The Hidden 20%

Why ARFID Is Rising: Autism, ADHD & the Eating Disorder Nobody Talks About

Dec 17, 2025
Dr. Josephine Neale, a child and adolescent psychiatrist and founder of Neale Health, dives into the nuances of Avoidant Restrictive Food Intake Disorder (ARFID). She shares insights on how ARFID often intertwines with autism and ADHD, highlighting its four subtypes: sensory challenges, fear-driven behaviors, low appetite, and their combinations. Josephine addresses the growing recognition of ARFID in modern life, especially during the holidays, and offers practical tips for families. Her compassionate approach aims to illuminate this often-misunderstood eating disorder.
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INSIGHT

ARFID Is Defined By Consequence

  • ARFID is a broad, recent diagnostic category for restrictive eating that causes real consequences rather than mere fussy eating.
  • The key distinction is consequence: physical, nutritional, or psychosocial impact separates ARFID from typical picky eating.
ADVICE

Begin With GP For Growth And Reassurance

  • Start with your GP for assessment and growth tracking; ask if a child is following expected weight and height centiles.
  • Seek reassurance first to determine if eating is normal picky behaviour or needs specialist input.
INSIGHT

Care Pathways For ARFID Are Fragmented

  • Referral pathways for ARFID are unclear and vary by local services, causing inconsistent care access.
  • Tailored pathways are needed so children get pediatric, psychiatric, or combined input based on individual needs.
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