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Unlocking Progress: Exposure and Response Prevention Therapy (ERP) for Food Avoidance: Strategies for Exposing ARFID Sufferers to New Foods

Updated: Apr 8

Avoidant/Restrictive Food Intake Disorder (ARFID) is defined as a pattern of eating that is limited in variety and quantity of food (Thomas, J. J., & Eddy, K.,2019a), and it poses unique challenges for individuals struggling with it because it tends to lead to disordered eating patterns and is associated with important medical and psychological consequences. Characterized by an aversion to certain foods, ARFID can severely impact one's quality of life and nutritional health. However, with strategic interventions and patience from a specialist and their family, individuals with ARFID can gradually expand their food repertoire and regain a healthier relationship with food and the process of eating. In this blog post, we'll explore effective strategies that are used by professionals to expose children and adults with ARFID to new foods, fostering a journey towards food acceptance and improved well-being.


ARFID is a complex eating disorder characterized by a persistent disturbance in eating or feeding that results in failure to meet appropriate nutritional and/or energy needs. Individuals with ARFID may avoid certain foods based on sensory characteristics such as taste, texture, smell, or appearance, or due to concerns about aversive consequences such as choking, vomiting, or gastrointestinal distress. ARFID goes beyond mere "picky eating"; it involves a deep-seated fear, discomfort and/or disgust with certain foods, often driven by sensory sensitivities, anxiety, traumatic episodes, or other psychological factors. This disorder can manifest in various ways, from avoiding entire food groups to restricting intake due to fears of choking or gastrointestinal distress.


Below are some food exposure strategies that may be helpful for individuals with ARFID:


  1. Gradual Exposure: Gradual exposure involves gradually introducing new or avoided foods in a systematic and controlled manner. This is done by creating a hierarchy of food exposures starting with small, non-threatening portions of the food and gradually increasing the amount over time. This approach allows individuals to become more comfortable with the sensory aspects of the food and reduces anxiety associated with trying new foods.

  2. Desensitization Techniques: Desensitization techniques involve gradually exposing individuals to the sensory aspects of the avoided food in a controlled environment. This may include activities such as touching, smelling, or observing the food without the expectation of eating it. Over time, individuals may become less sensitive to the sensory aspects of the food, making it easier to try.

  3. Positive Reinforcement: Providing positive reinforcement and encouragement is used to motivate individuals to try new foods. This can include praise, rewards, or other incentives for engaging in food exposure activities and trying new foods, even if they are only able to take small steps initially.

  4. Modeling and Social Learning: Providing a safe environment and modeling appropriate eating behaviors and attitudes toward food is key in the process of healing. The therapist completes the exposures with the client and encourages the individual to observe others eating and enjoying the avoided food which can help normalize the experience and reduce anxiety. Social learning techniques such as peer modeling or group exposures are effective in promoting food acceptance.

  5. Exposure Hierarchy: Creating an exposure hierarchy involves ranking avoided foods based on level of difficulty or anxiety associated with trying them. Individuals can then work through the hierarchy at their own pace, starting with easier foods and progressing to more challenging ones as they become more comfortable.

  6. Cognitive-Behavioral Techniques: Cognitive-behavioral techniques such as cognitive restructuring, relaxation techniques, and coping skills training help individuals manage anxiety and challenging thoughts related to trying new foods. These techniques are used in conjunction with food exposure exercises to enhance effectiveness.

  7. Multisensory Approaches: Engaging multiple senses during food exposure activities help individuals become more comfortable with the sensory aspects of the food. This includes activities such as cooking or preparing the food, tasting small portions, and exploring the texture, color, and smell of the food.

It's important for individuals with ARFID to work with a therapist and/or registered dietitian specialized in treating eating disorders to develop a personalized treatment plan that addresses their specific needs and challenges. This may include a combination of the strategies mentioned above, tailored to the individual's health status, needs, preferences, and goals.


Overcoming ARFID requires patience, persistence, and a comprehensive approach tailored to individual needs. By implementing targeted food exposure strategies, individuals can gradually expand their dietary repertoire, reclaiming enjoyment and autonomy in their eating habits. With professional guidance and unwavering support, the journey towards food acceptance becomes an empowering step towards improved health and well-being.


Recognizing the early signs of eating disorders is critical for early intervention and successful treatment. If you or someone you know is exhibiting any of these warning signs, please contact us today at info@homeforbalance.com or at 561.600.1424 for a FREE 30-minute consultation! With early intervention and appropriate support, individuals struggling with eating disorders can embark on the path to recovery and reclaim their health, body, and well-being. Remember, you are not alone, and help is available.


For more information about eating disorders, please refer to the checklist below:


Noticing ED the Signs and Symptoms
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References:


Thomas, J. J., & Eddy, K. (2019a). Cognitive-behavioral therapy for avoidant/restrictive food intake disorder: Children, adolescents, and adults. Cambridge University Press.


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