Therapy for ARFID: What Does it Look Like?

Written by Dr. Colleen Reichmann, clinical director of Wildflower Therapy

When most people think about eating disorders, they imagine conditions like anorexia or bulimia. They imagine someone who is fiercely trying to control their weight. But there’s another eating disorder that’s less talked about, yet very real- and it looks different from anorexia and bulimia in a number of important ways: Avoidant/Restrictive Food Intake Disorder (ARFID). Over the last few years, research has shown that ARFID is as common, and in some settings more common- than anorexia and bulimia. It can impact children, teens, and adults. And it is NOT just about being a “picky eater.” It’s a serious condition that can deeply affect physical health, emotional well-being, and daily life.

At Wildflower Therapy in Philadelphia, we specialize in eating disorder treatment, including ARFID. Whether you’re a parent worried about your child’s extremely limited diet, a teen struggling with constant anxiety around food, or an adult noticing the way that your limited food intake affects your social life and relationships- therapy can make a meaningful difference.

So What is ARFID?

ARFID stands for Avoidant/Restrictive Food Intake Disorder. Unlike other eating disorders, ARFID is not about body image or weight concerns. Instead, it shows up as extreme food avoidance or restriction for reasons such as:

Sensory sensitivities (taste, texture, smell, or appearance of food feels overwhelming or intolerable)

Fear of aversive consequences (such as choking, vomiting, or an allergic reaction)

Low interest in eating (simply not feeling hungry or finding food unappealing in general)

While many children go through a phase of selective eating, ARFID goes beyond typical developmental patterns. It can result in nutritional deficiencies, difficulty maintaining a healthy weight, and disruptions in everyday life (This is arguably the most important piece to consider when trying to identify if you or a loved one from may have ARFID. Are family meals hellish? Do social gatherings and parties feel like a non-option? Even if someone’s weight is relatively unaffected, if their eating struggles get in the way of normative life activitie-it’s worth investigating.)

ARFID in Children

For children, ARFID often becomes visible when mealtimes turn into a battleground. Parents may notice their child refusing entire food groups, eating only a handful of “safe foods,” or experiencing intense anxiety when new foods are introduced.

Children with ARFID may:

Struggle to get adequate nutrition for growth and development

Experience fatigue, irritability, or difficulty concentrating

Avoid birthday parties, school lunches, or playdates because of food anxiety

Parents often feel overwhelmed, frustrated, or worried. It’s important to know this isn’t a matter of willpower or parenting. This is a real eating disorder. If you, as a parent, continue to feel that your child’s selective eating goes far beyond what other parents are reporting- if meals feel like a totally desperate situation-it’s worth seeking out an evaluation and potentially more professional support.

ARFID in Teens

The teenage years are already full of transitions, pressures, and identity development. For teens with ARFID, food struggles can add another layer of stress.

Teens may:

Feel embarrassed about their limited diet

Avoid eating with friends or at social events

Experience increased anxiety or depression linked to food avoidance

Miss out on important nutrients during a time when their bodies are still growing

Because teens are navigating increasing independence, ARFID can also create tension between parents and adolescents. A specialized therapist can provide a safe, supportive space for both the teen and family to understand what’s happening and develop strategies for healing.

ARFID in Adults

Although ARFID is often diagnosed in childhood, it can absolutely continue into adulthood. In fact, some adults may not realize until later in life that their eating difficulties are part of an eating disorder.

Adults with ARFID may:

Struggle to share meals with coworkers, partners, or friends

Experience shame or frustration about their food limitations

Have ongoing medical issues linked to poor nutrition

Feel anxious about dating or traveling due to food restrictions

Living with ARFID as an adult can be incredibly isolating—but with the right treatment, it’s 100% possible to make meaningful progress and expand flexibility with food.

ARFID and Neurodivergence

ARFID frequently co-occurs with neurodivergence, especially autism and ADHD. For autistic individuals, sensory sensitivities can play a major role in food avoidance. Certain textures, smells, or flavors may feel overwhelming, and ARFID can develop as a way to cope with this discomfort.

This is why it’s so important that treatment for ARFID in autistic people isn’t left solely to one professional, such as an occupational therapist. While OTs can provide valuable support with sensory integration, an eating disorder specialist therapist brings expertise in addressing the psychological, emotional, and relational aspects of ARFID. Together, these supports can form a comprehensive care team.

Additionally, it’s important to note that just because body image is not the driving factor in restriction for folks with ARFID, this does not mean that body image is not a struggle at all. In our culture, body discontent is the rule, not the exception. Many folks with ARFID start out with a sensory aversion to food, live at a lower weight for awhile, and then develop fears of gaining weight after becoming comfortable at this lower weight. Hence, you can probably see why an eating disorder therapist who is still highly trained in body image work would be important!

At Wildflower Therapy, we frequently work alongside OTs, dietitians, pediatricians, and other providers to ensure that our autistic and neurodivergent clients with ARFID get the holistic care they deserve.

