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Services
ARFID — Avoidant/Restrictive Food Intake Disorder — describes a pattern of eating that is significantly narrower or more avoidant than would be expected, and that affects nutrition, growth, function, or social participation. It is not the same as preferring certain foods or being a "picky eater". It is a recognised eating-disorder diagnosis, and it co-occurs at higher rates in autistic people and other neurodivergent populations than in the general population.
ARFID can sit on different drivers. Sensory responses to food — texture, smell, temperature, appearance — can be intense and consistent. Fear-based avoidance can follow a choking, vomiting or allergic episode. Low interest in eating itself can quietly narrow the diet over years. In a neurodivergent person, more than one of these may be present, and the pattern may be intertwined with broader autistic, ADHD or sensory processing patterns.
Standard "just try the food" approaches frequently make things worse. The work in this pathway is structured. The dietitian and supporting team know both eating-disorder care and neurodivergence, and the work is paced against what this nervous system can actually do.
This service is for neurodivergent adults (and supporting families where relevant) with a diagnosed or strongly suspected ARFID picture — significantly restricted intake, sensory-driven food avoidance, fear-based avoidance, or quietly low-interest eating that has become a clinical concern. It is not for ordinary preference or for short-term changes in eating during a difficult period.
The first appointment reads the eating picture in detail. Which foods are accepted, which are not, what the drivers appear to be, what previous approaches have been tried, current nutritional adequacy, weight history where relevant, broader neurodivergent picture, mental-health context.
The work distinguishes between sensory-driven ARFID, fear-driven ARFID, low-interest ARFID and mixed patterns. The strategy is different for each. Where the picture is complicated by autism, ADHD, comorbid anxiety, or earlier trauma around eating, those are held in the plan rather than worked around.
Goals are set carefully and explicitly. Sometimes the goal is to expand variety. Sometimes the goal is to maintain nutritional adequacy without expansion. Sometimes the goal is to reduce the distress around eating rather than to change what is eaten. The goal the person and their team agree to is the goal the plan is built against.
A graded plan is built. For sensory-driven patterns, careful and consented exposure may sit alongside sensory desensitisation work. For fear-driven patterns, exposure-based work integrated with anxiety treatment. For low-interest patterns, structural support for adequate intake rather than expansion. Where pharmacological or medical support is appropriate, that is layered in through the medical part of the team.
The plan is held with the rest of the biio. neurodivergent team — psychology, OT, sensory work, medical management — so the eating work is supported rather than competed with by the rest of the plan. Where eating-disorder specialist services or paediatric services are the right next step, that referral is made clearly through the same record.
ARFID is rarely a short course of work. The plan moves at the pace the person can hold. Maintenance work continues as the picture stabilises. Where the pattern flares — illness, stress, a sensory or environmental change — earlier work can be returned to rather than started again.
When the ARFID work is going well, the change is usually gradual. Nutritional adequacy stabilises. Distress around eating eases. Where expansion of variety is the goal and the pacing is right, foods that were not accepted become tolerated, then sometimes accepted. Where the goal was holding ground, ground is held without losing further variety.
This service does not "cure" ARFID, and the framing of cure is rarely what helps. ARFID often runs across years and the strategies sit alongside the person across that time. What the work can do is reduce the cost ARFID is taking from daily life, support nutritional safety, and treat the eating picture with the seriousness it deserves rather than the dismissiveness it often meets.