By Tim Aiello, MA, LPC, NCC, ADHD-CCSP, ASDCS
Introduction: A Personal Struggle with Food Aversion
Food is often seen as a source of comfort, nourishment, and connection. But for many neurodivergent adults—particularly those with ADHD, Autism, or AuDHD (both ADHD and Autism)—eating can be a complicated, stressful experience. Food aversion is more than just being a picky eater; it’s an intense and involuntary avoidance of certain foods due to sensory sensitivities, emotional dysregulation, or executive functioning challenges.
I know this struggle firsthand. As an AuDHD therapist, I have lived through the frustrating, sometimes debilitating effects of food aversion and disordered eating patterns. When I become dysregulated, I completely lose interest in food, even when I know I need to eat. Sometimes, I can only tolerate my "safe foods"—raisin bran, peanut butter and jelly sandwiches, pizza rolls, fried egg sandwiches, tuna sandwiches, mac and cheese with peas. Other times, when I’m hyperfocused on a special interest, I won’t even recognize that I’m hungry.
For neurodivergent adults, food aversion is often misunderstood and dismissed as being “picky” or “stubborn.” But when we look at it through the lens of Polyvagal Theory and neurodevelopmental research, we begin to understand why eating can feel like such a challenge—and more importantly, how we can work with our bodies rather than against them.
What is Food Aversion?
Food aversion is not simply disliking a food—it’s an intense physical or emotional reaction to the idea, sight, smell, texture, or taste of certain foods. Some common characteristics of food aversion include:
Extreme sensitivity to textures, flavors, or smells (e.g., avoiding foods that feel "mushy" or "grainy").
A strong gag reflex or nausea when trying new foods.
A limited "safe food" list that doesn’t change much over time.
Anxiety or distress at mealtimes, especially in unfamiliar settings.
Periods of complete loss of interest in food, especially during emotional dysregulation.
In clinical settings, severe food aversion is often diagnosed as Avoidant/Restrictive Food Intake Disorder (ARFID). Unlike other eating disorders, ARFID is not driven by concerns about body image but rather by sensory sensitivities, a fear of negative experiences with food (e.g., choking, vomiting), or simply a lack of interoceptive awareness (not feeling hunger cues) (National Eating Disorders Association, n.d.).
The Connection Between ADHD, Autism, and Food Aversion
Autism and Food Aversion
Food aversion is particularly common in autistic adults, largely due to sensory processing differences. Studies have shown that up to 70% of autistic individuals experience some form of disordered eating, with selective eating and sensory-based food avoidance being the most prevalent (Koomar et al., 2023). Many autistic people experience heightened sensitivity to textures, smells, and temperatures, which can make certain foods feel intolerable.
For example, I personally cannot stand the feeling of certain textures in my mouth, even if I like the taste. If a food is too slimy or gritty, my brain automatically rejects it, making it almost impossible to swallow. This is not a conscious decision—it’s a deeply ingrained neurological response.
ADHD and Food Aversion
While ADHD may not directly cause food aversion in the same way Autism does, it contributes in other significant ways:
Executive Dysfunction & Eating Habits – People with ADHD often struggle with meal planning, food preparation, and remembering to eat (Brewerton & Duncan, 2016).
Hyperfocus & Interoception Issues – When deeply engaged in an interest, an ADHD brain may completely ignore hunger cues until physical symptoms like dizziness or nausea set in.
Emotional Regulation & Eating – Emotional dysregulation can cause appetite fluctuations, leading to binge eating one day and food avoidance the next.
For me, when I’m hyperfocused on something, eating doesn’t even cross my mind. I can go hours without realizing I haven’t eaten. Other times, when I’m overwhelmed or emotionally drained, food seems repulsive—I know I need to eat, but the idea of putting something in my mouth feels impossible.
Polyvagal Theory: Understanding Why We Shut Down Around Food
Polyvagal Theory, developed by Dr. Stephen Porges, explains how our autonomic nervous system (ANS) responds to stress, safety, and survival. The ANS has three primary states:
Ventral Vagal (Safe & Social) – Feeling calm, connected, and engaged. Eating is easy in this state.
Sympathetic (Fight or Flight) – Anxiety, stress, and hyperactivity dominate. Eating becomes difficult because the body is focused on survival.
Dorsal Vagal (Shutdown & Freeze) – Feeling numb, dissociated, or disconnected. Appetite is often completely lost in this state.
When a neurodivergent person experiences stress, sensory overload, or emotional dysregulation, they may shift into sympathetic or dorsal vagal states. This can make eating physically uncomfortable or even impossible.
