What is ARFID and Autism?

ARFID stands for Avoidant/Restrictive Food Intake Disorder. This is an eating disorder seen most commonly in children, though adults can experience it too. People with ARFID limit the amount or variety of food they eat, not because of body image concerns but due to reasons such as sensory sensitivities, fear of choking or vomiting, or a general lack of interest in food. Unlike other eating disorders (such as anorexia or bulimia), ARFID is not linked to worries about weight or body shape.

People with ARFID may:

• Eat a very limited range of foods, often sticking to certain colours, textures, or brands.
• Avoid certain foods after a traumatic event, like choking or vomiting.
• Struggle to maintain a healthy weight, or experience poor growth.
• Not meet their required nutritional needs, leading to potential health problems.
• Depend on supplements or nutritional drinks to get enough nutrients.
• Experience distress or extreme anxiety around meal times.

Most people will have foods they dislike, but with ARFID, the avoidance is so severe that it causes problems with health, development, and daily life.

Typical Features of ARFID

• Lack of interest in eating or food.
• Sensory-based avoidance (e.g. rejecting food because of its texture, smell, or appearance).
• Concern about negative effects of eating, such as choking or vomiting.
• Inadequate nutrition or weight loss.
• Social difficulties at mealtimes.

ARFID can sometimes be mistaken for fussy eating. However, fussy eating usually does not have the same level of impact on health and daily living, and most children will eventually grow out of fussy eating. With ARFID, the extreme restriction does not lessen with age, and can get worse if left unaddressed.

Causes and Risk Factors of ARFID

Several factors may contribute to ARFID.

• Sensory sensitivity: Some people are more sensitive to textures, smells, or tastes.
• Traumatic experiences: Previous episodes of choking, vomiting, or severe reflux can trigger fear around eating certain foods.
• Co-occurring conditions: Children with conditions like autism spectrum disorder (ASD), anxiety, or ADHD are more likely to develop ARFID.
• Lack of hunger cues: For some, their body does not give strong signals of hunger or fullness.

Not everyone with these risk factors will develop ARFID, but awareness can help spot it early.

Signs That Someone May Have ARFID

ARFID affects people in different ways. You might notice:

• Eating a very narrow range of foods (for example, only beige or white foods).
• Taking a long time to finish meals.
• Getting upset or anxious when faced with new foods.
• Difficulty eating with others, or avoiding social events involving food.
• Physical symptoms like tiredness, cold hands and feet, dizziness, or problems with hair and skin.
• Needing vitamin or calorie supplements because of restricted eating.

People with ARFID are often visibly anxious about food, and meal times can become a source of stress for the whole family.

Diagnosis and Treatment of ARFID

A diagnosis requires assessment by a health professional, usually a GP, paediatrician, or a mental health specialist. They will look for signs that food restriction:

• Is not related to body image
• Leads to health consequences (like weight loss, poor growth, or nutritional deficiencies)
• Causes significant disruption to family or social life

Treatment depends on how severe ARFID is. The goals are to:

• Improve food flexibility and variety
• Support healthy weight gain and nutrition
• Reduce anxiety around meal times

Treatment approaches often involve:

• Cognitive Behavioural Therapy (CBT): Helps address negative thoughts and anxieties related to food.
• Sensory-based food therapy: Explores and increases tolerance to different textures, smells, and tastes.
• Dietetic support: Helps with nutritional needs and safe weight gain.
• Family involvement: Provides support, structure, and encouragement.

Progress may be slow. Those supporting someone with ARFID need patience, understanding, and professional input.

What is Autism?

Autism, formally known as Autism Spectrum Disorder (ASD), is a developmental condition. People with autism experience the world in a different way from those who are not autistic. Autism affects how people communicate, interact, and process sensory information.

Autism is described as a spectrum because there is a wide range of strengths, challenges, and differences among autistic people. Some may need significant support, while others may live quite independent lives.

Key Signs of Autism

Although every autistic person is different, certain signs are common:

• Difficulties with communication and interaction (finding it hard to understand social rules, expressing feelings, or reading body language).
• Repetitive behaviours and routines (such as repeated movements, strict rituals, or needing routines to stay the same).
• Intense or unusual interests, sometimes called ‘special interests’.
• Sensory sensitivities (over- or under-sensitive to lights, sounds, touch, or other sensory input).
• Challenges in predicting or planning for changes in environment or routine.