Why Therapy Matters for ARFID

ARFID doesn’t resolve by simply “trying harder” or “forcing” more variety. In fact, pressure around eating often makes things worse.

Therapy provides a safe space to:

Uncover and illuminate the roots of ARFID (sensory sensitivity, fear, low interest)- which are high individualized and vary hugely person to person.

Reduce anxiety and distress around food

Learn coping skills for trying new foods at a tolerable pace

Support the family system so parents don’t feel stuck in power struggles

Address shame, isolation, or social anxiety related to eating

An eating disorder therapist uses evidence-based approaches tailored to the individual’s needs. This might include cognitive-behavioral therapy (CBT-AR for ARFID), exposure therapy, family-based interventions, and mindfulness or self-compassion practices.

ARFID Treatment in Philadelphia and Across Pennsylvania

At Wildflower Therapy, our team of eating disorder specialists is here to support individuals and families navigating ARFID.

We offer:

In-person ARFID therapy in Philadelphia

Virtual ARFID treatment throughout Pennsylvania, New Jersey, Delaware, Florida, Vermont, South Carolina, Virginia, Massechusetts, and Ohio.

This means you can access care whether you’re local to the Main Line, or Philly, or living in any of those states mentioned.

We also understand that eating disorders rarely exist in isolation. If ARFID co-occurs with anxiety, depression, OCD, or neurodivergence, we’ll create a personalized treatment plan that addresses the whole person.

How Parents and Loved Ones Can Support Someone With ARFID

If you’re caring for someone with ARFID, you may feel worried, confused, or even helpless. Here are a few reminders:

Validate, don’t minimize: Even if ARFID looks like “picky eating,” it’s important to take it seriously.

Remove pressure: Forcing or bribing often increases anxiety around food.

Seek professional help early: The sooner ARFID is identified, the sooner support can begin.

Build a team: Look for an eating disorder therapist, dietitian, and medical provider who understand ARFID (and potentially neurodivergence).

You Are Not Alone

ARFID can feel isolating, but you don’t have to navigate it alone. Whether you’re a parent of a child with ARFID, a teen who feels misunderstood, or an adult realizing your eating struggles have a name, help is available.

At Wildflower Therapy in Philadelphia, we believe in compassionate, personalized care. We know that every individual’s relationship with food is unique, and we’re here to walk alongside you as you take steps toward healing.

Therapy for ARFID at Wildflower Therapy

If you’re looking for ARFID treatment in Philadelphia or across Pennsylvania, New Jersey, Delaware, Florida, Vermont, South Carolina, Virginia, Massechusetts, and Ohio. , our team of eating disorder specialists is here to help. We offer both in-person sessions in Philadelphia and virtual therapy statewide to make support accessible.

You deserve a relationship with food that feels safe, nourishing, and flexible. With the right care, healing from ARFID is possible.

Contact us today at Wildflower Therapy to learn more about our ARFID treatment options

Frequently Asked Questions About ARFID Therapy

What is the best treatment for ARFID?

The best treatment for ARFID typically includes therapy with an eating disorder specialist who understands ARFID. Approaches like CBT-AR (Cognitive Behavioral Therapy for ARFID), exposure-based work, and family involvement are especially helpful. At Wildflower Therapy in Philadelphia, our team specializes in ARFID treatment for children, teens, and adults.

Do you offer ARFID therapy near the Main Line (Villanova, Bryn Mawr, Ardmore)?

Yes! Wildflower Therapy offers in-person sessions at our Philadelphia office, which is easily accessible from Main Line towns like Villanova, Bryn Mawr, Ardmore, and beyond. We also provide virtual ARFID treatment throughout Pennsylvania for families and individuals who prefer online care. Both virtual and in-person therapy can be effective for folks with ARFID.

Can adults have ARFID?

Absolutely. While ARFID is often diagnosed in childhood, many adults also live with ARFID. We work with adults across Philadelphia and Pennsylvania who want to improve their relationship with food and reduce the stress ARFID causes in daily life.

Does ARFID therapy help autistic individuals?

Yes. ARFID frequently co-occurs with autism, ADHD, and other forms of neurodivergence. Our therapists collaborate with occupational therapists, dietitians, OTs, and medical providers to provide holistic, specialized care. For autistic individuals with ARFID, an eating disorder specialist is an important part of the treatment team.

Can I get ARFID therapy virtually if I live outside Philadelphia?

Yes! Wildflower Therapy provides virtual ARFID therapy across Pennsylvania, New Jersey, Delaware, Florida, Vermont, South Carolina, Virginia, Massechusetts, and Ohio.

How do I know if my child’s picky eating is ARFID?

While many kids go through phases of picky eating, ARFID is more extreme and often comes with anxiety, distress, or physical health impacts like poor growth, nutritional deficiencies, or weight loss. If you’re unsure, reaching out for an evaluation with us!