ARFID Treatment for Adults in Grand Rapids: Symptoms and Misdiagnosis
For many adults, eating has never felt simple or intuitive. Meals may bring stress instead of nourishment, and food choices can feel rigid, limited, or overwhelming. Yet for years, these struggles have often been dismissed as “picky eating,” anxiety, or a medical issue without a clear explanation.
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder that affects adults more often than many people realize. Because it does not involve body image or weight concerns, it frequently goes unnoticed—especially in adulthood. With the right diagnosis and specialized treatment, however, recovery and improved quality of life are possible. Compassionate, evidence-based ARFID treatment is available right here in the Grand Rapids area at Sanford Behavioral Health. Give us a call at 616.202.3326 today to get started.
Understanding ARFID in adults
ARFID is an eating disorder defined by ongoing restriction in the amount or variety of food a person eats. Unlike anorexia nervosa or bulimia nervosa, ARFID is not driven by concerns about weight, body shape, or appearance.
Instead, ARFID may develop due to:
- Strong reactions to taste, texture, smell, or temperature
- Fear or anxiety related to choking, vomiting, or getting sick
- Low appetite or a lack of interest in food
While ARFID is often identified in childhood, many individuals continue to struggle into adulthood or are not diagnosed until later in life. Adults with ARFID may appear to function “well enough” on the surface, but over time, restrictive eating can lead to poor nutrition, fatigue, or other health issues. They may unintentionally lose weight or struggle to maintain weight when their bodies need more nourishment.
ARFID is a real concern
Even though it’s not related to body image or weight on its surface, poor nutrition has health consequences. Being outside of healthy weight ranges or not eating a nutritious diet can lead to deficiencies. In turn, these can cause skin issues, mental health concerns like brain fog, brittle bones, heart problems, and a weakened immune system. The longer someone lives with ARFID without seeking help, the more impact it has on their health.
Common symptoms and signs of ARFID
Adults with ARFID might not have signs that look like stereotypical eating disorders. Instead, symptoms tend to affect daily functioning, health, and relationships rather than focusing on weight or appearance.
Physical and nutritional symptoms
- Unintentional weight loss or difficulty maintaining weight
- Nutritional deficiencies or abnormal lab results
- Ongoing fatigue, dizziness, or weakness
- Gastrointestinal discomfort without a clear medical cause
- Feeling full very quickly or avoiding meals altogether
Behavioral and eating patterns
- Reliance on a very limited list of “safe” foods
- Avoidance of entire food groups
- Strong need for foods to be prepared in very specific ways
- Skipping meals when preferred foods are unavailable
- Using supplements or shakes instead of eating a variety of foods
Emotional and social impact
- Anxiety before or during meals
- Fear of eating in social situations or restaurants
- Embarrassment or shame around eating habits
- Withdrawal from gatherings that involve food
Why ARFID is often misdiagnosed in adults
Many adults with ARFID spend years seeking answers before receiving an accurate diagnosis. This is not because the symptoms aren’t affecting their lives. Rather, it’s often because ARFID doesn’t always fit common expectations of what an eating disorder looks like.
Mistaken for “picky eating”
Restrictive eating that begins in childhood can be shrugged off as picky, even when it persists into adulthood. Adults may be told they are simply particular about food, rather than experiencing a condition that affects their health and functioning.
Misattributed to anxiety or gastrointestinal issues
Because ARFID frequently involves fear, anxiety, discomfort, or physical symptoms, individuals are often referred for anxiety treatment or extensive gastrointestinal testing. While these evaluations can be valuable, they may miss the underlying eating disorder if ARFID is not considered.
Overlooked due to weight bias
ARFID affects people of all body sizes. Adults who aren’t visibly underweight can still experience malnutrition, medical complications, and significant impairment, yet may not be screened for an eating disorder because of assumptions tied to weight.
Conditions that commonly co-occur with ARFID
Other mental health and/or neurodevelopmental conditions often co-occur alongside ARFID. This doesn’t mean one condition causes another, but it does mean that they can influence one another. Co-occurring conditions can also make treatment more complex, meaning a personalized treatment plan is usually the best way forward.
Common co-occurring concerns include:
- Anxiety disorders
- Obsessive-compulsive disorder (OCD)
- Trauma-related stress
- Attention-deficit/hyperactivity disorder (ADHD)
- Autism spectrum traits, particularly related to sensory sensitivity
Specialized ARFID treatment helps people manage both their eating disorder and any co-occurring conditions at the same time. That way, they can keep making progress after treatment and become more confident in making strides on their own.
How ARFID is diagnosed in adults
Diagnosing ARFID involves more than identifying restrictive eating. A thorough assessment examines how eating patterns affect a person’s physical health, emotional well-being, and daily functioning.
Diagnosis typically includes:
- Medical evaluation to assess nutritional status and rule out other conditions
- Psychiatric assessment to understand mental health history, co-occurring concerns, and behaviors
- Nutritional assessment to evaluate food intake, deficiencies, and eating patterns
Because ARFID is so complex, working with a treatment team that specializes in diagnosing and treating eating disorders is essential.
Effective treatment approaches for ARFID in adults
ARFID treatment focuses on helping adults feel safer, more flexible, and more nourished around food—without forcing change or using shame-based approaches.
Core principles of ARFID treatment
- Trauma-informed, compassionate care
- Respect for sensory sensitivities and neurodiversity
- Gradual, supported exposure to feared or avoided foods
- Focus on health, functioning, and quality of life rather than “normal” eating
Common treatment components
Treatment may include:
- Psychiatric oversight and medical monitoring
- Nutrition therapy with registered dietitians (with a focus on weight restoration if needed)
- Meal support in structured, therapeutic settings
- Exposure therapy to reduce fear and avoidance
- Coping skills for managing anxiety and distress around eating
- Family therapy for better understanding and support
ARFID treatment at Sanford Behavioral Health in Grand Rapids
At Sanford Behavioral Health, adults with ARFID receive care from our multidisciplinary, psychiatrist-led team experienced in treating eating disorders and co-occurring conditions.
Our approach includes:
- Psychiatrist-led medical care to support physical and mental health
- On-staff dietitians who specialize in eating disorder treatment
- Meal support and a clinical kitchen, helping patients practice eating in a supportive environment
- Exposure therapy, tailored to sensory sensitivities and fear-based avoidance
- Trauma-informed care to support better healing
- Recreation, movement, yoga, and art therapy to support overall well-being
Sanford Behavioral Health offers ARFID treatment in our outpatient eating disorder program. The outpatient program is a great, flexible option for many people since you can often keep your work, school, or family obligations with minimal changes to your schedule. Our center is just 12 minutes from downtown Grand Rapids via I-96 W off Exit 23. Get in touch with us today to verify your insurance coverage or to find out if ARFID treatment could be the right next step for you.
