Maybe your child only eats a small number of foods or reacts strongly to certain textures. Perhaps your meals feel stressful, or eating just doesn’t come easily. If that sounds familiar, you’re not imagining it, and you’re not alone. For some people, these patterns are part of an eating disorder called avoidant/restrictive food intake disorder (ARFID). But what causes ARFID?

Like all eating disorders, ARFID doesn’t have a single cause—it typically develops from a mix of biological, environmental, and psychological factors. One thing that makes ARFID different, though, is that it isn’t driven by body image or a desire to lose weight. It’s often shaped by things like sensory sensitivities, differences in appetite, and fear or anxiety around eating.

If you are reading this after a hard night, or in the quiet that comes after a binge, I want you to know that you are not alone. I have sat with so many clients who described that same feeling, the deep exhaustion of making the same private promise over and over and watching it slip away again. I have sat with clients who carried this for years before they ever said the word “binge” out loud to anyone, certain that the problem must somehow be them. I want to say plainly, to you, that binge eating is not a failure of willpower, and it is not a sign that something is wrong with who you are. Binge eating responds to understanding, gentle work, and the right kind of support. Over time with these solid things in place, it can genuinely start to shift. This guide is here to help you make sense of what you have been living with, and to point toward what actually helps.

If you have felt afraid of food your entire life, or avoided food centered events, you might be navigating something more than picky or restrictive eating. Feeling afraid of food or avoiding social situations can have a much deeper root than you realize. I have sat with clients bravely sharing how certain textures or foods make them feel immobilized and afraid. I have sat with clients whose fear of vomiting has prevented them from eating and taking deep breaths in years. All of these clients express a fear that something is broken within them. You might have wondered what is different about your relationship with food, and this guide is here to help you understand more about ARFID. ARFID is real, it is recognized, and it is treatable at any age.

Lily is the founder of Thrope Therapy, a boutique group practice in Midtown Manhattan specializing in eating disorders, body image, and related concerns. She is a licensed clinical social worker and certified intuitive eating counselor, and the founder of the Recovery Supper Club, a free monthly dinner gathering for people in recovery in New York City.

Adolescence is genuinely a complicated time for food and bodies. Teenagers are undergoing real physiological changes. They are developing their own identities and testing independence, including around food choices. They are swimming in a social media environment that is saturated with diet culture, fitness content, and body commentary. Some food experimentation and self-consciousness about appearance is developmentally typical. This makes it genuinely hard to know when something has shifted from normal teenage behavior into something that warrants real concern. The line is not always obvious, and teenagers are often skilled at minimizing what is happening, whether or not they are doing so consciously.

In New York City, most therapists list eating disorders as one of many things they treat. You will find eating disorders alongside anxiety, depression, relationship issues, life transitions, and trauma on the same profile. That is not necessarily a red flag. A therapist can genuinely work well with a client whose eating disorder co-occurs with depression or anxiety. What matters is whether eating disorders are a genuine clinical focus, not just a checkbox. And there are ways to tell the difference.