It’s hard to navigate any eating disorder or disordered eating pattern. As a dietitian (and human), I’ve seen and experienced how tough it can be to break unhelpful patterns, overcome aversions, and finally figure out a way of eating that supports both your health and your life.

When it comes to Avoidant/Restrictive Food Intake Disorder (ARFID), the challenges can be pretty unique. Sure, there may not be the body image concerns that come with many other eating disorders. But being an extremely picky eater, or being afraid to eat certain things for various reasons, can really derail your social life, your confidence, and your nutrition status. Whether it’s because of extreme picky eating, sensory sensitivities, or fears around food due to a medical condition, ARFID can have a profound impact on your physical and emotional well-being.

At Ruby Oak Nutrition, we specialize in helping clients with ARFID overcome these challenges through compassionate, individualized care. We work with clients in-person in Raleigh, NC and virtually in North Carolina and several other states. Our ARFID dietitians are in-network with Blue Cross Blue Shield, Aetna, Cigna, Medcost, Curative, and the North Carolina State Health plan.

If you’re ready to book an appointment, go here to fill out our interest form and book at a time that works for you.

If you have questions about what ARFID is, how it’s treated, and how an ARFID dietitian can help, read on to learn more.

What is ARFID?

ARFID is a relatively new diagnosis, added to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) in 2013. It’s not about body image concerns, which makes it pretty unique and separates it from other eating disorders like anorexia nervosa or bulimia nervosa. Instead, ARFID is characterized by restrictive eating that stems from:

• Sensory sensitivities: Textures, smells, or even the appearance of certain foods may feel intolerable.
• Fear of negative consequences: You might avoid food because of a past choking incident, vomiting, or allergic reaction.
• Lack of interest in eating: Food might simply not feel appealing or satisfying.

ARFID can lead to nutritional deficiencies, significant weight loss, and in extreme cases the need for interventions like high-calorie nutrition supplements or feeding tubes. What’s often even more stressful for our ARFID patients is that it can make social eating situations (like parties, family gatherings, catered work lunches, or dinner out with friends) really difficult and sometimes embarassing.

How Ruby Oak Nutrition’s ARFID dietitians can help

Our team of dietitians is trained to address the unique challenges of ARFID. We take a compassionate, individualized approach to help you expand your diet, meet your nutritional needs, and reduce your anxiety around food. Here are some of the ways we can help:

1. Nutritional Assessment: We evaluate your current eating patterns and identify potential nutrient gaps.
2. Exposure Therapy: Our dietitians often collaborate with therapists to implement exposure strategies, helping you slowly and safely try new foods.
3. Meal Planning: We create flexible, achievable meal plans that align with your comfort level.
4. Collaboration: ARFID treatment often involves a multidisciplinary team, including therapists and sometimes occupational therapists, especially if sensory sensitivities are a major concern.

The ultimate goal? To improve your quality of life and help you develop a more positive relationship with food. ARFID treatment is a long-term process — it often takes a year or more to feel like ARFID isn’t interfering with your life anymore — but there are so many quick wins along the way, like being able to eat at a restaurant that was formerly off-limits, or learning to cook a fear food in a way that actually works for you.

Why choose Ruby Oak Nutrition?

If you or your child has ARFID, working with a specialized dietitian can make all the difference. Here’s why Ruby Oak Nutrition is the right choice:

• Expertise in ARFID: Our team has experience working with clients who have ARFID. We understand the complexities of the disorder, and we know that every single person requires a slightly different roadmap for ARFID treatment. We take the time to get to know you, and we tailor our approach accordingly.
• Support Without Judgment: We provide a safe, nonjudgmental space to explore your relationship with food. We understand how isolating ARFID can feel and are here to support you every step of the way.
• Convenient Access: With in-person care in Raleigh and Durham, NC, and virtual services in 15 states, we make it easy to get the help you need, wherever you are.
• In-Network With Your Insurance: We’re in-network dietitians with Blue Cross Blue Shield, Aetna, and the North Carolina State Employee Health Plan. Nearly all plans cover an unlimited number of dietitian visits if you have an eating disorder diagnosis. Some clients may have a small co-pay, but most clients don’t pay anything out of pocket to work with us.

Does insurance cover ARFID treatment?

