Eating Disorder Awareness Month

When you hear “eating disorders,” what is the image that pops into your mind? Perhaps it is the image of an extraordinarily thin young woman who works out excessively. Or perhaps a teen girl who picks at her food and runs to the bathroom during meals. But these images only tell one story out of many. This Eating Disorder Awareness month, I want to highlight the most misunderstood eating disorder.

What Are Eating Disorders?

So, what are eating disorders? Eating disorders are complex mental health conditions that are influenced by biology, psychology, and social environment. There are many different types of eating disorders, from restrictive-based eating disorders like Anorexia Nervosa and ARFID, to bingeing disorders like Bulimia Nervosa and Binge Eating Disorder.

Those with anorexia typically have a strong fear of gaining weight, a distorted body image, and restrict their food intake. Bulimia and BED include binging, with the added aspect of compensatory behaviors (purging) with bulimia. Eating disorders do not have one look, and they do not discriminate. All eating disorders are serious and can cause the individual real harm. 

Eating disorders affect people of all genders, races, body sizes, and socioeconomic backgrounds - not just thin, white, teenage girls. Many individuals with eating disorders reside in average-sized or larger (fat) bodies, which can delay diagnosis and treatment due to stigma and bias.

So what is missing from this list? Avoidant/Restrictive Food Intake Disorder (ARFID) affects millions of people each year.

What Is ARFID?

Avoidant/Restrictive Food Intake Disorder was added to the DSM-5 in 2013. ARFID is a restriction-based feeding and eating disorder. Many refer to it as “extreme picky eating,” but ARFID goes beyond simple preferences. ARFID is not about weight, body image, or a sense of control, but rather a restrictive disorder distinct from Anorexia. Unlike other eating disorders, ARFID is not driven by weight, shape, or body image concerns. These individuals avoid foods due to sensory concerns, a lack of interest in food, low appetite, and/or a fear of adverse consequences.

Sensory sensitivities to texture, temperature, smell, or appearance can strongly influence food avoidance. For some individuals, ARFID develops after a frightening experience such as choking, severe GI distress, or vomiting, leading to an intense and persistent fear of eating certain foods. And in others, experience a chronically low appetite or a general lack of interest in food, often forgetting to eat or feeling indifferent toward meals altogether. It is common to have more than one of these informing food avoidance in ARFID.

ARFID is not caused by stubbornness, defiance, or “picky eating gone too far” and affects children, teens, and adults of all ages. Picky Eating can be developmentally appropriate between the ages of 2 and 4. This can look like eating 30 or more foods and at least 1 food from most groups.  In children, ARFID often overlaps with pediatric feeding disorder (PFD), a developmental feeding concern that is affected by medical, psychosocial, feeding skill, and nutritional challenges, as well as commonly occurring alongside medical, neurological, developmental, and mental health concerns like Autism, anxiety, and OCD. Shame and misunderstanding often prevent individuals and families from seeking help. In teens and adults, ARFID is often accompanied by a traumatic event regarding food, though this is not a requirement for diagnosis. Shame and misunderstanding often prevent individuals and families from seeking help. 

Treating ARFID

Eating disorders have one of the highest mortality rates of any mental health condition, and early intervention significantly improves recovery outcomes. If left untreated, ARFID can cause health concerns like malnutrition, gastrointestinal issues, and cardiovascular problems. ARFID can lead to nutritional deficiencies even when someone appears to be eating “enough.” Luckily, recovery is possible! ARFID is best treated with CBT-AR. CBT-AR combines the concepts of Cognitive Behavioral Therapy (CBT) with Exposure Response Prevention (ERP) and the Sequential Oral Sensory Approach to Feeding (SOS). By taking a sensory-based approach with psychotherapeutic techniques, we can provide a more holistic treatment for those with ARFID.

In children, other feeding techniques such as Occupational Therapy and Speech Therapy are also recommended in order to treat the whole person. While more research needs to be done, it stands to reason that adolescents and adults would also benefit from these interventions. All ages may benefit from medical and nutrition counseling (best done by a Registered Dietitian, rather than a ” nutritionist”) as well as a more well-rounded treatment team. Family support and psychoeducation play a crucial role in recovery, especially for children and adolescents.

Expanding Empathy This Awareness Month

Eating disorders are not trends, phases, or a diet gone too far, and ARFID is no exception. ARFID is real, serious, and deserving of care, compassion, and evidence-based treatment. Just because it does not center around weight or body image does not make it less severe. The medical, nutritional, and psychosocial consequences are significant, and the distress individuals and families experience is valid!

This month, let’s expand our understanding. Learn about eating disorders beyond the stereotypes. Share accurate information. Challenge misconceptions when you hear them. Speak up when someone dismisses ARFID as “just picky eating.” The more we educate ourselves and others, the more we create space for earlier identification, better support, and meaningful recovery.

Awareness saves lives - all of them!

For more information and resources, check out these websites:

The Alliance for Eating Disorders: 

https://www.allianceforeatingdisorders.com/

Feeding Matters:

https://www.feedingmatters.org/ 

Looking for treatment?

Speakeasy is equipped to treat eating and feeding disorders. Christina Munro (our resident feeding and eating disorder specialist) will be running a parent group about picky eating, pediatric feeding disorder, and ARFID beginning at the end of February 2026. Christina has both professional and lived experience in the field, and thoroughly enjoys treating all feeding and eating disorders. Email info@speakeasytherapyco.com for more information.

Christina