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Why Autism and Food Issues Often Go Hand in Hand

  • Evgeniya Zhukovskaya
  • Apr 15
  • 7 min read
Autism and Food Issues

Autistic children face unique challenges with food. Research indicates that 70% of autistic children show atypical eating behaviours, while only 5% of non-autistic children experience similar patterns.


The impact goes well beyond food priorities. Studies show that half of adults with anorexia are autistic or display elevated autistic traits. The data also reveals that autistic children and young people make up 44% of Avoidant Restrictive Food Intake Disorder (ARFID) cases. These findings prove how autism significantly shapes eating patterns.



The Sensory World of Autism and Food Textures


The relationship with food of people with autism is deeply rooted in how they process sensory information. Research shows that approximately 90% of autistic people experience sensory symptoms, especially with smell and taste.


These challenges aren't just about food preferences - they create real obstacles to eating a varied diet.

How sensory processing differences affect eating


The brain of autistic individuals processes sensory information differently. They might be extra sensitive (over-responsive) or less sensitive (under-responsive) to various stimuli. This unique sensory processing directly shapes their eating habits. Several body systems play a crucial role:


  • Proprioception (body awareness)

  • Vestibular (balance)

  • Interoception (awareness of internal states)


Interoception helps people recognise hunger and fullness, but many autistic people struggle with this awareness. That's why simple advice like "eat when hungry" doesn't work well - many can't easily identify these body signals.


Common texture aversions in autism


Texture sensitivity is one of the main reasons why autistic individuals avoid certain foods 1. Autistic children usually prefer foods with similar textures - they stick to either soft or crunchy options. These patterns start early:


Babies with tactile sensitivity often struggle during weaning (7-9 months). They gag, spit out, and refuse textured foods 2. Many end up relying on smooth purées or foods that melt easily. On the flip side, children who love crunchy foods might have lower sensitivity and seek out more intense sensory experiences 2.


Most school-age children narrow their food choices to just 5-10 items 2. These usually fit into specific categories like "beige carbohydrates" (bread, pasta, crisps) or foods with predictable textures (smooth yoghurts, chocolate buttons).


When texture sensitivity becomes overwhelming


Sensory overload happens when intense sensory input becomes too much to handle. Food can trigger intense anxiety about eating in autistic individuals. This anxiety often leads to:


  • Meal-related tantrums

  • Ritualistic eating behaviours

  • Complete food refusal

  • Strong reactions when foods touch each other


Research in the Journal of Developmental and Behavioural Paediatrics found that autistic children have substantially more unusual eating habits than their peers. These include food aversions, loyalty to specific brands, and eating rituals 19.


The environment plays a big role too. Bright lights, loud noises, and crowded spaces can make these sensitivities worse. This makes eating at school or restaurants particularly difficult 4.


Developmental Stages of Food Issues in Autism


Food problems show up before other signs of autism. Research shows that 89% of autistic children have some type of eating difficulty. These problems change as children grow older and create unique challenges at each stage.


Early signs in toddlers and young children


Parents might notice feeding problems before their child gets an autism diagnosis. Studies of large groups of children suggest that eating problems during infancy could point to higher autism symptoms later in childhood 6. The most common challenges at this age include:


  • Food selectivity (the biggest problem)

  • Mealtime tantrums

  • Trouble with oral-motor eating skills

  • Hard time expressing food priorities


Autistic toddlers tend to refuse food more often than other children their age. Most non-autistic children grow out of this phase 6. Children who have unusual sensory reactions and delayed motor skills find eating extra challenging, which makes these early eating problems worse 6.


School-age challenges and peer influences


Food issues take different paths during primary school years. The largest study of 396 autistic children found four distinct patterns:


School brings extra pressure from eating with peers and social expectations. Research points out that feeding problems relate more to general behaviour issues than to autism severity 7.


Adolescent and adult food patterns


Most children stop being picky eaters by age 6, but autistic people often remain selective with food through their teen years and beyond 8. While many children outgrow restricting eating habits, autistic individuals seem to follow a different pattern.


Research shows autistic teens and young adults stick to familiar foods and avoid certain textures and strong flavours. This selective eating can limit social opportunities and affect daily life skills 8. The nutrition concerns remain important as restricted diets continue past childhood.


Beyond Picky Eating: Autism and Food Refusal


Parents can tell the difference between a child being "picky" and showing real food refusal. Research backs this up and shows that most children might reject new foods now and then. However, food selectivity in autism often means avoiding whole food groups like proteins or vegetables 9.


Distinguishing between priorities and true refusal


Food selectivity affects up to 83% of autistic children, and they often stick to a very limited set of foods. Regular picky eating usually disappears by age 6.


Research shows autistic children have more reasons to refuse foods than their peers - about 2.2 reasons compared to 1.2 for neurotypical children 10.

The key difference lies in how intense and persistent the refusal becomes. About 40% of neurotypical children can't point to specific reasons for refusing food. This number drops to just 9.4% for autistic children 10. Food refusal often comes with eating rituals (46%) and a strong resistance to new foods (69%) 9.


