Can Adults Have ARFID?Understanding the Eating Disorder That Often Goes Unnoticed for Years
Written by Dr. Colleen Reichmann, owner and clinical director of Wildflower Therapy
When most people picture an eating disorder, they imagine dieting, body image concerns, or a desire to lose weight. But for many children, teens, AND adults struggling with food, the experience looks completely different.
Sometimes disordered eating looks like avoiding food because textures feel unbearable. Others fear choking, vomiting, or getting sick after eating. Some feel overwhelmed by the sensory experience of meals altogether. Many have lived for years believing they are simply “extremely picky,” “difficult,” or “bad at eating.”
In reality, they may have ARFID.
Avoidant/Restrictive Food Intake Disorder (commonly called ARFID) is an eating disorder that can affect both children and adults. Although awareness of ARFID has grown dramatically in recent years, many adults are only now beginning to realize that the struggles they have carried for decades may actually have a name.
What Is ARFID?
ARFID is an eating disorder characterized by restrictive eating that is not primarily driven by body image or a desire to lose weight. Instead, people with ARFID may avoid food due to:
• sensory sensitivities to texture, smell, taste, or appearance
• fear of aversive consequences like choking, vomiting, allergic reactions, or nausea
• low appetite or lack of interest in eating
• overwhelming anxiety or distress around food experiences
Unlike anorexia nervosa, ARFID is not centered around body dissatisfaction or pursuit of thinness. However, the nutritional, emotional, and social impacts can still be significant.
Adults with ARFID may struggle with:
• nutritional deficiencies
• weight changes
• exhaustion around meals
• social isolation
• shame about eating habits
• anxiety when traveling or eating with others
• difficulty maintaining adequate intake during stressful periods
For many adults, these patterns have existed for years. When that’s the case, it can be really challenging to pivot to the idea that this is actually a true eating disorder, and one that they deserve support for.
Why ARFID Often Flies Under the Radar in Adults
One reason ARFID can go undetected for so long is because many adults grew up before ARFID was widely recognized as a diagnosis.
ARFID was only formally added to the DSM-5 in 2013, making it one of the newer recognized eating disorders. Before that, many children and adults with ARFID were labeled as:
• “picky eaters”
• anxious eaters
• sensory-sensitive
• difficult around food
• gastrointestinal patients
• people with “quirks” or “food phases”
Because ARFID is still relatively new in public awareness, countless adults were never screened for it growing up. Many adapted their lives around food avoidance so effectively that others barely noticed.
Some learned to quietly rotate through a narrow list of “safe foods.” Others avoided restaurants, social events, dating situations, work lunches, or travel where food uncertainty felt overwhelming. Many became skilled at masking distress around eating.
Adults are also more likely to have developed coping strategies that conceal the severity of the problem. Someone may technically be eating enough calories to survive while still experiencing enormous anxiety, restriction, shame, or nutritional imbalance. Others have accepted that they are only able to eat certain kinds of food (for example, fast food, due to the certainty and sameness around texture and taste that it can provide) and have hence had to lean into a continuous diet of foods that may not meet all of their nutritional needs.
In other cases, ARFID is overlooked because providers mistake it for something else entirely.
What Conditions Commonly Co-Occur With ARFID?
ARFID frequently overlaps with other mental health, developmental, and medical conditions, which can make diagnosis more complicated.
Common comorbidities include:
• obsessive-compulsive disorder (OCD)
• autism
• ADHD
• sensory processing differences
• emetophobia (fear of vomiting)
• gastrointestinal disorders
• panic disorder
• other eating disorders
For neurodivergent adults especially, ARFID symptoms are often deeply intertwined with sensory experiences, routine needs, overwhelm, or interoceptive differences.
Many adults with ARFID have spent years in treatment for anxiety or GI symptoms without anyone recognizing the eating disorder component underneath it all.
Others may have been repeatedly told they are “too picky,” “dramatic,” or “not trying hard enough,” leading to profound shame and self-criticism.
What ARFID Can Actually Feel Like
One of the reasons adults with ARFID often go unidentified is because their internal experience can be difficult to explain.
Many adults describe:
• foods suddenly feeling “unsafe”
• intense disgust reactions
• gagging responses they cannot control
• fear of choking despite logically knowing they are safe
• feeling overwhelmed by textures or smells
• eating becoming exhausting rather than enjoyable
• embarrassment around needing “safe foods”
• panic when favorite foods change unexpectedly
Importantly, ARFID is not a matter of stubbornness or immaturity. The nervous system’s response to food can feel very real and very intense.
What Treatment for Adult ARFID Might Look Like
The good news is that ARFID is treatable-yes! Even in adulthood.
Treatment often works best when it is compassionate, collaborative, and tailored to the specific reason someone is restricting food. Not all ARFID looks the same, and treatment should reflect that.
Depending on the person, therapy may include:
• building nutritional stability and consistency
• slowly expanding flexibility around foods
• reducing fear responses related to eating
• sensory accommodations rather than shame
• exposure-based work done gradually and collaboratively
• nervous system regulation skills
• addressing co-occurring anxiety, OCD, autism, or trauma
• helping clients reconnect with hunger/fullness cues
• reducing shame and self-criticism around eating
For adults who have spent years believing they were simply “bad at food,” receiving an ARFID diagnosis can feel unexpectedly emotional. Many experience grief for how long they struggled without support, but also relief in finally understanding themselves differently.
Treatment is not about forcing someone to become a “perfect eater.” It is about increasing flexibility, nourishment, safety, and quality of life.
Adults Can Have ARFID-Yes, Even If No One Noticed Earlier
Many adults with ARFID became experts at hiding their struggles. Some were overlooked because they maintained a socially acceptable weight. Others were misdiagnosed, minimized, or told they would “grow out of it.”
But struggling with food in adulthood is NOT something you simply have to live with forever.
If eating feels exhausting, anxiety-provoking, sensory-overwhelming, or isolating, it may be worth exploring whether ARFID could be part of the picture. Understanding the why behind food avoidance is often the first step toward healing.
Looking for Support in Philadelphia or on the Main Line?
If you are looking for ARFID therapy in Philadelphia, Wayne, Devon, or the surrounding Main Line areas, Wildflower Therapy offers both in-person and virtual sessions.
We specialize in working with children, teens, adults struggling with anxiety, depression, interpersonal issues, body image and eating disorders.
We provide therapy in-person in Philadelphia or Devon, or virtually for anyone in Pennsylvania, New Jersey, Delaware, Florida, South Carolina, Vermont, Virginia, Ohio, and Massechusetts. We work with children, adolescents, and adults. We are neurodivergent-affirming, queer-celebratory, and feminist-relational in our work.
If you’re looking for therapy for your child or yourself in one of the states mentioned above, or are seeking virtual parent coaching or consultation anywhere in the world, we invite you to reach out for your free consultation call.