Autism and ARFID: When ‘Picky Eating’ Is So Much More

“Autism and ARFID: When ‘Picky Eating’ Is So Much More” was written by Maurya Hart, BSc, RD and edited/reviewed by Jackie Silver MHSc, RD.

Medical Disclaimer: The information in this article is meant for educational purposes only. It is not intended to be personalized medical or nutrition advice. For a plan tailored to your needs, please consult with a Registered Dietitian or qualified healthcare professional.

Disclosure: This post may contain affiliate links with which I may earn a small commission but at no additional cost to you. Affiliate links help bloggers like me to provide you with free content. All opinions expressed here are genuine. 

Last updated: July 3, 2025

Introduction to Autism and ARFID

Autistic individuals often have unique relationships with food due to their sensory preferences and interests. It is usually (but not always) first noticed in childhood, where autistic children tend to prefer certain foods, textures, and tastes that are familiar to them. This is sometimes called “picky eating” or “selective eating.” With the right support, selective eaters are often able to expand their accepted safe foods and eat enough, so they are able to get all the nutrients they need in their diet. 

In some cases, food intake is so limited that it can lead to difficulties with health and other aspects of life. These cases go beyond picky eating, as there are often other factors at play preventing the person from eating enough. For people with avoidant restrictive food intake disorder, or ARFID, (children or adults) it can be extremely difficult to eat enough food. This blog post will outline what ARFID is, how it relates to autism, and what types of support are available for people with autism and ARFID.

What Are Autism and ARFID?

Autism is a neurodevelopmental condition, meaning that autistic people’s brains develop differently than the brains of people that are not autistic. Autistic folks have unique ways of communicating, and specific preferences and interests. When it comes to food, autistic individuals may experience sensory preferences in terms of taste, texture, smell, and even color. They may prefer to stick to foods that provide a familiar and consistent sensory experience, such as crackers or chicken nuggets rather than vegetables and fruit, which can vary in taste and texture.

Autistic people are also more likely to experience some other mental and physical conditions, such as attention deficit hyperactivity disorder (ADHD), anxiety disorders, digestive issues (such as constipation), and sleep disorders. Sometimes, autistic people may also have avoidant restrictive food intake disorder (ARFID), a feeding disorder recognized by the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

ARFID is a feeding disorder (sometimes also called eating disorder) that may be diagnosed when someone has a significantly low or inadequate intake of food. When someone has ARFID, they do not consume enough food and nutrients to support their well-being and growth. 

People with ARFID may have limited food intake for several different reasons. These are categorized into the following ARFID subtypes:

1. Very strong sensory sensitivities (strong reactions to certain tastes, textures, or smells of foods), also called “Avoidant ARFID“
2. A lack of interest in eating or food, also called “Limited ARFID“
3. A fear of negative consequences associated with eating food (for example, a strong fear of choking or throwing up), also called “Aversive ARFID“

These are the three most common “subtypes” of ARFID. However, recent research has identified two more subtypes of ARFID.

An analysis of 319 British children and adolescents revealed that the most common type of ARFID was a “Combined” presentation, where more than one of the above subtypes was present. For example, a child with ARFID may have a strong dislike of mushy textures (Avoidant) and also a lack of interest in food (Limited).

When we hear the term “eating disorder,” we often think of someone who restricts food intake due to concerns about body image or a fear of gaining weight. Traditionally, ARFID was defined as an eating disorder that occurs without these weight or body shape concerns. 

However, new research suggests that body image issues and ARFID can sometimes co-exist, even if they are not the primary driver of food avoidance. The research found that a person can have limited food intake due to ARFID, but also have body image concerns which may result in behaviors such as bingeing. 

It’s also important to know the difference between ARFID and selective eating. Many people who are selective eaters eat enough food to maintain their weight and meet all their nutrient needs. With ARFID, people are not able to meet their nutritional needs, which results in one or more of the following outcomes:

• Significant weight loss, being consistently underweight, or not growing properly in children/infants
• Nutritional deficiencies, which can look like cracks in the corner of your mouth, brittle hair and nails, hair loss, or scaly skin (as a few examples)
• Being dependent on oral nutritional supplements (such as Ensure or Boost) or a feeding tube
• Significant interference with typical daily functioning (struggling with completing daily activities such as going to school or work, having energy throughout the day)

Again, it’s important to note that ARFID can look different for different people. Even though the definition of ARFID talks about not eating enough to meet nutrition and energy needs, it is possible to have ARFID and live in a larger body. People can experience significant distress related to food and not eat enough, without having physical signs of malnutrition (as listed above).

If any of these experiences sound familiar to you, it’s important that you get support from a healthcare professional. Reaching out to your family doctor, therapist, or any other healthcare professional you trust can be a step in the right direction to getting the help you need. ARFID is usually managed by a team of clinicians, which may include a psychologist or psychiatrist, a registered dietitian, and medical doctors.

