Not Just “Picky Eaters”: The Reality of ARFID

Avoidant/Restrictive Food Intake Disorder (ARFID) is a lesser-known eating disorder. It can impact every part of life, from physical health to social interactions and self-esteem. In this blog, I’m sharing a bit about what ARFID is, my own lived experience, and some reflections from my practice as an eating disorder therapist.

​​What is ARFID?

ARFID – Avoidant/Restrictive Food Intake Disorder – is categorized in the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders) as an “eating or feeding disturbance”. This may include sensory sensitivity, fear of aversive consequences from eating, or a lack of interest in eating. This can manifest in various ways, such as distress around certain food textures/smells, experiencing fear of foods being contaminated or causing illness, and this can lead to having a very limited range of acceptable or “safe” foods. ARFID resources tend to focus on children but as an eating disorder therapist, I’ve worked with many adults who are struggling. There can be an overlap with neurodivergence (e.g. autism, ADHD), particularly around sensory difficulties and needs.

​My Personal Experiences

I usually describe my own experiences as “disordered eating” as I’ve flitted between difficulties over the years but have never been formally diagnosed with an eating disorder. I didn’t even consider that there was an issue until I started learning more about eating disorders and how diet culture and weight stigma had shaped my relationship with food. When I came across ARFID, it really resonated, especially around the fear aspect.
I was fortunate to go travelling in my 20s, but it wreaked havoc on my gut. I had food poisoning numerous times and became anxious about what I could eat, as almost everything seemed to make me feel nauseous and with a bad stomach. I saw various professionals—medical and holistic—most of whom wanted to tell me what not to eat. It led to more restriction and cutting out food groups, and I just got increasingly scared of food. I even cut out tomatoes for a while, which, as someone who loves pasta and pizza, was really no good!

My poor stomach has taken the brunt of most things in my life—emotionally and physically—which I still manage today, though it’s much better now. It took me years to start rebuilding what I could eat. It didn’t begin with pushing myself to eat more; it started with finding more routine and stability when I moved back to the UK. I started having therapy and working on my relationship with food and exercise. I found more safety, stability and acceptance, and found more compassion for myself.
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I was also untangling a lot of diet culture messaging, which added complexity. I didn’t hate my body anymore, but I certainly didn’t love it. I was, at least, starting to be a little kinder to it. Gradually, I felt brave enough to try new things, but it’s scary when food has made you ill before. I wanted more variety in my eating and less anxiety around it. That meant challenging a lot of the narratives I’d grown up with about what’s “healthy” and “good” and what I “should” eat. I wanted to find my own way of eating that was best for my body, on my terms. Like many people who’ve struggled with eating, I had safe foods, and liked to check menus before eating out and was often prepared with my own snack, just in case. I accepted these were my needs and these were valid. 

​Norms, Expectations and ARFID

I feel at ease with food now, but I’ll never forget the fear eating once caused. I know what it’s like to feel anxious eating out or at someone else’s home. To worry there’ll be nothing you can eat, or that people will judge you as picky or difficult. To feel like you can’t eat like a “normal” person. It’s incredibly shaming to feel like the odd one out, that you’re being dramatic or too much. And it’s too easy to internalise that blame. This can have a huge impact socially, professionally, and in daily life.

Now, working as a counsellor with clients experiencing ARFID, I feel grateful for my own experiences as this helps a great deal in my work. Everyone’s story is different, but I do understand the turmoil, the shame, and the frustration. I understand what it’s like to feel like you don’t fit in and are not “normal”. The main thing I want people to know is: your struggle is valid. It’s a hard way to live. It’s not your fault. And you absolutely deserve help and support.

So… what is normal eating, and who even gets to decide that? Spoiler: “normal” eating doesn’t exist.

We start learning about food from the moment we’re born. Our early experiences and narratives around food create lasting templates. We learn how to eat from others—family, culture, society—and those “norms” get hard-wired into our brains. As babies, we cry and get fed, but as we grow, meals come with rules. I’m speaking here from my perspective as a white British person, so it's a limited cultural lens, but I was taught about “balanced” meals, five-a-day, good and bad foods, the “ideal” plate, etc.
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Even in recent years, nurses have given me generic eating advice leaflets from the 1980s, which assume there is one right way to eat (often based on white western ways of eating). It’s unrealistic to think there’s one “right” way to eat. Our bodies are different, people are different and our backgrounds and cultures are different. Our needs are different.

We need to find our own normal and not feel ashamed of it.

​Neurodiversity and ARFID

There is a big overlap between all eating disorders and neurodiversity. I use the term here to refer to the natural variations in how people think, process, and interact with the world. Through my own practice, I’ve learned how important it is to look through both a neurodiverse and an intersectional lens. Even when working with neurotypical clients, everyone has different preferences and ways of processing.

With ARFID, sensory sensitivities are common. Texture, taste, and even the inconsistency of certain foods can be overwhelming. Fruit and veg, for example, can vary massively in taste and feel from day to day, whereas a packet of crisps or crackers will always be the same. That predictability feels safe.
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For neurodivergent people, there can be added pressure to mask and “fit in,” which includes eating in a “normal” way. When society pushes a narrow idea of “normal” or “healthy” eating, it excludes and potentially harms many people. The shame that comes with feeling “not normal” can sometimes be a bigger problem than the actual food avoidance. This is especially hard for children or young people, who may already be struggling to eat and have limited autonomy. The pressure to conform can unintentionally make things worse, even if it comes from a place of concern. In my work, I’m often helping people work through bad experiences with food from the past, for instance being forced to eat certain foods, which can be a traumatic experience which stays with them into adulthood. 

​Acceptance and Peace with Food

Many people with ARFID want help to expand food choices, reduce anxiety, and live a more flexible life. However, building self-acceptance and reducing self-criticism is an important part of healing. Unlearning diet culture, setting boundaries with others, and creating a sense of safety—around food, people, and places—can all make a huge difference.
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People with ARFID may feel nervous about seeking help, fearing they’ll be forced to eat or judged harshly. That’s why it's so important to create a non-judgmental, collaborative space. ARFID is so individual that there’s no one-size-fits-all approach. Person-centred, collaborative and flexible support is important. There are limited evidence-based treatment guidelines specifically for ARFID, but NHS options may include CBT, exposure therapy, or family therapy for young people, along with nutritional support. 

My Approach - Therapy for ARFID

In my work, I use an integrative approach, which means adapting to clients’ needs, drawing from various theories and tools. These are some approaches which have been helpful for clients:

• Exploring shame and difficult emotions
• Building autonomy and individuality
• Unpacking childhood and societal “shoulds”
• Looking at experiences that may have contributed (e.g. illness, fear of choking or vomiting)
• Supporting confidence, resilience, and boundary-setting
• Going at their pace, no pressure to try new foods unless they feel safe to do so
• Encouraging professionals and loved ones to reflect on their own beliefs about food, bodies, and health norms

 
A wider understanding of ARFID is needed, along with more literature and resources. It’s also important for professionals to reflect on their own views, biases and relationships with food. Although ARFID is generally talked about as separate from fears around weight and body image, I believe it is always within the context of diet culture and the thin ideal as we all grow up surrounded by this. Understanding these influences, for both clients and professionals, is important for this work.

I hope we can keep building on our knowledge of ARFID as a society and reduce any myths and stigma, so we can help support people the best we can.

I offer counselling sessions online for ARFID and a broad range of disordered eating. I offer a free 15-minute initial consultation. 

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