ARFID and Sensory Eating

What is ARFID?

ARFID is a multifaceted eating disorder and it stands for Avoidant Restrictive Food Intake Disorder.   Prior to its formal recognition in 2013, it may have been mistaken for picky eating, anorexia or other eating disorders however it is typically not centred around body image/weight (although in some people it may be). It is not well understood by many medical professionals, especially if they have no experience with working with this.

ARFID is predominantly a fear of eating anything outside a select number of safe identified foods and drinks (neophobia). For some, this safe-list may only have a handful of foods on it.  If no safe foods are available, the person will not eat. 

 It  exists on a spectrum and there may be combinations of subtypes i.e. avoidance + restrictive, so no two people experience it in exactly the same way.  ARFID can fluctuate over time and food restrictions often exacerbate during periods of change, stress, low mood and physical illness.   One myth is that people “simply grow out of ARFID”, however for many this is a lifelong condition that needs compassion and support. 

ARFID can also overlap with other anxiety-related conditions including OCD, binge eating or anorexia nervosa. It may or may not result in weight loss or nutritional deficiencies. .


ARFID significantly impacts quality of life for many reasons. This could be social difficulties and stigma where diet and feeding preferences look drastically different to the societal norm. Or reduced access to safe foods or sensory-friendly eating environments which create further unpredictability and anxiety around eating.   

What are the causes and contributors to ARFID?

  • Neurobiological differences - neurodivergence (such as Autism and ADHD) and sensory processing differences impact how people experience the outer and inner world. This is noticeable during highly sensory experiences such as eating. 

  • Trauma which could be a one-off incident or a number of smaller events over time. These events may or may not be directly food-related, however they create an internal hypervigilance towards food or the eating environment.   

  • Physiological conditions may also amplify ARFID or even trigger sudden-onset dietary restrictions. These include  PANS/PANDAS, Post-viral illness, mast-cell activation and neuroinflammation, Hypermobility spectrum disorders and chronic GI issues i.e. SIBO. Your practitioner can explore some of these conditions with you if you suspect they may be contributing to the overall load. 

  • Neural pathways involving histamine and dopamine which regulate appetite, eating behaviours and attention may also be involved. 

  • Nutrient insufficiencies for example zinc and iron, or medications (including stimulants) also affect appetite and interoceptive awareness.

How does neurodivergence intersect with ARFID?

Who is more likely to experience ARFID?

Whilst ARFID is listed as a paediatric condition in the DSM, it can affect people of any age, gender, race or body size.  Common overlapping diagnoses include Autism Spectrum, ADHD, PTSD/trauma, generalised anxiety disorders, OCD, sensory processing issues, CFS and Fibromyalgia. In addition, having multiple eating disorders such as Anorexia and ARFID combined is not uncommon, but it can make ARFID harder to recognise.

What are the potential health risks to having a very restricted diet?

  • Not consuming enough macronutrients: protein, carbohydrate or fat which are needed for energy, growth and repair. Studies in children with ARFID have found deficiencies in macro and micronutrients, especially protein, B vitamins,

  • Nutritional deficiencies with knock on effects on all aspects of health

  • Reduced microbial diversity in the gut that may underlie gastrointestinal symptoms  

  • There may be weight loss, slowed growth or height

How do neurodivergent-affirming practitioners support you with ARFID?

  • Prioritise your autonomy and safety - you are in full control and involved in all decisions around your care

  • Validating your experiences with food and helping you to identify, understand and honour your sensory needs

  • Coping skills to manage anxiety, stress and overwhelm 

  • Co-creating a plan to improve accessibility to your safe foods 

  • Supporting you in broadening your foods choices at your pace should you wish to expand this 

  • Monitoring nutritional status and bridging any nutritional gaps 

  • Exploring any underlying digestive, structural or physical issues that might be contributing 

  • Advocacy and supporting self-advocacy to help manage social encounters and expectations outside of yourself

How can you self advocate?

  • Join ARFID support groups which can validate and normalise your experiences 

  • Setting boundaries with the people in your life prior to meeting them so they understand what you are and are not comfortable discussing with them. i.e. “I am not open to discussion or comments about my diet /body/ health right now”

  • Scripting responses that explain your needs or shut down any unhelpful conversations around your eating.  I.e. “I have sensory issues that impact my ability to eat some types of food but I am working with a health professional to ensure I’m getting the nutrition I need”  

What  do I do / not do if someone I care about has ARFID? 

❌Do not try to coerce, guilt, force or use fear-based  approaches to pressure them into eat such as sending people articles about restricted diets and illness. 

❌Label them as “picky” “fussy” or “non-compliant” which the person can internalise and feel shame about

❌Do not infantilize or criticise their food choices (i.e. processed foods) or behaviours (i.e. the need to supplement rather than eat a diverse range of foods)

✔️Educate yourself on ARFID and any overlapping conditions the person may have 

✔️Listen to their experiences without judgement or projecting societal expectations of what a normal diet looks like

✔️Help them to access safe foods and accommodate their sensory needs 

Claire Sehinson