Avoidant/restrictive food intake disorder (ARFID) is characterized by food aversions due to sensory sensitivities and fears of choking or vomiting. It can lead to malnutrition if untreated.
Attention-deficit hyperactivity disorder (ADHD) can occur alongside ARFID. But the underlying reason behind eating problems isn’t the same.
Co-occurring ARFID and ADHD can be managed with the right support. This may involve therapy, medication, medical care, nutritional oversight, self-care, and other supports.
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder that’s characterized by highly restrictive eating habits. But unlike with other eating disorders, people with ARFID aren’t trying to restrict their food intake because of their body shape or weight. Their disordered eating stems from sensory sensitivities and anxiety about consuming certain foods or food groups.
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by problems with attention, focus, and other aspects of executive functioning. It often occurs alongside ARFID.
In some people, ADHD can affect eating habits. For example, some people with ADHD may forget to eat due to time blindness, a common ADHD trait that makes it difficult to track the passage of time. A recent large-scale study [1] revealed that children with ARFID were nine times more likely to have ADHD than children without ARFID.
What drives disordered eating in ADHD and ARFID isn’t the same. But since they frequently co-occur, it can be hard to know if a person’s symptoms are a result of ADHD, ARFID, or both. Learning more about what these conditions have in common and what sets them apart can help you identify eating problems in yourself or others and know when to reach out for help.
Signs of avoidant or restrictive eating in ADHD
To be diagnosed with ARFID, a person must meet specific diagnostic criteria. But broadly speaking, it’s characterized as [2] a “failure to meet appropriate nutritional and/or energy needs.”
Here’s what that might look like for a person with ADHD:
Having little to no interest in eating due to sensory characteristics of foods or fears of choking, vomiting, or other unwanted outcomes of eating
Only consuming certain items on a short list of what they consider “safe” foods
Significant weight loss in adults or failure to meet physical developmental milestones in children
Needing to rely on supplements or a feeding tube to avoid nutritional deficits
Experiencing mental, emotional, and social impairments due to disordered eating
The care you need, when you need it
Learn how Rula can support your mental health journey
How ARFID and ADHD are linked
We don’t yet fully understand the connection between ARFID and ADHD.
But here’s what researchers have discovered about why these two conditions might be linked:
Sensory sensitivity: While ARFID is an eating disorder, it shares some characteristics with developmental disorders like ADHD. Both conditions are linked to increased food-related sensory sensitivity [3]. People with ARFID or ADHD (or both) may avoid certain foods due to texture, taste, or smell.
Executive functioning: Both ARFID and ADHD can create problems with executive-functioning [4] skills like planning, organization, self-control, flexibility, and memory. These challenges may cause someone to forget to eat, struggle to try new foods, plan and prepare meals, and more.
Interoception: When a person isn’t in touch with their body’s sensations, including hunger or fullness cues, it’s called interoception. This can happen with ADHD [5] and eating disorders [6], including ARFID. When someone doesn’t feel physically hungry, they may not eat. Over time, this can lead to harmful nutritional deficits.
Medication: One of the most common side effects of some medications for ADHD is appetite loss. So, unfortunately, if a person also has ARFID, taking ADHD medication can make it even harder to consume enough food.
How to tell the two conditions apart
ARFID and ADHD can sometimes look similar. A trained professional can help clarify what may be driving the eating challenges.
These conditions may affect eating in unique ways:
Someone with ADHD might not eat due to forgetfulness, lack of planning, or hyperfocusing on an activity and skipping meals. They may have some preferred foods but can be flexible when those options aren’t readily available. Eating problems due to ADHD may improve with some structure. However, this typically isn’t the case with ARFID.
Someone with ARFID has food aversions due to sensory sensitivities. If they don’t like how a food tastes, smells, or feels, they simply won’t eat. They may also avoid food due to fears of choking or vomiting. Left untreated, ARFID can create dangerous malnutrition that, in some cases, can be life-threatening [7].
ADHD and ARFID often co-occur, which can make diagnosis and treatment more complex.