Autism is usually spotted in childhood, but some people may not receive a diagnosis until they are older.

Causes of Autism

The cause of autism is not fully understood. Research suggests several factors may be involved, mostly genetic. It is clear that autism is not caused by parenting style or family background.

Autistic people are born with their differences, but experiences in early life may help shape how their autism presents. Every autistic person is unique.

Autism in Daily Life

Living with autism brings both strengths and challenges. Autistic people might:

• Be very knowledgeable about their interests.
• Have good attention to detail.
• Notice subtle changes in their environment.
• Struggle with changes and uncertainty.
• Find socialising exhausting, or communicate in a different way.

Society is learning to be more accepting and supportive, but autistic people still face misunderstanding and barriers.

Support for autistic people may look like:

• Adjustments at school or work
• Support from family and carers
• Access to therapies, such as speech and language therapy

Sensory Differences in Autism

Many autistic people have sensory differences. Everyday sounds, textures, or lights might be overwhelming or even painful. Others may seek out sensory experiences, such as bright lights or certain textures.

• Sensory overload can cause distress, anxiety, or even physical pain.
• Some people might avoid certain situations because of their sensory needs.
• Sensory tools or aids, such as noise-cancelling headphones, weighted blankets, or fidget toys, can help.

Awareness and respect for sensory needs are important. Changes in the physical environment can make a big difference for autistic people.

The Link Between ARFID and Autism

Research shows a strong connection between ARFID and autism. Many children and adults with autism show patterns of restrictive eating. Some may eventually get a diagnosis of ARFID on top of their autism diagnosis.

Here’s why the two conditions often overlap:

• Sensory sensitivities are common in autistic people and can cause strong preferences or aversions to certain foods.
• Autistic people might have routines or rituals around food and eating, sticking to foods that feel familiar or comfortable.
• Communication differences might make it hard to explain fears or discomfort related to food.
• Anxiety, which is common in autistic people, can contribute to avoidant behaviours.

Differences Between ARFID and Autism

• ARFID is an eating disorder. It is defined by avoidance or restriction of food beyond cultural or developmental norms.
• Autism is a lifelong developmental condition affecting communication and behaviour.

People can have ARFID without being autistic, but the conditions often overlap. When they do, support must consider both sets of needs.

Supporting People With ARFID and Autism

People with both ARFID and autism need understanding, practical support, and flexibility. Often, routines and structure help, but too much rigidity can feed into restrictive eating patterns.

Good support includes:

• Creating calm, predictable meal environments.
• Respecting sensory needs, like lighting, sounds, seating, and textures.
• Slow introduction to new foods, without pressure.
• Keeping communication clear and using visuals where helpful.
• Involving professionals such as occupational therapists, speech and language therapists, and dietitians.

Quick fixes rarely work. Building trust and safety is key for long-term change.

Advice For Families

Supporting someone with ARFID and autism can feel isolating and exhausting. You are not alone, and help is available.

It may help to:

• Seek support from GP or school nurse.
• Request specialist autism or eating disorder services.
• Look for local or national support groups.

Self-care and patience are important, both for the person with ARFID and autism and for those supporting them.

The Role of Schools and Care Providers

Schools often notice food avoidance first. Teachers and lunch staff can spot patterns such as skipping meals, trading packed lunch items, or obvious anxiety around food.

Ways organisations can help include:

• Staff training to increase knowledge and confidence in supporting children with ARFID and autism.
• Working with parents or carers to understand a child’s safe foods and routines.
• Making small changes like flexible lunch seating, quiet areas, or adapted meal plans.
• Involving the child or young person in planning and decision-making.

Professional input helps schools make reasonable adjustments and reduce distress at mealtimes.

Where to Get Help

For anyone worried about ARFID or autism, GPs are a first point of contact. Early input can help prevent physical and emotional health problems. There are national charities and support groups, such as:

• National Autistic Society
• Beat (UK’s eating disorder charity)
• ARFID Awareness UK

These groups offer advice, helplines, and sometimes peer support.

Final Thoughts

Both ARFID and autism are lifelong, but supportive environments and patient, practical help can improve health and wellbeing. Recognising the signs early on makes a real difference.