The anxiety connection


Anxiety plays a big role in autism-related food refusal. Mealtimes can trigger real fear responses in many autistic people. Their bodies go into 'fight or flight' mode, which naturally suppresses hunger 11.


This anxiety can demonstrate itself as fear of:


  • Swallowing or choking

  • Trying unfamiliar foods (neophobia)

  • Becoming ill after eating

  • Unpredictable food situations


What might look like stubborn behaviour is often real distress. Changes make this anxiety worse, which leads to more rigid eating patterns 12.


When food refusal becomes dangerous


Selective eating rarely causes weight loss, but it can lead to serious health issues. Nutritional deficiencies might develop, causing:


  • Poor bone growth

  • Constipation

  • Vitamin and mineral deficiencies 13


These issues can worsen into conditions like anaemia, scurvy, and rickets 1. Cases of extreme selectivity might lead to diagnoses like Avoidant/Restrictive Food Intake Disorder (ARFID). ARFID is more common among autistic people than the general population. Moreover, some autistic people show signs of pica - eating non-food items like paper, cloth, plastic, or stones.


Interoception and Hunger Cues in Autism


Interoception, known as the 'eighth sense', is a vital part of how autistic individuals interact with food. Research shows that many autistic people experience significant differences in interoceptive awareness. These differences shape their relationship with eating and hunger.


Understanding internal body signals


Our body's internal states send us signals about hunger, thirst, temperature, and bladder fullness 14. Most people receive clear guidance from these signals for their daily functions. Autistic individuals often process these vital internal cues differently 15.


This sensory system difference shows up in several ways:


  • The body doesn't signal hunger until severe symptoms appear like headaches, stomach pain, or mood swings 16

  • Fullness signals don't register until reaching painful levels

  • Different bodily sensations get mixed up (hunger feels like thirst or anxiety) 15

  • Physical states and emotions become hard to connect 3


Interoception gives us the ability to recognise hunger and fullness. Many autistic people report challenges with this awareness 2. This challenge with interoception lies at the heart of autism's connection to food.


Why 'eating when hungry' isn't simple


"Eat when you're hungry" sounds like simple advice. But this assumes you can reliably feel hunger signals - something many autistic people can't do. The nervous system adds another layer of complexity. Autistic individuals often experience heightened fight-or-flight responses. These responses naturally suppress hunger signals. The body directs all energy to survival systems during stress, which temporarily shuts down digestive signals 3.


This creates a challenging cycle.

Stress makes it harder to detect hunger. Less eating follows, which stresses the body more and makes hunger even harder to recognise 3. Regular meal times become significant because natural hunger cues might lead to irregular or insufficient nutrition.

These interoceptive differences help explain why autistic individuals might overeat, undereat, or stick to rigid food routines. These behaviours often serve as ways to cope with unreliable internal signals 16.



Conclusion


The link between autism and food challenges plays a key role in providing the right support and care. These issues go beyond food priorities and affect most autistic people's daily lives. Their unique challenges come from sensory responses, growth patterns, and how they process internal body signals.


These challenges can feel huge, but the right support and knowledge can make eating patterns and quality of life better. Anyone facing these challenges can schedule a free 30-min call to explore personal strategies and support choices. Early and consistent support helps people with autism build a better relationship with food while honouring their sensory needs, ensuring good nutrition, and making mealtimes less stressful.



FAQs


Q1. How does autism affect eating habits?


Autism often impacts eating habits due to sensory sensitivities, difficulties with change, and challenges in processing internal body signals. Many autistic individuals experience food selectivity, texture aversions, and anxiety around mealtimes, which can lead to a limited diet and nutritional concerns.


Q2. Are food issues in autism just a phase?


Unlike typical picky eating that often resolves in childhood, food-related challenges in autism frequently persist into adolescence and adulthood. These issues often follow a different developmental trajectory, requiring ongoing support and management throughout various life stages.


Q3. How can parents distinguish between picky eating and food refusal in autistic children?


Food refusal in autism is typically more intense and persistent than typical picky eating. Autistic children often avoid entire food groups, have specific reasons for refusing foods, and may experience anxiety around eating. If food selectivity is severe or impacts health, professional assessment may be necessary.


Q4. Why might an autistic person struggle to eat when hungry?


Many autistic individuals have difficulty recognising internal body signals, including hunger cues, due to differences in interoceptive awareness. This can make it challenging to identify when they're hungry or full, potentially leading to irregular eating patterns or reliance on structured mealtimes rather than natural hunger signals.


Q5. What strategies can help manage food-related challenges in autism?


Managing food challenges in autism often requires a multifaceted approach. This may include creating a sensory-friendly eating environment, gradually introducing new foods, establishing consistent mealtime routines, and working with professionals such as occupational therapists or nutritionists. It's important to respect individual sensory needs while ensuring proper nutrition.


 

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