ARFID and Autism: Understanding the Connection

ARFID and Autism: Understanding the Connection

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder in which a person eats too little, avoids many foods, or both. Unlike anorexia nervosa, the restriction is not motivated by weight or body-shape concerns. It is usually connected to sensory discomfort, fear of negative consequences, or a low interest in eating.

ARFID can affect children, adolescents and adults. It is more serious than ordinary selective eating because it causes one or more significant consequences:

• Weight loss or difficulty growing as expected

• Vitamin, mineral or other nutritional deficiencies

• Dependence on nutritional supplements or tube feeding

• Significant difficulty participating in school, work, family meals or social activities

A person does not have to be underweight to have ARFID. Someone may consume enough calories from a very limited selection of foods while still experiencing nutritional deficiencies or major disruption to daily life.

Why might someone with ARFID avoid food?

ARFID commonly involves one or more of three patterns.

Sensory sensitivity

Certain textures, smells, flavours, temperatures, colours or appearances may feel intensely unpleasant. A person might tolerate only foods with a particular texture or reject a familiar product when its packaging, recipe or appearance changes.

Fear of negative consequences

Eating may trigger a strong fear of choking, vomiting, pain, an allergic reaction or another harmful outcome. This pattern sometimes begins after a frightening experience involving food or illness.

Low interest in eating

Some people experience weak hunger signals, become full quickly or find eating unrewarding. They may forget to eat or experience meals as demanding tasks rather than enjoyable activities.

These patterns can occur separately or together.

How is ARFID connected to autism?

ARFID and autism are separate diagnoses, but they often occur together. Several experiences associated with autism may make eating more difficult and increase vulnerability to ARFID.

Sensory processing differences

Autistic people may experience taste, smell, texture, temperature and sound more intensely or differently. A food that seems mildly unpleasant to someone else may cause genuine pain, nausea, gagging or sensory overload for an autistic person.