ARFID in adults: when eating has been hard for as long as you can remember.

Plenty of adults have eaten the same handful of foods for as long as they can remember. They plan the week around what will be on the table, eat before they go out, and quietly dread the work lunch, the wedding, or dinner with a new partner’s family. Some of them have never heard the word ARFID. They’ve just heard “fussy” for thirty years.

What ARFID can look like in an adult life

ARFID stands for avoidant/restrictive food intake disorder. It’s restrictive eating that isn’t about body shape or wanting to lose weight. In adults it often shows up as:

• a small set of safe foods you rely on, and real distress when they aren’t there
• the same breakfast or lunch for years, because it’s predictable
• a strong fear of choking, gagging or being sick, often after one bad experience
• food that never feels very interesting, so eating becomes a job you forget to do
• saying no to invitations, travel or dates because of what you might be asked to eat
• tiredness, low energy, or a nutrient your GP keeps finding low

Usually one of three things is driving it, or a mix: how food feels to your senses, fear of what could happen when you eat, or simply low interest in eating. Working out which one is doing the heavy lifting matters, because the support is different for each.

Why it gets missed in adults

If you grew up being called a picky eater, you probably learnt to manage it without anyone noticing. You order the same thing, you eat beforehand, you have a line ready for when someone comments. Adults get very good at hiding this.

It also gets missed because people expect an eating disorder to be about weight and appearance. ARFID can happen at any body size, and many people with it have no wish to change their body at all. So it doesn’t match the picture a lot of people, including some health professionals, have in their heads.

What ARFID therapy involves

We start with what already works. Your safe foods are how you stay fed and steady. We protect them first, and nobody takes anything away.

We work out what’s driving it. Senses, fear, low interest, or some of each. That shapes everything that follows.

Change happens at your pace, and only where you want it. If there are foods you would like to be able to eat, for your health, your social life or your own reasons, we work towards them in small steps you choose. There is no “just one bite”.

We make room for a bigger life around food. Some of the work is about food itself. Some of it is about the meeting, the holiday or the relationship that food has been quietly shrinking, and what matters enough to you to work towards.

We bring your GP in where it helps. ARFID can affect nutrition, so a GP, and sometimes a dietitian, are part of good care. I work alongside them, with your consent.

Do I need a diagnosis to start?

No. You don’t need a diagnosis, or to be sure this is ARFID, to book. Many adults start because something has finally become too hard to manage alone: a new job, a relationship, a health scare, or just being tired of planning everything around food.

With a Mental Health Treatment Plan from your GP you can be eligible for a Medicare rebate of $89.50 a session, on up to 10 sessions a calendar year. You can also start privately with no referral and add a plan later, with rebates from that point on. Sessions are by telehealth anywhere in Australia, with in person times in Perth being planned.

Working with me

I’m Lauren Lynch, an Accredited Mental Health Social Worker and ANZAED Credentialed Eating Disorder Clinician. ARFID is a core part of my work, with adults, teenagers and children. Read more about ARFID therapy for children, teens and adults, or about eating disorder therapy in Perth and by telehealth. If you’re wondering about Medicare, the Eating Disorder Plan, explained walks through how the plans work. If ADHD is part of the picture too, read ARFID and ADHD.

This article is general information, not therapy or a diagnosis. If you’re worried about your eating or nutrition, please speak with your GP.