Issue 6: Understanding ARFID: What Health Professionals Need to Know

3 Steps to help a client, patient, or loved one with ARFID

Welcome back to another issue of our therapist & allied professional newsletter!

We are hearing more and more about restrictive eating disorders—and today we want to highlight one that is not driven by body image: Avoidant/Restrictive Food Intake Disorder (ARFID).

Although often confused with “picky eating,” ARFID involves a significantly limited range of foods for reasons that go beyond preference.

🎥 Short Watch: ARFID Explained by Registered Dietitians: Signs, Causes & How to Support Recovery

Like all eating disorders, ARFID is a complex condition. It can occur at any age and may develop for several different reasons. Contributing factors may include:

• Fear of aversive consequences (e.g., nausea, vomiting, choking, or illness)

• Sensory sensitivity related to texture, smell, taste, or appearance

• Low appetite or reduced interoceptive awareness

•A combination of any of the above

In our practice, we frequently see overlap between ARFID and neurodiversity, although neurotypical individuals can absolutely experience ARFID as well.

The disorder becomes especially concerning when the restricted intake leads to weight loss, deviation from expected growth patterns, nutrient deficiencies, or significant interference with social functioning, relationships, or daily life.

Key Considerations in Assessment

Because ARFID has multiple possible root causes, it’s essential to explore the individual’s why before selecting interventions.

For example, supporting someone whose challenge is primarily sensory will require a different approach than supporting someone whose core struggle is fear of vomiting/getting sick from food.

Understanding the reason behind the restriction is foundational to building an effective treatment plan.

What Are the Best Steps When Supporting Someone With ARFID?

1. Assess overall adequacy of intake

Before addressing variety, ensure the individual is eating enough to maintain health, weight stability, and energy needs.

Consider:

• Are they eating often enough?
• Are they able to eat enough volume at one time?
• Are they able to tolerate sensation in their stomach and body from eating without worry?
• Has their weight been stable, or is their growth continuing along their expected growth curve?

Bottom line: Before expanding variety, we must first support “enoughness.”

2. Explore their underlying “why”

Understanding the client’s motivation makes treatment more collaborative and targeted.

Ask:

• Do they want to put on weight or gain strength?
• Are there nutrient deficiencies that they want to resolve?
• Do they want to be able to eat at a restaurant or go on a date without worrying about the food options available?
• Do they want to feel more comfortable just being around food?

This might mean we “food chain” toward common social foods (e.g., pizza or ice cream) long before we introduce more nutrient-dense options like vegetables.

3. Create readiness and bite-sized steps toward change

Once motivation is clarified, we can begin gradual, structured exposure through bite-sized steps toward change.

• Start with a familiar and tolerated food, then make small, predictable modifications.
  • For example, if a client enjoys raspberry yogurt, you might try:
    • Vanilla yogurt with raspberry jam →
    • Yogurt with mashed raspberries →
    • Yogurt with whole raspberries.
  • If the client tolerates chicken nuggets:
    • Explore different brands →
    • Move to chicken strips →
    • Transition to homemade versions

Important: When we are supporting change, please be very careful not to fall into the trap of forcing food. For individuals with ARFID, fear-based reactions are real. Pressure can increase anxiety, escalate conflict, and worsen the person’s relationship with food.

How Therapists Can Support Clients with ARFID

Therapists can play a vital role by helping clients explore their “why,” build interoceptive and emotional awareness, and understand the treatment process.

Let clients know there are evidence-informed strategies and multidisciplinary supports—often including dietitians, psychologists, and sometimes occupational therapists—that can help expand food variety and improve overall functioning and quality of life.

Providing education about what ARFID is (and is not) helps clients feel validated and better prepared for treatment.

Explore related articles:

Keep learning about ARFID through these articles and feel free to share them with clients:

Thank you for joining us for this issue of Nutrition for Mental Health. We always value your perspective. Feel free to reply with any thoughts, questions, or experiences you’d like to share

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