Risks of not eating enough
Whether it’s due to ARFID, ADHD, or a combination of both, not eating enough can create serious health consequences [8]. While very picky eaters may sometimes struggle to eat enough, ARFID and ADHD-related eating challenges are different. These conditions involve patterns like strong sensory distress, anxiety about food, or difficulty recognizing hunger. These challenges often affect health, growth, or daily functioning.
When a person’s body doesn’t have the fuel it needs to function properly, it can lead to:
Fatigue
Extreme weight loss
Thinning hair
Sleep problems
Dizziness
Cognitive dysfunction (i.e. forgetfulness or inattention)
Digestive issues
Aches and pains
Irregular menstrual cycles (for people with a uterus)
Muscle weakness
Low body temperature
If you’re worried that you or someone you love isn’t getting enough to eat, a medical or mental health professional can provide an assessment. An accurate diagnosis is an essential first step. From there, you can work with your provider to develop a personalized treatment plan that suits your needs, life, and goals.
Building healthier eating with ARFID and ADHD
Co-occurring ARFID and ADHD can be treated with the right support. Typically, that requires a combination of therapy, medication, nutritional guidance, and medical oversight. Both conditions should be treated simultaneously. But if there’s a serious health complication due to ARFID, that should be addressed first.
In addition to seeking help from a care team with experience treating developmental and eating disorders, some self-help strategies can help you manage co-occurring ARFID and ADHD.
For example:
Create consistent mealtime routines. Try to eat at the same time each day and make time to shop for your preferred foods so that you always have something safe to eat.
Experiment with new foods when you feel ready. Preparing a meal for a friend or taking a trip to the grocery store can help you engage with new foods if you’re not ready to eat them.
Talk to your provider about medication. If your ADHD medication is reducing your appetite, let your provider know. They may have some recommendations to reduce side effects, like changing the timing or dose of your medication.
When ARFID and ADHD overlap, progress often shows up in how someone describes their eating. A patient might say, ‘I forget to eat sometimes, but certain textures still bother me.’ That awareness helps separate sensory triggers from executive functioning challenges.
Brandy Chalmers, LPC
Clinical reviewer
Find care with Rula
ARFID and ADHD are two different conditions. But they can both cause eating problems. With ARFID, a person may have strong food aversions, fears about choking or vomiting, or little to no interest in eating. With ADHD, a person may experience nutritional deficits because they forget to eat, have trouble planning meals, or become hyperfocused on something else.
Over time, not eating enough can lead to serious health consequences. So if you’re struggling to nourish your body, don’t hesitate to seek professional help. With therapy, medication, nutritional guidance, and medical support, you can manage co-occurring ARFID and ADHD and heal your relationship with food.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- ARFID Associated with Elevated Risk for ADHD, Autism in Youth: New Study https://www.additudemag.com/arfid-autism-adhd-youth-comorbidities/?srsltid=AfmBOorN_RUgeAQm-OeDhYzP7nQxjscCRh-5FU7aatwwVBOVoBrGTbhT
- Avoidant Restrictive Food Intake Disorder (ARFID) https://www.nationaleatingdisorders.org/avoidant-restrictive-food-intake-disorder-arfid/
- Avoidant/restrictive food intake disorder (ARFID) symptoms in gender diverse adults and their relation to autistic traits, ADHD traits, and sensory sensitivities https://pubmed.ncbi.nlm.nih.gov/39962613/
- Conceptualizing Avoidant/Restrictive Food Intake Disorder via an Executive Functioning Lens https://pmc.ncbi.nlm.nih.gov/articles/PMC11524791/
- ADHD and Eating Disorders: Understanding Treatment and Recovery https://www.allianceforeatingdisorders.com/adhd-eating-disorders-treatment/
- Self-reported interoceptive sensibility across eating disorder symptoms: associations with sociodemographic factors https://link.springer.com/article/10.1186/s40337-026-01530-z
- Physical health complications in children and young people with avoidant restrictive food intake disorder (ARFID): a systematic review and meta-analysis https://pmc.ncbi.nlm.nih.gov/articles/PMC11261741/
- Avoidant/Restrictive Food Intake Disorder (ARFID) https://my.clevelandclinic.org/health/diseases/24869-arfid-avoidant-restrictive-food-intake-disorder
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
Rula’s editorial process
Rula’s editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness.
Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
