By Amy Duffy-Barnes, LMSW Clinical, Licensed Clinical Therapist at Heartstone Guidance Center
Avoidant/Restrictive Food Intake Disorder (ARFID) is a serious eating disorder that is often misunderstood, especially in the context of autism. ARFID is not a fear of weight gain or body image issues, but rather a disorder characterized by a significant avoidance of certain foods due to sensory sensitivities, past negative experiences with food (such as choking or vomiting), or a lack of interest in eating. The high correlation between ARFID and autism is well-documented, with many autistic individuals facing food avoidance due to heightened sensory sensitivities and nervous system challenges.
As a neurodiversity-affirming clinician, I believe in helping individuals with ARFID find strategies that honor their authentic selves, especially in how they relate to food. Instead of forcing food exposure or pushing for a rapid expansion of the diet, it’s important to work within a person’s “window of tolerance” and gently increase their capacity for food experiences.
ARFID and Autism: A Unique Relationship
Autistic individuals often experience heightened sensitivity in many areas of life, and food is no exception. Taste, texture, smell, and even the appearance of certain foods can trigger a strong negative reaction. For many on the autism spectrum, the nervous system is already in a heightened state due to chronic overstimulation, often leading to an overactive sympathetic nervous system (the system that controls the fight-or-flight response). This makes navigating the world, including food, more challenging.
Autistic individuals with ARFID often have a list of “safe foods” that provide comfort and security in a world full of overwhelming sensory input. When under stress, autistic individuals may rely even more heavily on these safe foods. It is essential to accept this aspect of ARFID, rather than fighting it, especially during times of high stress. The goal is not to push yourself to eat foods that feel repulsive or overwhelming, but to expand the window of tolerance for new foods when you are in a calm and balanced state.
Expanding the Window of Tolerance
The window of tolerance refers to the zone in which a person can function without feeling overwhelmed or triggered. When it comes to ARFID, the window of tolerance involves gradually increasing exposure to new foods without pushing the nervous system into a state of panic or shutdown. For autistic individuals, it is crucial to work on food tolerance when the nervous system is regulated, and allow yourself to return to safe foods during times of stress without judgment or guilt.
When we focus on expanding the window of tolerance, we are creating a gradual process that honors the body and mind’s need for safety. This approach allows you to approach food challenges when you are ready, rather than feeling forced or pressured to change overnight.
Self-Compassion and the Actual Self
Working with ARFID as a clinician I recommend helping clients rom an Internal Family Systems (IFS) perspective. Listening to a harsh "critic" or letting them be the predominant voice of self talk, this creates more internal stress, increasing the symptoms of ARFID. Clients need help finding and allowing the voice of the “actual self”to dominate the conversation. The voice of the actual self is the calm, centered, grounded, and compassionate that can navigate life’s challenges with clarity and balance. When working with ARFID, it is essential to allow the actual self to control the inner monolgue. Compassionate and supportive self talk allows stress to go down and symptoms of ARFID to decrease. This means clients can accept their relationship with food as it is, especially during stressful times.
Self-compassion is key. Many people with ARFID feel guilt or shame around their food choices, especially in social situations where they may be judged for their limited diet. Learning to use the compassionate voice of the actual self allows you to acknowledge these feelings without letting them control your actions or begin in engaging in self criticism. You are allowed to have safe foods, and you are allowed to feel okay about relying on them when needed. Allow the actual self to offer compassionate support. Your inner voice should sound like your best friend, beloved therapist, and the parents we all wish we would have had, offering unconditional love and acceptance.
15 Neurodiversity-Affirming Strategies for Managing ARFID
*Not all of these will work for all people, these are ideas to gently experiment with
Create a Food Hierarchy: During lower stress times, work on increasing your window of tolerance by creating a food hierarchy. Create a visual list (brains love visuals) with foods that feel the least challenging working up to more difficult ones.
Use Sensory Gradation: Explore food through touch, smell, or sight before attempting to taste it.
Pair New Foods with Safe Foods: Introduce new foods alongside familiar ones to reduce stress.
Respect Your Safe Foods: Always have a list of go-to safe foods, especially during stressful times.
Small, Manageable Changes: Modifying the visual appearance, texture or temperature of safe foods within your comfort zone can be a lower stress way of expanding the window of tolerance, so cut the dino nuggy in half.
Mindful Eating: Focus on the experience of eating, taking time to appreciate the sensory details you do enjoy. Allow yourself to go slow, gift yourself the time to eat. Create rituals around food you enjoy (colorful plates, light a candle, etc).
Visual Food Exposure: Spend time looking at pictures or videos of unfamiliar foods to gradually increase tolerance.
No Pressure Zones: Designate certain meals or times when no new foods need to be tried, giving yourself space to eat comfortably.
Gentle Exploration: Be curious about foods without any obligation to eat them—touch them, smell them, and explore.
Calming Practices Before Meals: Engage in calming activities, such as deep breathing or using a weighted blanket, before attempting to try new foods.
Self-Compassion Exercises: Practice self-compassion affirmations, reminding yourself that it’s okay to struggle and take things at your own pace.
Safe Food Kit: Keep a bag of safe foods with you when traveling or during unpredictable meal times to reduce anxiety.
Incorporate Movement: Engage in calming movement (somatic) exercises like stretching or yoga to reset the nervous system before meals.
Visualize Success: Practice visualizing eating and enjoying foods from your hierarchy to create a mental pathway for success.
Celebrate Wins: Recognize and celebrate even the smallest successes in your food journey, whether it’s trying a new food or simply touching it for the first time.
Find the Voice of Your Actual Self
Utilize principles from Internal Family Systems (IFS) to connect with the "Actual Self"—your centered, balanced, and compassionate core. In moments of stress or food-related anxiety, take a moment to pause and ask: What does my true Self say in this situation? This voice is calm, non-judgmental, and understands your needs without criticism. By practicing self-compassion and listening to this inner guidance, you can approach food challenges with gentleness, allowing yourself to decide when and how to expand your window of tolerance. Trust that your Actual Self will lead you to what feels right, without forcing or pressuring yourself beyond your capacity.
Tapping into this authentic, compassionate Self helps you honor where you are in your journey and supports a healthier, more balanced approach to your relationship with food.
Final Thoughts
Treating ARFID, especially in autistic individuals, requires a compassionate, neurodiversity-affirming approach. It’s not about forcing changes but rather creating a safe, supportive environment where individuals can gradually expand their comfort zones. Recognizing the role that stress, sensory overload and nervous system damage play in ARFID is crucial, and learning to balance periods of exploration with moments of self-compassion and acceptance is key to long-term success. At Heartstone Guidance Center, we focus on helping individuals accept and work with their unique experiences, rather than against them. As a neurodiversity-affirming practice, we know there is no such thing as a one size fits all approach!
By respecting your body’s needs and working at your own pace, it is possible to build a more comfortable and nourishing relationship with food—one that honors your neurodivergent self.