ARFID, Picky Eating, Anorexia, and Other Eating Disorders

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If you or your loved one suffers from an eating or body-image disorder, we can help. We treat the full spectrum of eating disorders and body-image issues, including anorexia nervosa, bulimia nervosa, binge eating, selective eating disorder (SED) -- also known as picky eating or avoidant/restrictive food intake disorder (ARFID), and obesity. Our personalized treatment approach takes into account your personal issues and challenges, as well as your experiences within your family and community. Our experience shows that families come away stronger when they participate in their loved one’s treatment. 

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Assessments

We conduct several evaluations to determine the best course of treatment.

Psychological Interview and Consultation

We gather a detailed health history and work with you to identify the goals of your treatment.

Questionnaires

Your answers to our questions help us assess the severity of your symptoms and other factors that may affect your treatment, including your personality, stress levels, social functioning, and coping skills.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Treatments

After gathering information about your history and goals, we tailor a plan to help you develop healthy eating habits. We realize that not every patient responds to every type of therapy. Our doctors and therapists identify the best method to improve your relationship with food.

Mindfulness-Based Cognitive Behavioral Therapy

Combines advances in cognitive-behavioral treatment with mindfulness-based approaches. This helps you learn to be more aware and accepting of ongoing joyous and aversive experiences so that life becomes more vital from moment to moment. We’ll also help you develop problem-solving and meal-planning skills and explain the importance of food diaries.

Dialectical Behavioral Therapy

Emphasizes how you experience and respond to your emotions. You’ll learn how to keep your emotions in check, become more mindful, and improve your interpersonal skills. The goal of this therapy is to reduce the symptoms that trigger your eating disorder.

Acceptance and Commitment Therapy

We encourage you to notice and accept unwelcome thoughts and feelings that contribute to disordered eating rather than trying to control or block them. We also work with you to help you identify your personal values so you can find greater meaning in life.

Accelerated Experiential Dynamic Psychotherapy

Builds on what is known about physiological changes that occur with the experience of traumatic life events. By helping you to activate the restorative branch of your nervous system in the presence of aversive remembrances, you will be taught to more fully experience the full range of emotions rather than being closed off due to past traumatic events.

Interpersonal Therapy

We help you build and maintain quality relationships with family members, friends and co-workers, all of who help to reduce the symptoms of your eating disorders.

Family-Based Eating Disorder Treatment

We believe it’s important to involve your social support network in your treatment. Your family members will be part of the support team that helps you restore your health.

Group Eating Disorder Treatment

Group support can be invaluable in regaining your footing, whether you or your loved one is struggling with an eating disorder. We offer several ongoing skill-focused group treatments. Some are geared for adults and adolescents with eating disorders, and others for parents and spouses of patients.

Nutrition Therapy

Essential to restoring healthy eating habits, nutrition therapy starts with a one-on-one evaluation with a registered dietitian who assesses your current eating habits and designs a program tailored to your specific needs. We design meal plans to establish a healthy and balanced diet, taking into account your preferences, schedule, and metabolic needs.

Food and Mood Program

Understanding how certain foods affect your mood and emotions can help you make better food choices. We help you increase your awareness of the complex interaction between foods and mood through the use of cell phone apps and biological measurements, such as your blood sugar and stress hormone levels.

Picky or Selective Eating Services

We are at the forefront of care for this newly recognized eating problem, where children and adults severely restrict the types of food they eat or reject foods on the basis of taste, texture, or sensory quality. This eating pattern can lead to inadequate nutrition, family conflict, and social isolation. If you are affected by selective eating, you will learn skills that help you manage fears of necessary foods.

Call for an Appointment

Why Choose Duke

A Team Approach to Treatment
You’ll work with doctors and therapists from many specialties, including psychiatrists, gastroenterologists, endocrinologists, psychologists, social workers, physical therapists, and nutritionists. We also work closely with specialists throughout Duke Health to provide care for people with complex conditions often associated with eating disorders, such as diabetes, celiac disease, polycystic ovarian syndrome, digestive disorders, and endocrine disorders.

Nationally Recognized Experts
We have decades of experience in improving our patients’ health and eating habits. Our pioneering program for adult picky eaters has been featured in Time magazine and ABC-TV's Nightline

Selective Eating Disorder Treatment and Support
Treatment for extreme picky eating, often referred to as selective eating disorder and now officially recognized as Avoidant/Restrictive Food Intake Disorder (ARFID), is offered to children and adults who live near Duke. Add your name to our mailing list and learn more about our additional treatment options, including immersion programs and parent workshops

A Holistic Approach
We believe treatment should take into account your personal issues and challenges, as well as your experiences within your family and your community. Our methods are aimed at addressing all the factors that affect your body image and eating patterns.

Family Support and Training
We know the important role your family plays in your well-being. We offer parent-training groups and weekends, as well as sibling and spouse support.

Access to Clinical Trials
You may be eligible to participate in studies designed to better understand -- and explore new treatments for -- eating disorders, including picky eating in adults. For more information, please email Kristen.Caldwell@duke.edu.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 10 pediatric specialties by U.S. News & World Report for 2024–2025.