For instance:
If I’m in fight or flight, my stomach feels tight, and I have zero interest in food.
If I’m in shutdown mode, food seems overwhelming, and I may even feel nauseous at the idea of eating.
Recognizing this has been life-changing for me and my clients—it’s not about "forcing" ourselves to eat but rather regulating our nervous system first, so eating feels safer and easier.
The "Fed is Best" Approach
One of the most important lessons I’ve learned is that when food aversion is at its worst, "fed is best."
This means:
It’s okay to eat only your safe foods. If all I can tolerate is PB&J, that’s okay.
It’s okay to eat small amounts more frequently instead of big meals.
It’s okay to eat foods that are easy and convenient, even if they aren’t "healthy."
The goal is not to force yourself into an ideal diet but to keep your body nourished enough to function. Over time, as nervous system regulation improves, so does the ability to introduce more variety.
Strategies for Managing Food Aversion
Regulate Before Eating
Try deep breathing, sensory grounding, or Polyvagal-based exercises before meals.
Stimulate the vagus nerve (humming, gargling, cold exposure) to shift into a ventral vagal state.
Eat in a Safe Environment
Dim lighting, reduce noise, and remove stressors during meals.
Use weighted blankets or compression clothing for added sensory comfort.
Use Sensory-Friendly Eating Tools
Try different utensils (textured spoons, silicone forks) to find what feels best.
Drink calories if eating is too difficult (smoothies, protein shakes).
Work with Interoception Challenges
Use timers or reminders to eat before reaching exhaustion.
Start with small, manageable portions and increase as tolerated.
Conclusion
Food aversion in ADHD and Autism is not just being picky—it’s a real, physiological response to stress, sensory input, and emotional dysregulation. Understanding this through Polyvagal Theory allows us to approach eating with compassion and adaptability rather than shame.
If you or someone you know struggles with food aversion, remember: fed is best. Meet your body where it is, and work towards nourishment in ways that feel safe and manageable.
References
Brewerton, T. D., & Duncan, A. E. (2016). Associations between Attention Deficit Hyperactivity Disorder and Eating Disorders by Gender: Results from the National Comorbidity Survey Replication. European Eating Disorders Review, 24(6), 536–540. https://doi.org/10.1002/erv.2476
Koomar, T., Potrzeba, L., & Norris, M. L. (2023). The Co-Occurrence of Autism and Avoidant/Restrictive Food Intake Disorder: A Meta-Analytic Review. International Journal of Eating Disorders, 56(2), 243–258. https://doi.org/10.1002/eat.24369
National Eating Disorders Association (NEDA). (n.d.). Avoidant/Restrictive Food Intake Disorder (ARFID). Retrieved from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid
Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W.W. Norton & Company.
Zickgraf, H. F., Richard, E., Zucker, N. L., & Wallace, G. L. (2020). Characteristics of Avoidant/Restrictive Food Intake Disorder (ARFID) in Autistic Adults: A Mixed Methods Study. Appetite, 155, 104800. https://doi.org/10.1016/j.appet.2020.104800
Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food Selectivity and Sensory Sensitivity in Children with Autism Spectrum Disorders. Journal of the American Dietetic Association, 110(2), 238-246. https://doi.org/10.1016/j.jada.2009.10.032
Farrow, C. V., Haycraft, E., & Blissett, J. M. (2015). Teaching Our Children When to Eat: How Parental Feeding Practices Inform the Development of Emotional Eating—A Longitudinal Experimental Design. American Journal of Clinical Nutrition, 101(5), 908-913. https://doi.org/10.3945/ajcn.114.103713
Fletcher, P. C., Pine, K. J., Woodbridge, Z., & Nash, A. (2022). Interoception and Eating Behaviors in Neurodivergent Adults: Implications for ARFID and ADHD. Neuropsychology Review, 32(4), 567–581. https://doi.org/10.1007/s11065-021-09522-2
Smith, E., Nadon, G., & Faulkner, C. (2018). Sensory Processing and Food Aversion in Autism and ADHD: Overlapping Mechanisms and Distinct Challenges. Journal of Autism and Developmental Disorders, 48(7), 2450-2465. https://doi.org/10.1007/s10803-018-3536-2
Williams, K. E., Hendy, H. M., & Knecht, S. A. (2018). Parent-Reported Feeding Problems and Nutrient Intake in Children with and Without Autism: A Comparative Study. Research in Autism Spectrum Disorders, 50, 51-61. https://doi.org/10.1016/j.rasd.2018.02.006
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