ARFID in Adults: Symptoms, Risks, and Treatment Options

If you’ve spent years feeling “picky,” anxious at mealtimes, or stuck with a very short list of foods you can tolerate, you might wonder if something more is happening. Avoidant/Restrictive Food Intake Disorder, or ARFID, is an eating disorder that can affect adults of every gender, body size, and background. Unlike other eating disorders, ARFID is not driven by body image concerns or fear of weight gain. Instead, it often stems from sensory sensitivities or fears of negative experiences related to eating, like choking, nausea, or pain. For many, these patterns serve as a way to calm the nervous system and avoid distressing experiences. Understanding ARFID can be the first step toward finding relief and building a more flexible, peaceful relationship with food.

What is ARFID?

Avoidant/Restrictive Food Intake Disorder (ARFID) is recognized in the DSM-5 as a feeding and eating disorder that affects people across all age groups, including adults. An accurate diagnosis is essential for receiving the right treatment and avoiding confusion with other eating disorders, so care can truly address your unique needs.

Clinically, ARFID involves a persistent inability to meet nutritional and energy needs, which leads to medical complications or psychosocial challenges. Unlike anorexia nervosa and similar disorders, ARFID is not driven by body image concerns. Instead, it often stems from sensory sensitivities, fear of negative experiences like choking or vomiting, or a very low interest in eating.

Although ARFID lacks the element of body dissatisfaction, it is very much a real eating disorder that can significantly impact daily life. It may interfere with social experiences, limit time with family and friends, and prevent you from doing things you wish you could.

Historically considered a feeding disorder of infancy or early childhood, growing research and awareness have led to ARFID being recognized in adults as well. This shift has opened the door for people to receive the help they need, without being dismissed as “just picky.”

At NewCircle in Birmingham, Alabama, ARFID in adults is one of the conditions the team supports through Residential, Partial Hospitalization (PHP), and Intensive Outpatient (IOP) programs for teens and adults. Care is trauma-informed, identity-affirming, and centered on creative, community-based healing.

ARFID is more than “picky eating”

People with ARFID significantly limit the amount or variety of food they eat, often because of sensory discomfort, fear of aversive consequences, or very low interest in eating. Some may not be able to explain why certain foods feel unacceptable; they just know something doesn’t “feel right.” Unfortunately, ARFID is often dismissed as “not that serious” or confused with picky eating, which can lead to delayed diagnosis and treatment.

Food preferences are normal and shift throughout life experiences, but ARFID is not just pickiness. It can negatively impact health, growth, and social and emotional well-being.

ARFID can look like:

• Strong avoidance of foods with certain tastes, textures, temperatures, smells, or visual qualities
• Avoidance of foods due to negative associations or traumatic experiences
• Fear of choking, gagging, vomiting, or a medical reaction that drives ongoing restriction
• Very low interest in eating, muted hunger cues, or feeling full very quickly
• Changes in health, mood, work, or relationships because intake is so limited

These patterns can start in childhood and continue into adulthood, or they can begin after a medical event, trauma, or a period of intense stress. Unlike picky eating, ARFID involves more severe food restriction and avoidance of certain foods, often leading to significant health impacts.

How common is ARFID in adults?

Research on ARFID in adults is still emerging. A 2023 study of over 50,000 adults who completed the National Eating Disorders Association online screening tool found that 4.7% screened positive for probable ARFID. Most available data comes from outpatient treatment settings, and future research, including randomized clinical trials, is needed to better understand the disorder and treatment outcomes.

ARFID can occur across the lifespan, in all body sizes, races, and genders, and may be more common among people with gastrointestinal or neurodevelopmental conditions.

If you have been wondering, “How common is ARFID in adults?”, the short answer is that it is more widespread than many people realize. You are not alone.

If these patterns sound familiar, you can have a low-pressure conversation with the NewCircle team by calling (205) 848 4514 or sending a confidential message through ourcontact form. You deserve support that meets you with calm, not judgment.

ARFID in adults symptoms you might notice

Many adults minimize what they’re experiencing, saying things like, “I’m just picky” or “I’m overreacting.” Naming ARFID symptoms can help you see the full picture and decide if specialized care might help. These symptoms often overlap with anxiety, obsessive-compulsive symptoms, ADHD, autism traits, and trauma histories, which can make diagnosis complex.

Common ARFID symptoms include:

• Sensory sensitivity that keeps your intake very limited
• Fear of choking, gagging, vomiting, or severe medical reactions
• Low interest in eating, rare hunger, or losing interest after only a few bites
• Health and energy changes, such as fatigue, dizziness, feeling cold, or nutrient deficiencies
• Anxiety in situations that involve eating and conflict or misunderstanding in relationships

It may be time to seek support if you notice lightheadedness or fainting, frequent illness, exhaustion that makes daily responsibilities hard to manage, or a sense that life has become smaller to avoid eating situations.

