommended intake for many vitamins and minerals, including vitamin D, B12, zinc, and iron. A doctor can identify which deficiencies apply to you personally.

Depending on what they find, they may recommend supplements or nutritional support drinks. This is not meant to replace food. It is meant to keep your body supported while you work on expanding what you eat.

What Does Treatment Actually Look Like Day to Day?

Many people wonder what ARFID treatment feels like in practice. It is not a quick fix, but most people notice meaningful changes within a few months of consistent work.

You might start by meeting with your dietitian weekly to review your current foods and set one small goal. In therapy, you might spend the first few sessions just talking about your history with food. Only when you feel ready do you begin working directly with feared or avoided foods.

Progress looks different for everyone. In the 2021 CBT-AR adult study, participants added an average of 18 new foods over the course of treatment. For some people, adding two or three new foods in a year is a major victory. If you are working on how to treat ARFID at home between sessions, your therapist can give you specific exercises to practice.

How to Find ARFID Treatment as an Adult

Finding a provider who knows ARFID well can take some searching. Here are practical steps to get started:

• Ask your primary care doctor for a referral to an eating disorder specialist

• Search the Alliance for Eating Disorders directory online

• Contact university or hospital eating disorder programs, as they often treat ARFID

• Look for telehealth providers if local options are limited

• Contact your insurance company for a list of covered eating disorder specialists
• Find a dietitan online covered by insurance through Nabi

When you reach out to a provider, ask directly whether they have experience with ARFID in adults. Not all eating disorder specialists have ARFID training. That is okay to ask about.

Recovery Is Possible

ARFID in adults is real, and it deserves real treatment. You are not being difficult. You are not choosing this. And you do not have to figure it out alone.

Treatment works. It takes time, but with the right support, many adults with ARFID expand their food range, reduce anxiety around eating, and feel more comfortable in social food situations.

If you are ready to take the next step, talking to a doctor or eating disorder specialist is a great place to start. You deserve care that takes your experience seriously.

If you or someone you know is struggling with an eating disorder, the National Alliance for Eating Disorders helpline is available at 1-866-662-1235.

Sources

1. Thomas JJ, et al. (2021). Cognitive-behavioral therapy for adults with avoidant/restrictive food intake disorder. International Journal of Eating Disorders. PMC8375627.

2. Archibald A, et al. (2023). Current evidence for ARFID: Implications for clinical practice. JCPP Advances.

3. Hilbert A, et al. (2021). Macro- and micronutrient intake in children with ARFID. Nutrients. PMC7911718.

4. Zickgraf HF & Theim KR. (2024). ARFID: Review and recent advances. Focus (American Psychiatric Association).

5. National Eating Disorders Association (NEDA). ARFID overview.

6. StatPearls (NCBI Bookshelf). (2024). Avoidant Restrictive Food Intake Disorder.