At Jackie Silver Nutrition, we are a team of registered dietitian nutritionists who are equipped to support children and adults with autism and ARFID. We can support you, or your child, in managing nutritional deficiencies, gaining or maintaining weight, trying new foods, and finding ways to feed yourself that work for you. Book a FREE 15 minute discovery call today to see if we would be a good fit to support you.

Autism and ARFID: Understanding the Connection

Although experts aren’t sure what causes autism or ARFID (it is likely a mix of genetic and environmental factors), it’s common for these two conditions to co-occur. A recent review of the scientific literature found that among children diagnosed with ARFID, up to 50% were also autistic. While ARFID is most often diagnosed early in life, it can occur  into adulthood if there is no intervention. More research is needed to understand how common ARFID is among autistic adults.

There are some shared characteristics of autism and ARFID that may help explain why it is common for them to happen together. For example, many people with autism and ARFID present with the “Avoidant” sensory sensitivity sub-type of ARFID, where their food intake is limited because they feel a strong aversion to  certain textures, tastes, or smells.

Individuals with ARFID are also likely to have anxiety, with up to 70% of people with ARFID also having some type of anxiety disorder. Autistic folks are also more likely to experience anxiety – up to 50% of autistic adults may have an anxiety disorder. Especially if an individual has had an unpleasant experience related to choking, vomiting, or a negative experience related to food in general (e.g., being forced to eat things that they do not like), this can result in severe anxiety surrounding eating. With ARFID, this anxiety causes a person to not meet their nutritional needs, and can often result in other health consequences. 

When someone does not meet their nutritional needs for a long time, such as with ARFID, this can have long term effects on health. Some physical health consequences of ARFID may include:

• Problems with digestion, such as constipation and diarrhea
• Low bone mineral density, which can lead to osteoporosis
• Heart problems, such as a slower than normal heart rate
• In women, not having a regular period due to low iron and not enough body fat

Because ARFID can be a lifelong disorder without intervention, it is important that people with ARFID get the support they need to achieve proper nutritional intake and avoid long-term health consequences. One healthcare professional that can help with meeting nutritional intake with autism and ARFID is a registered dietitian.

How a Dietitian Nutritionist Can Help With Autism and ARFID

A registered dietitian (RD) is specifically trained to assist people in meeting their nutritional needs, in the context of different circumstances and health conditions, including autism and ARFID. An RD provides support in every step of the process, from creating a safe eating environment, to helping you or your child meet personalized targets for energy, protein, vitamin and mineral intake.

Even if you don’t have a formal diagnosis, an RD can still help navigate things like sensory sensitivities, losing weight without meaning to, or having difficulty eating enough to have energy for your daily activities. We will work with you to optimize your nutritional intake in a way that is safe for you, whether that looks like increasing portion sizes of safe foods, adding a multivitamin supplement, and/or slowly expanding your accepted safe foods.

We have a number of strategies in our toolbox to help support autistic individuals who also have ARFID. These include:

• Food chaining, a process that involves starting from a safe food and gradually trying different forms of this safe food, or similar foods, until a new target food is accepted. For example, we might start with frozen French fries, then go to homemade French fries, and eventually get to roasted potatoes.
• SOS Trained Techniques: These techniques are specifically designed for those who have sensory sensitivities. We will go at your pace and work within what feels safe for you to expand your nutritional intake.
• Establishing a peaceful meal time routine, which can be especially helpful to create consistency and reduce mealtime stress. We use calming strategies such as deep breathing to help manage food-related anxiety.

At Jackie Silver Nutrition, our team of dietitians is trained to provide support to autistic and neurodivergent folks, people with ARFID, and more. Book a *FREE 15 minute discovery call today to learn about how we can work together to meet your goals. We provide non-judgemental care to children, teens, and adults and meet you where you are in your nutrition journey. 

*Currently only available to Canadian residents of Ontario, New Brunswick, Nova Scotia, and US residents of certain states, including but not limited to New York, New Jersey, Connecticut, Massachusetts, Pennsylvania, Texas, and California. If your state is not listed here, please inquire to see if we can still support you.

Conclusion and Take-Aways

Autism is a neurodevelopmental condition, and ARFID is an eating disorder, but there are several similarities between them. Autism and ARFID are likely to co-exist, with up to 50% of people diagnosed with ARFID also being autistic. In both cases, people may find they have extreme sensory sensitivities, a disinterest in food, or anxiety surrounding food. If these factors are preventing you from eating enough, it may be time to reach out and get support. 

Our team of dietitian-nutritionists specializes in ARFID, neurodivergent populations, and sensory challenges. We also recognize that no two people are alike, so we will work with you, at your own pace, to find personalized strategies and meet your nutritional goals. Whether you want to expand your safe foods, or work within your accepted foods to increase your energy or get stronger, we are here to help.

👉 Check out these other blog posts that may be of interest to you:

• Why Working with an Autism Dietitian Is Key To Your Health
• Autism and Food Aversion: 7 Practical Eating Tips
• Food Chaining for Picky Eaters
• 17 Food Chaining Examples for Selective Eaters
• Autism Safe Foods: Foods for Sensory Sensitivity
• Meal Prep for Picky Eaters: A Parents’ Guide