What causes ARFID in adults

ARFID often reflects a mix of biological factors, nervous system sensitivity, and lived experience:

• Sensory sensitivities: Certain textures, smells, or temperatures may feel overwhelming or threatening, leading to a very short list of “safe” foods. These patterns are more common in people with autism or sensory processing differences.
• Distressing events: ARFID can develop after choking, severe gagging, intense vomiting, or medical procedures involving eating or swallowing. The brain learns to associate eating with danger long after the event has passed.
• Low appetite or muted hunger cues: Some adults describe very low interest in eating or early fullness, which may relate to interoception, or the ability to sense internal states like hunger and fullness.

ARFID often appears alongside anxiety, OCD symptoms, ADHD, autism traits, and trauma histories. Importantly, ARFID is not a personal failing. Responsive feeding therapy and other approaches can help create a low-stress mealtime environment and rebuild trust in eating.

Health and emotional risks linked to ARFID

ARFID in adults can exist in any body size, so serious medical and emotional risks sometimes get missed, especially when weight or labs look typical at a glance. But physical risks can occur across the range of body sizes.

Possible physical risks include:

• Difficulty maintaining a stable weight that is right for your body
• Nutritional deficiencies, including low iron, B vitamins, or other micronutrients
• Dizziness, fainting, low blood pressure, or feeling cold much of the time
• Impaired bone health and a higher risk of fractures over time

Emotionally, ARFID can lead to isolation, anxiety, and distress. Many adults report that their mood and relationships are impacted by their ARFID, dreading invitations that involve eating, feeling embarrassed or “too much” for others, and feeling exhausted by having to plan life around safe options. Studies show that people with ARFID often experience significant psychological strain, yet many are not in treatment.

If you are wondering what healing could look like, you can explore ARFID in adults treatment options at NewCircle by calling (205) 848-4514. You can ask questions, share your story, and move at a pace that feels respectful.

Treatment Options at NewCircle

There is no single path for ARFID treatment, but research and lived experience highlight approaches that can be effective and compassionate. At NewCircle, care blends therapy, skills practice, and nutrition support.

With your therapist, you’ll build coping skills for anxiety and distress while actively addressing avoidance patterns. Exposure work happens throughout programming, giving you the chance to apply these skills in real time. Our dietitians partner with you to set goals for consistent intake and gradual variety expansion, helping correct nutrient deficiencies and move toward food freedom.

These approaches are available across NewCircle’s continuum of care for ARFID through Residential, PHP, and IOP programs for teens and adults.

Across all levels, ARFID treatment at NewCircle is guided by an individualized treatment plan developed in collaboration with mental and medical professionals. The treatment plan may include goals related to weight gain, nutritional stabilization, and improving physical health, as well as increasing food variety and reducing anxiety around eating. ARFID treatment can include individual and group therapy, skills-focused groups, collaborative nutrition work, family and community education, and creative or movement-based therapies. Time with therapy dog companions can also help many people feel more regulated and confident during exposures and meals.

If you are curious about how NewCircle could support you or someone you love with ARFID, you can reach out today at (205) 848-4514. You can share what life has been like and explore options together.

When you are ready to explore treatment for ARFID in adults

If you recognize yourself in these descriptions of ARFID in adults, you are not broken, and you are not alone. Care can be paced, collaborative, and aligned with your values. It can honor the ways you have been trying to stay safe, while helping you build a wider, more stable life.

NewCircle provides ARFID treatment in Birmingham, Alabama, for teens and adults who are ready for more support. To learn more, you can call (205) 848 4514 or message us through our contact form. You deserve a circle of care that believes in your healing.

Sources:

• American Psychiatric Association. (2013). Feeding and eating disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Eating-Disorders.pdf
• American Psychiatric Association. (2022). Avoidant/Restrictive Food Intake Disorder (ARFID).https://www.psychiatry.org/getmedia/8bcf8b72-f3cc-403c-9cfb-5c89e086d5db/APA-DSM5TR-AvoidantRestrictiveFoodIntakeDisorder.pdf
• D’Adamo, L., Anderson, L. M., Kinasz, K., & Becker, K. R. (2023). Prevalence, characteristics, and correlates of probable avoidant/restrictive food intake disorder among adult respondents to an online eating disorder screening tool. Journal of Eating Disorders, 11, 158.https://doi.org/10.1186/s40337-023-00939-0
• Nicholls-Clow, R., Simmonds-Buckley, M., & Waller, G. (2024). Avoidant/restrictive food intake disorder: Systematic review and meta-analysis demonstrating the impact of study quality on prevalence rates. Clinical Psychology Review, 114, 102502.https://doi.org/10.1016/j.cpr.2024.102502
• Ramirez, Z., & Kerner, N. A. (2024). Avoidant restrictive food intake disorder. In StatPearls [Internet]. StatPearls Publishing.https://www.ncbi.nlm.nih.gov/books/NBK603710/
• National Institute of Mental Health. (2024). Eating disorders: What you need to know (NIH Publication No. 24 4901).https://www.nimh.nih.gov/health/publications/eating-disorders
• National Eating Disorders Association. (n.d.). Avoidant/Restrictive Food Intake Disorder (ARFID).https://www.nationaleatingdisorders.org/avoidant-restrictive-food-intake-disorder-arfid/