Autism and Related Conditions Resources: Connections, Challenges, and Care

For most people, eating daily meals comes naturally. But for others, eating can be a daily source of stress, discomfort or even fear. Certain textures might feel unbearable, new foods might trigger anxiety or eating might simply not feel important. These experiences are real and valid, and they’re central to understanding avoidant-restrictive food intake disorder (ARFID).

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ARFID is an eating disorder characterized by limited food intake or avoidance of food. It can be due to sensory sensitivities, fear of negative consequences (like choking or vomiting) or lack of interest in eating. ARFID was first classified in 2013 and differs from other eating disorders (like anorexia nervosa) in that it is not driven by body image concerns.

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Approximately 1-5% of people have ARFID, but it’s much more common in autistic individuals than in the general population. There’s substantial overlap between ARFID and autism, and both are highly heritable. Many autistic individuals have unique relationships with food sensory sensitivities, strong preferences and a desire for routines, which are also traits commonly associated with ARFID.

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About 1 in 5 autistic individuals (and a similar number of their parents) have avoidant-restrictive eating traits, and about 1 in 10 meet the full criteria for ARFID. Among individuals who have an ARFID diagnosis, approximately 8% to 55% are also autistic. More than half of individuals with ARFID have other co-occurring conditions such as anxiety, depression, sleep disorders or learning differences.

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ARFID has three main subtypes, which often overlap:

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• Sensory-based avoidance: This involves strong aversions to specific sensory characteristics of food such as texture, taste, smell, temperature or appearance. Individuals may eat only foods that feel safe and avoid many others based on sensory discomfort.
• Fear-based avoidance: Eating is restricted due to fear of negative consequences such as choking, vomiting, allergic reactions or pain. These fears may begin after a traumatic food-related event, or they may develop on their own over time.
• Low interest in eating: This is sometimes called “lack of interest” and involves low appetite, feeling full after eating only a small amount of food or a general indifference to food. Eating may feel like a chore, and individuals may forget to eat or feel overwhelmed by the demands of mealtimes.

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These subtypes are not mutually exclusive, and many people with ARFID experience a combination of them.

Digestive problems are very common in the autistic community, and they’re more than just tummy aches. Autistic adults often report a range of gastrointestinal (GI) symptoms, including constipation, nausea, abdominal pain and bloating. These concerns can seriously impact daily life, yet they’re often overlooked or misunderstood by healthcare providers. This guide is here to validate your experience, provide helpful information and support you in advocating for better care.

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Did you know when autism was first described it was thought of as a version of childhood-onset schizophrenia? Today, we know that autism and schizophrenia are unrelated diagnoses with very different features. Understanding the overlap between autism and schizophrenia, however, remains important, as schizophrenia may be more common among autistic people than in the general population. One study suggests that autistic youth may be three to six times more likely to develop schizophrenia than allistic (AKA non-autistic) peers. 

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Read on to learn about these two diagnoses’ co-occurrence and how to get support.