Specialized ARFID Therapy for Adults in Washington D.C

What ARFID Looks Like for Adults

You've been called a "picky eater" for as long as you can remember. The label never captured what's happening: you eat from a list of maybe ten or twelve foods, prepared the same way, from the same brands when possible. The list has shrunk over time.

Your mother brings up your eating at every family dinner, sometimes directly, sometimes by repeating something the doctor said last year. You've stopped explaining because nothing changes; the next dinner brings the same questions and the same exchanges.

School events become their own logistics: the class breakfast where parents eat with the kids, the back-to-school potluck, the holiday concert with the cookie reception after. You pack your kid's lunch but skip the staff-room food yourself. Your kid has started to notice that you don't eat what the other parents eat.

Hosting means watching them watch you. The dinner you put together is for them, not for you, and you've gotten skilled at deflecting the polite questions about why you're not eating: you ate before, you're saving room, you had a big lunch.

Underneath all of it, the shame. You're competent everywhere else in your life, and somehow eating, the one thing that comes naturally to most people, is the one thing that's not working for you.

Learn more about my approach to working with adults with ARFID.

ARFID Recovery Using CBT-AR

You go to the new restaurant the group has been talking about and order something off the regular menu. You stop arriving with a backup plan, stop pre-eating before you leave the house, stop making the food disappear without eating it. You're paying attention to the story your friend across the table is telling about her new job, instead of running calculations about your plate.

Your mother stops asking about your eating because there's nothing remarkable to ask about anymore. Your father stops offering you food with that practiced disappointment. The questions that defined the family dinner table for decades stop coming. Dinner stops running the full two hours of food talk before anyone gets to anything else.

You eat at the school event. The class breakfast stops being a meal you watch your kid eat while you don't. At the back-to-school potluck, you put food on a plate and eat it standing up next to the other parents. Your kid stops noticing that you're the parent who never eats.

Having people over stops being a meal where you spent the night moving food around the plate to look like you ate. You eat what you serve. The polite questions don't come up because there's nothing prompting them. The kindness of your guests stops feeling like scrutiny, because what's on your plate matches what's on theirs.

Recovery means having a wide enough range that food stops being the thing your life has to work around. You don't have to love all foods to get there.

The medical side starts to follow. The iron levels stabilize, the B12 numbers come up, the supplements your doctor has been adjusting for years finally have something to work with. The fatigue that's been baseline for as long as you remember gets less constant. The annual physical stops being a list of things that aren't quite right.

Getting Started with ARFID Therapy in Washington D.C.

Cost: $300 per session

Insurance: Private-pay, with monthly superbills you can submit to your insurance for potential out-of-network reimbursement. HSA and FSA accounts can be used for payment.

Frequency: Weekly sessions, typically 50 minutes.

Length of treatment: Most clients see meaningful progress within 20 to 30 sessions over 6 to 12 months. ARFID is specialized work, and I keep a small caseload so each client gets the focused attention this kind of therapy requires.

Format: Secure, HIPAA-compliant video. You can join from your home, your office, or anywhere private with a stable connection.

About Your Adult ARFID Clinician: Grace Annan, LICSW, LCSW-QS

I'm Grace Annan, a licensed clinical social worker whose practice centers on adult ARFID, with related work in adult eating disorders, body image after body change, and adult ADHD and autism assessments. Adult ARFID is one of the rarest specialties in adult mental health: most ARFID care is built for children, and adults who continue to experience ARFID often go years without finding a clinician who treats it as its own condition.

My work uses Cognitive Behavioral Therapy for ARFID (CBT-AR), the evidence-based treatment developed at Harvard Medical School. Studies show about 7 out of 10 people no longer meet ARFID criteria after a course of CBT-AR. We work systematically through food exposure, sensory tolerance, and the daily-life impact of the eating limitations.

D.C. License: DC-LC200003064

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Frequently Asked Questions

Can I do ARFID therapy online if I live anywhere in Washington D.C.? Yes. I'm licensed to provide telehealth services to adults throughout the District of Columbia. The sessions take place over a secure, HIPAA-compliant video platform.

How do I know if I have ARFID versus being a picky eater? ARFID is more than preference. It's a restricted way of eating that affects your health (nutritional deficiencies, weight concerns), your daily functioning (avoiding meals or social events), or causes significant distress. If your eating limitations have followed you into adulthood and are interfering with your life, that's the line where it moves from preference into something a clinician can help with.

Do you take insurance? No. I'm a private-pay therapist. I provide monthly superbills you can submit to your insurance company for potential reimbursement of out-of-network mental health services. Many PPO plans reimburse a portion of the fee.

What if I've never done therapy before? Many of my ARFID clients haven't. The focus is on practical skill-building and structured food exposure, not deep emotional processing. The work is concrete and the goals are clear.

What if my ARFID is connected to autism or ADHD? This is very common, and it's part of why I built my practice this way. Many adults with ARFID also have ADHD, autism, or sensory processing differences, and CBT-AR can be adapted to account for those. If you're not sure whether ADHD or autism is also part of your picture, I conduct adult assessments for both as a separate offering, so the work stays inside the same practice instead of getting split across providers.

What if my family doesn't believe ARFID is real? You don't need their belief to do this work. ARFID is a recognized clinical diagnosis (added to the DSM in 2013), and the treatment is structured around your eating, not your family's understanding of it. Many of my clients have spent years being told to "just eat"; the work is about building your range, not converting the people around you.

What if I'm the one hosting and the people I'm cooking for are watching what I eat? Hosting is its own version of the food anxiety and it shows up a lot in adult ARFID. We can work on practical strategies for what to serve and how to manage the social dynamics around your own eating, and on expanding the range of foods you can eat in front of others without it feeling exposing.

Do you offer support options besides individual ARFID therapy? Individual therapy is the format for this work because food exposure planning needs to be tailored to your specific tolerance and history. I also lead a body image support group for adults in Washington D.C., but that's a separate offering for a different population.

Areas Served in Washington D.C.

I provide online ARFID therapy to adults throughout Washington D.C., including Northwest, Northeast, Southwest, and Southeast quadrants, Capitol Hill, Georgetown, Dupont Circle, Foggy Bottom, Adams Morgan, Columbia Heights, Petworth, Brookland, Cleveland Park, Mount Pleasant, Friendship Heights, Tenleytown, Woodley Park, Logan Circle, Shaw, Bloomingdale, Anacostia, Navy Yard, Capitol Riverfront, and all surrounding neighborhoods.

If you live anywhere in DC, you can work with me.

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