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. Our personalized treatment approach is based on your personal experiences and challenges. We emphasize the crucial role of social support and include families in our treatment plan when appropriate and possible. Our experience shows that families grow stronger when participating in their loved one’s treatment.

Conditions We Treat

We treat conditions in which one’s fear, disgust, or guilt about food or eating gets in the way of living a safe, healthy, and vibrant life. We also treat conditions where there is a distrusting, disconnected, or negative relationship with one’s body or body image. For some, struggles with food and the body cause difficulties in living a safe and fully free life. Disorders we treat include anorexia nervosa, Avoidant/Restrictive Food Intake Disorder, bulimia nervosa, picky eating, and binge eating disorder.

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Assessments

We conduct several evaluations to determine the best course of treatment. Then we present a plan – also called a case formulation – in which we collaborate with you to develop a shared understanding of your symptoms and what factors may be contributing to them. From this, we map out a treatment plan. We collect measures of your symptoms along the way to ensure our plan is working and we adjust as needed.

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. These assessments continue throughout your treatment so we can ensure they help you reach your goals and inform providers about changes that may be needed in your treatment.

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

This combines advances in cognitive-behavioral treatment with mindfulness-based approaches. It 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 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 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 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 learn to 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.

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.

We provide Feeling and Body Investigators – ARFID Division, a treatment developed at Duke and tested in a trial by the National Institutes of Health. Children learn to treat their sensitivities as a superpower that helps them enjoy vibrant life experiences – including experiences that involve food.

Picky eating in kids can cross a line into an unhealthy fear of food. A new study by Duke researchers reveals more children experience those fears than their parents realize.

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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 include your issues and challenges, as well as experiences within your family and your community. Our methods address 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. Email Duke Center for Eating Disorders eatingdisorders@dm.duke.edu for information about our free, weekly virtual parent support groups for parents of high school age and older children with eating disorders.

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.

This page was medically reviewed on 11/13/2024 by