Maybe you've been eating the same handful of foods for as long as you can remember.
You know exactly which restaurants have something you can eat. You have strong opinions about food textures, brands, and preparation methods. And there's a good chance someone has told you that you just need to try something new.
As if you hadn't considered that.
Maybe you've spent years feeling embarrassed at dinner parties, avoiding restaurants, or explaining to people that no, you really can't just pick the onions off.
And maybe you've wondered why something that seems so easy for everyone else feels nearly impossible for you.
What if your relationship with food isn't simply about being picky?
For some people, these experiences are part of a condition called avoidant/restrictive food intake disorder, or ARFID.
And while ARFID is often discussed in the context of children, adults can experience it too.
What Is ARFID?
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder involving persistent avoidance or restriction of food that interferes with someone's nutritional needs, physical health, or everyday functioning.
Unlike anorexia nervosa or bulimia nervosa, ARFID isn't driven by a desire to lose weight or change body shape.
Instead, food avoidance may be connected to sensory sensitivities, fear of unpleasant consequences from eating, or a limited interest in food.
ARFID can affect people of all ages and body sizes.
You don't have to be underweight to have ARFID. And you don't have to have experienced a dramatic choking or vomiting incident for food to feel overwhelming.
For some people, eating has always been difficult. For others, symptoms develop or become more severe after a particular experience.
The Three Common ARFID Presentations
ARFID doesn't look the same for everyone. Clinicians commonly describe three patterns, which can also overlap.
1. Sensory Sensitivity: When Food Textures Feel Unbearable
Maybe the smell of eggs makes you gag.
Maybe you can eat a potato when it's crispy but not when it's mashed.
Maybe you have a very specific brand of bread you can tolerate, and when the company changes its recipe, your entire breakfast routine is suddenly a problem.
For people with sensory-based ARFID, the texture, smell, appearance, temperature, or taste of food can trigger intense discomfort or disgust.
This isn't necessarily about disliking a flavor.
Sometimes the sensory experience itself feels genuinely intolerable.
2. Fear of Aversive Consequences: When Eating Feels Dangerous
Some people avoid food because they're afraid something bad will happen when they eat.
Common fears include:
Choking or being unable to swallow.
Vomiting or feeling nauseated.
Having an allergic reaction.
Experiencing gastrointestinal discomfort.
Becoming ill after eating.
For example, someone who experienced a choking incident might begin avoiding certain textures, eating very slowly, or taking unusually small bites.
Over time, their list of acceptable foods may become smaller.
Even after relevant medical concerns have been evaluated, the fear can persist.
And the more someone avoids eating situations that trigger anxiety, the harder those situations may begin to feel.
3. Low Interest in Eating: When Food Just Isn't Appealing
Not everyone with ARFID experiences intense fear or sensory distress.
Some people simply have very little interest in eating.
They may rarely feel hungry, forget to eat, become full quickly, or experience eating as a chore rather than something enjoyable.
This can still create significant nutritional and functional challenges.
And it's important to recognize that this presentation may require a different treatment emphasis than fear-based avoidance.
ARFID vs. Picky Eating: What's the Difference?
Plenty of people have foods they dislike.
Having preferences, avoiding certain textures, or ordering the same meal at a restaurant doesn't automatically mean someone has an eating disorder.
The difference is often how significantly those patterns interfere with someone's health and life.
ARFID may involve nutritional deficiencies, inadequate intake, dependence on supplements or nutritional support, or substantial difficulty participating in everyday activities involving food.
Maybe you avoid traveling because you aren't sure you'll find something you can eat.
Maybe you skip meals during work events because you're embarrassed about your food preferences.
Maybe your diet is so limited that meeting your nutritional needs has become difficult.
The question isn't simply how many foods you eat. It's how much your eating difficulties are affecting your life.
A qualified clinician can help determine whether these experiences meet the criteria for ARFID or reflect another concern.
Can Adults Develop ARFID?
Absolutely.
Some adults have experienced ARFID symptoms since childhood without ever receiving a diagnosis.
They may have grown up being described as difficult, stubborn, dramatic, or overly picky.
Others develop restrictive eating patterns later in life, sometimes following a frightening eating experience, gastrointestinal illness, or another significant event.
ARFID can also occur alongside conditions such as OCD, anxiety disorders, autism, and ADHD.
These overlaps can make assessment especially important because similar-looking food avoidance behaviors may have different underlying causes.
And those differences matter when choosing treatment.
How Does ERP Help With ARFID?
