What is ARFID?
ARFID (Avoidant/Restrictive Food Intake Disorder) is an eating disorder that involves significant restriction of what or how much a person eats. It is often driven by sensory sensitivity, fear of aversive consequences (e.g., choking, vomiting), low interest in eating, or some combination. It is a chronic condition that often co-occurs with anxiety, autism, ADHD, and OCD, and requires specialized treatment.
Specialized training
I have formal training in the three protocols with the strongest current evidence base for ARFID:
- CBT-AR (Cognitive Behavioral Therapy for ARFID), developed at Massachusetts General Hospital - the most established structured treatment for ARFID across age groups.
- SPACE-ARFID (Supportive Parenting for Anxious Childhood Emotions, adapted for ARFID), developed at Yale - a parent-based approach for children where direct work is not the right fit.
- FBT-ARFID (Family-Based Treatment for ARFID), adapted from the gold-standard FBT protocol - a parent-empowered model with multidisciplinary coordination.
Clinical approach
Because ARFID varies widely from person to person, treatment is tailored to meet individual needs. Treatment begins with a comprehensive assessment including history, current maintaining factors, prior interventions, co-occurring conditions, and the specific drivers of restriction. From there, treatment may include all or some of the following:
- Structured exposure-based work with the individual using CBT-AR
- Parent-based intervention using SPACE-ARFID when direct work with the child is not indicated or has not been productive
- Family-based treatment (FBT-ARFID) with active parent involvement at meals
- Integrated approaches drawing on anxiety treatment
Where appropriate, I coordinate with pediatricians, psychiatrists, occupational therapists, and registered dietitians.
Who I see
- Children and adolescents with ARFID
- Adults with ARFID
- Families managing selective eating that does not meet full ARFID criteria but is significantly impairing
- Clients who are medically stable
I do not treat clients who are underweight, losing weight, or otherwise medically unstable. Those presentations may need a higher level of care, and I'm glad to provide referrals.
Because ARFID often co-occurs with anxiety and OCD, treatment may also draw on approaches I use for those conditions. See anxiety & OCD for more.