When Avoidant/Restrictive Food Intake Disorder (ARFID) is discussed, the focus is often on children. Pediatric feeding clinics, early intervention models, and parent-led treatment approaches dominate the literature and training spaces. While this work is essential, it can unintentionally leave an important group of overlooked: adults with ARRID.
People do not “grow out of” ARFID simply because they age. Many adults meet full diagnostic criteria, experience significant impairment, and struggle to access appropriate care, often because ARFID is still viewed primarily as a childhood condition.
ARFID started in childhood
If you are an adult with ARFID, your eating challenges may have started in childhood. In fact, you may not remember ever not struggling with food. Perhaps differences in your eating may have waxed and waned over the years–for some people with ARFID, when stress increases, their ability to eat decreases.
As a child, you may not have gotten any help with your eating. Your parents may have asked your well-meaning pediatrician about your food selectivity, and the pediatrician may have offered advice along the lines of: “they will grow out of it.” Children often reject new foods at first, this is a normal part of learning to eat. In the case of ARFID, more often than not, children don’t naturally “grow out of it.”
“When they get hungry enough, they will eat” is another piece of advice your parents may have received. Again, if you have ARFID, this advice doesn’t appear to be effective. Often, people who experience ARFID struggle to eat due to sensory differences, fear, and/or low hunger. Even when they may feel hungry, eating feels too overwhelming.
ARFID started after a medical condition or traumatic experience with food
Your ARFID may have developed due to medical or chronic conditions that started in childhood or adulthood. For instance, gastrointestinal disorders (IBS, gastroparesis, heartburn, etc.), chronic nausea or vomiting, pain with eating or swallowing, and sensory differences, are a few common examples.
ARFID can also develop if you had a traumatic event around food, such as a choking episode, allergic reaction, vomiting, or other medical emergency involving food.
Over time, food avoidance may become reinforced as a protective strategy, thereby reducing discomfort, symptoms, or fear of symptom flare-ups. While initially adaptive, this avoidance can evolve into a rigid restriction that persists even when medical symptoms improve.
The medical community, family, friends, and our culture at large may have indicated that your eating challenges are “all in your head.” These messages are not true but often stigmatize eating and lead to an increase in shame and embarrassment, which can then function as a barrier to accessing treatment. Treatments such as CBT-AR and client-centered treatments that pay particular attention to sensory differences are being studied.
Socializing like dating, getting together with friends, and going to work or school events is often what brings adults into treatment. Reduction in socializing can lead to feelings of isolation, depression, anxiety, and low self-confidence.
Wanting to increase body weight is another reason adults seek treatment. You may also be experiencing physical symptoms such as fatigue, low energy, and nutritional deficiencies.
ARFID treatment
You are not “just a picky eater” or “difficult,” but rather you do deserve to receive care that addresses ARFID as a legitimate eating disorder. It is not too late to change your relationship with food and, most importantly, reduce feelings of shame about your eating.