Exposure and response prevention (ERP) is a behavioral treatment best known for treating OCD. Exposure-based approaches are also used in specialized ARFID treatment, particularly when fear, avoidance, or safety behaviors are maintaining food-related difficulties.
The basic idea is to gradually build new experiences with foods, sensations, or eating situations that have become difficult.
But exposure therapy isn't about putting an unfamiliar food in front of someone and insisting they eat it.
Effective treatment is individualized, collaborative, and responsive to the reasons someone is avoiding food.
For example, treatment might involve:
For sensory sensitivities: Gradually interacting with unfamiliar foods through looking, smelling, touching, tasting, or eating, depending on the person's needs and goals.
For fear of choking or vomiting: Developing a gradual hierarchy of eating experiences while reducing unnecessary fear-driven safety behaviors, after appropriate medical evaluation.
For limited food variety: Working toward greater flexibility with brands, preparation methods, textures, or eating environments.
For low interest in eating: Supporting consistent nutritional intake and developing practical eating routines, often alongside nutritional or medical care. Traditional fear-based exposure may not be the primary intervention for this presentation.
In my practice, I use ERP-informed strategies when they're clinically appropriate and helpful for a person's specific ARFID symptoms.
ARFID treatment may also involve nutritional rehabilitation, medical monitoring, and coordination with other providers. Exposure work should never require someone to disregard a genuine allergy, swallowing disorder, or medically necessary dietary restriction.
What Does an ARFID Exposure Actually Look Like?
Let's say you've eaten the same brand of crackers for years.
You know the texture, the taste, and exactly what to expect with every bite.
But trying a different brand feels overwhelming.
We wouldn't necessarily begin by asking you to eat an entirely unfamiliar meal.
Instead, we might create a gradual exposure plan that starts with tolerating the presence of another brand, opening the package, exploring the sensory differences, and eventually tasting it when appropriate.
Throughout the process, we'd pay attention to the thoughts, sensations, and avoidance behaviors that show up.
And we'd practice responding differently.
The goal isn't to force yourself to enjoy the new crackers.
It's to build flexibility and expand what feels possible.
You can dislike a food without needing to fear it.
That distinction can be an important part of recovery.
What If I've Had ARFID My Entire Life?
One of the most discouraging things about living with ARFID is feeling like your eating patterns are simply part of who you are.
If you've struggled with food since childhood, it can be difficult to imagine anything changing.
But longstanding patterns aren't necessarily permanent.
Our brains continue to learn throughout adulthood, and repeated, supported experiences can help build new associations with foods and eating situations.
This doesn't mean every sensory sensitivity will disappear or that you'll eventually enjoy every food.
It means you may be able to develop greater flexibility, improve nutritional adequacy, reduce distress, and participate in experiences that once felt inaccessible.
Progress might mean trying a new food.
It might mean being able to eat at a restaurant with friends.
Or it might mean having enough reliable food options that traveling no longer feels impossible.
Recovery doesn't have to look like eating everything. It can look like having more freedom, nourishment, and choices.
Online ARFID Therapy for Adults in Oregon, Texas, and Ohio
I'm a licensed therapist specializing in exposure and response prevention for OCD, ARFID, eating disorders, and anxiety-related concerns.
I offer virtual therapy for adults located in Oregon, Texas, and Ohio.
My approach focuses on understanding the function of food avoidance, identifying meaningful goals, and developing gradual, collaborative exposure exercises when appropriate.
Because sessions are virtual, we may be able to practice with foods and eating situations in your own environment.
I work with adults who are appropriate for outpatient treatment. Some people with ARFID need medical stabilization, nutritional rehabilitation, coordinated multidisciplinary treatment, or a higher level of care before or alongside outpatient exposure therapy.
You Deserve More Than a Life Organized Around Safe Foods
Imagine being able to travel without packing an entire suitcase of familiar snacks.
Going to dinner without checking the menu a week in advance.
Trying something unfamiliar without feeling overwhelmed by the possibility that you won't like it.
Or simply having enough food options that eating doesn't require so much planning.
You don't need to become someone who loves every food.
And you don't need to feel embarrassed about the foods that are difficult for you.
You deserve support that takes your experiences seriously and helps you work toward the kind of relationship with food that makes your life bigger, not smaller.
If you're an adult in Oregon, Texas, or Ohio who's struggling with ARFID symptoms, I offer a free 15-minute consultation to discuss your concerns and determine whether my approach might be a good fit.
Schedule your free consultation to learn more about online ARFID therapy.