One of the first questions many people have is whether their insurance will cover sessions with an ARFID dietitian. At Ruby Oak Nutrition, we accept a variety of insurance plans, including Blue Cross Blue Shield (BCBS), Aetna, and the North Carolina State Employee Health Plan. Here’s what you need to know:

ARFID Dietitian and Blue Cross Blue Shield

All of our dietitians are in-network with BCBS. Although the vast majority of plans cover ARFID treatment with a dietitian, it’s always best to check with your specific plan. Here’s how to navigate BCBS’s coverage:

• Check Your Plan: Look for terms like “nutritional counseling” or “eating disorder treatment” in your benefits summary.
• Call Your Plan: To get clear answers about your insurance coverage, use our Insurance Verification Script found here.

ARFID Dietitian and Aetna

Most Aetna plans cover dietitian services, and many of our dietitians are in-network with Aetna. As of January 2025, the North Carolina State Employee Health Plan is administered by Aetna — we’re in-network with this plan, too. Here’s how to navigate Aetna’s coverage:

• Look for Specific Coverage: Check your plan’s details for coverage related to eating disorders or nutritional counseling.
• Get a Referral: Aetna may require a referral from your primary care physician, especially if the treatment is tied to a medical diagnosis like ARFID.
• Call Your Plan: The best way to check your coverage is to call the number on your insurance card and ask the questions listed in our Insurance Verification Script.

ARFID Dietitian and Cigna

All of our dietitians are in-network with Cigna. Although the vast majority of plans cover ARFID treatment with a dietitian, it’s always best to check with your specific plan. Here’s how to navigate Cigna’s coverage:

• Look for Specific Coverage: Check your plan’s details for coverage related to eating disorders or nutritional counseling.
• Call Your Plan: To get clear answers about your insurance coverage, use our Insurance Verification Script found here.

What to expect in your first appointment

Your first session with an ARFID dietitian at Ruby Oak Nutrition is an opportunity to share your story and set goals. Here’s what might happen:

• Detailed Intake: We’ll ask about your eating history, current challenges, and goals.
• Nutritional Assessment: We’ll evaluate your current diet to identify gaps and potential nutrient deficiencies.
• Collaborative Goal-Setting: Together, we’ll outline steps to work toward expanding your food choices and meeting your nutritional needs.

Again, this process will take time, but that shouldn’t discourage you. Most of our sessions with ARFID patients are really fun, because they involve trying new foods, exploring different sensory experiences, and sometimes even cooking or preparing things! Some of our ARFID clients have told us that they look forward to their sessions each week because they’re exploratory and can feel like a nice break from work or other stressors.

Success stories

Here are a few examples of what can happen when you work with an ARFID dietitian to overcome food aversions and fears around eating:

• Case 1: Expanding a Limited Diet: A 10-year-old with severe ARFID went from eating only five foods to regularly trying new options. With the help of his dietitian, he and his parents gradually expanded their palate by introducing new foods one at a time on the dinner table. The boy had the first food (carrots) on his plate a few times a week for three weeks before he was willing to try a bite. Within 2 years, he was comfortable eating a much wider variety of foods and his parents told us that family meals were so much less stressful to plan and eat.
• Case 2: Overcoming Food Fear: An adult with ARFID caused by a choking incident in her pre-teen years began eating solid foods again after months of collaborative work with her dietitian and therapist. She started with soft foods like mashed potatoes, progressed to foods like pasta with sauce, and eventually was able to eat most meats.
• Case 3: Improved Social Life: A teen who avoided social eating situations due to restrictive ARFID started attending family meals and even going out with friends. This teen used to be embarrassed to eat in front of others, even their family, because they never knew if they’d be able to eat what was being served. Over the course of a year, their dietitian helped them figure out exactly what it was about certain foods that made them unappealing — turns out it was a mix of smell and “gritty” texture, not taste — so that they had a better idea of whether or not a meal would work for them.

The bottom line

If ARFID is impacting your life, you don’t have to navigate it alone. At Ruby Oak Nutrition, our team of dietitians is here to provide the specialized care you need to address your challenges and take steps toward a healthier, happier relationship with food. Whether you’re located near Raleigh, NC, or in one of the 15 states we serve virtually, support is just a click away.

Ready to take the first step? Book an appointment with one of our ARFID specialists today. Your journey to a better relationship with food starts here!

IWe’re a group of dietitians who take a non-diet, body-positive, identity-affirming approach to recovery and healing your relationship with food. Learn more about nutrition counseling for kids, teenagers, and adults, in-network with Blue Cross Blue Shield and Aetna insurance plans and offered virtually to clients in North Carolina and over a dozen other states.

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