Understanding Food Aversion in Neurodivergence
Picky eating is common among individuals, affecting both children and adults. It is usually outgrown, or preferences may change, so that a once-disliked food may later be tolerated and enjoyed. An extreme reaction to a food, such as gagging, vomiting, and intense anxiety, is a hallmark of food aversion. It is often associated with hypersensitivity to a specific sensory attribute, such as taste or texture, rendering a wide variety of foods with similar attributes intolerable.
Food aversions are common among individuals with sensory processing disorder, autism, and ADHD. It has been estimated that behavioral feeding problems in children with autism could be as high as 51-89%. Individuals with autism may insist on sameness, which can make eating highly restrictive. In contrast, individuals with ADHD portray more impulsivity and dopamine-seeking behaviors around food choices, which can lead to fixations on specific food likes and dislikes (Grot).
The Core Causes: Sensory and Emotional Triggers
As previously mentioned, hypersensitivity to foods due to an overstimulated nervous system can result in an inability to tolerate certain textures, smells, colors, and even temperatures. For instance, an individual may dislike mushy foods, thereby limiting their potential food choices to mashed potatoes, yogurt, or bananas.
A core trait among individuals with autism is the need for control and routine. Introductions to new foods or foods they dislike can create a sense of lack of control, leading to an anxious feeding environment and further restrictions or avoidance of foods. It may even be common for someone with autism or ADHD to desire to eat the same foods daily or even at every meal because it offers the safety of knowing what to expect.
Strategies for Managing Aversions and Expanding the Diet
Creating a Safe Food List and Building Trust
Managing food aversions can be challenging, but in some situations, overcoming them is possible. Specific strategies, like creating a safe foods list, can help and provide comfort. Additionally, discussing potential new foods before mealtimes and allowing the individual with food aversions to have some say and control in choosing the new food may help. This can help substantially with children who often feel a lack of control over what they eat. Consistent meal times and a routine are also key to creating predictability and trust.
Gentle Exposure Therapy and Food Chaining Techniques
When introducing new foods, simply place the new food on their plate and allow them to look at it, touch it, and smell it before eating. This can help reduce anxiety associated with the new food and lead to greater acceptance. Food chaining can help picky eaters by introducing new foods that resemble familiar foods in appearance, texture, or taste. For instance, try chicken nuggets, then introduce fish sticks or fish nuggets to try fish. Or using potato chips to introduce banana chips.
Check out this helpful handout for more information. It is important to remain patient when introducing new foods to help reduce stress and anxiety.
Check out this helpful handout for more information. It is important to remain patient when introducing new foods to help reduce stress and anxiety.
The Importance of Professional Support
Occupational therapists and feeding therapists are very great resources for individuals with food aversions and other disordered eating behaviors. If you suspect either yourself or your child is struggling with food aversions, talk with your healthcare provider to get a referral to a specialist to work with you to overcome feeding behavior challenges.
Furthermore, a referral to a registered dietitian is helpful in ensuring that nutritional needs are met for optimal health and growth, especially in children. Sometimes, multivitamins are needed, along with oral nutrition supplements such as protein shakes, to help meet calorie and protein requirements. Dietitians may also have great ideas for alternative foods to try, which will help expand variety.
FAQs
What is the difference between picky eating and a food aversion?
Picky eating is generally characterized by strong food preferences that may change over time, while food aversion involves an intense sensory or emotional response to certain foods. Individuals with food aversions may experience anxiety, gagging, nausea, or even vomiting when exposed to foods with specific textures, smells, flavors, or appearances.
Why are food aversions more common in people with autism and ADHD?
Food aversions are often linked to sensory processing differences that are common in autism and ADHD. Certain textures, temperatures, smells, colors, or tastes may feel overwhelming or unpleasant. Additionally, routines and predictability can provide comfort, making familiar foods feel safer than unfamiliar options.
What is food chaining, and how can it help?
Food chaining is a gradual technique used to expand food variety by introducing foods that are similar to a person's accepted "safe foods." For example, someone who enjoys chicken nuggets may be encouraged to try fish sticks because they share a similar texture and appearance. This approach can reduce anxiety and make new foods feel less intimidating.
Should children be forced to eat foods they dislike?
Generally, forcing foods can increase stress, anxiety, and resistance around eating. A more effective approach is gentle exposure, allowing a child to see, touch, smell, and eventually taste new foods at their own pace. Building trust and maintaining a positive mealtime environment are often more successful strategies for expanding food acceptance.
When should someone seek professional help for food aversions?
Professional support may be beneficial when food aversions significantly limit dietary variety, affect growth or nutritional status, cause distress at mealtimes, or interfere with daily life. Occupational therapists, feeding therapists, and registered dietitians can help develop individualized strategies to improve food acceptance while ensuring nutritional needs are met.
References
1Picky eating vs. ARFID — How to tell the difference. (2025, May 16). UCLA Health. https://www.uclahealth.org/news/article/picky-eating-vs-arfid-how-tell-difference
2Vasilakis, M., Polychronis, K., Panagouli, E., Tzila, E., Papageorgiou, A., Thomaidou, L., Psaltopoulou, T., Tsolia, M., Sergentanis, T. N., & Tsitsika, A. K. (2022). Food Difficulties in Infancy and ASD: A literature review. Children, 10(1), 84. https://doi.org/10.3390/children10010084
3Grot, M., Białek-Dratwa, A., Krupa-Kotara, K., Grajek, M., Nigowski, M., Szczepańska, E., & Kowalski, O. (2024). Negative Aspects of Dietary Habits in Children and Adolescents with Autism Spectrum Disorders. Nutrients, 16(18), 3059. https://doi.org/10.3390/nu16183059
4Chawner, L. R., Blundell-Birtill, P., & Hetherington, M. M. (2019). Interventions for Increasing Acceptance of New Foods Among Children and Adults with Developmental Disorders: A Systematic Review. Journal of Autism and Developmental Disorders, 49(9), 3504–3525. https://doi.org/10.1007/s10803-019-04075-0
5Fishbein, M., Cox, S., Swenny, C., Mogren, C., Walbert, L., & Fraker, C. (2006). Food Chaining: A systematic approach for the treatment of children with feeding aversion. Nutrition in Clinical Practice, 21(2), 182–184. https://doi.org/10.1177/0115426506021002182
6Coping with Picky eating the pediatric dietary intervention. (n.d.). https://www.pediatrics.columbia.edu/file/77485/download?token=IFA-PeOq
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