Useful articles about health

Nadine Dirks shares her experience of avoidant restrictive eating as a symptom of attention deficit hyperactivity disorder (ADHD).

In our Through My Eyes series, we provide a platform for people to share how a particular medical condition has affected their life. By shining a spotlight on the physical and emotional, this series aims to raise awareness while providing practical advice and support to any readers who may be experiencing something similar.

Share on PinterestDesign by Medical News Today; photography courtesy Nadine Dirks.

For as long as I can recall I have been quite averse to certain foods. I hated the consistency of tomatoes, the texture and smell of bananas, and the way yogurt was just smooth. I just put it down to disliking certain foods — that was how my family saw it, too.

I would insist my sandwiches be made without butter because I didn’t like the coating on my tongue after eating it. I loathed touching raw meat, particularly chicken, because the smell drove me up the wall, and the texture felt almost slimy.

Jelly, processed meats, and anything with multiple components, like trifle, made my skin crawl. It was sensory overload and I couldn’t seem to process it. Some days I would get frustrated with myself because I would suddenly be overwhelmed even by foods I did enjoy, like avocado, eggs, or cheese.

I couldn’t understand why it was such an uphill battle just to eat something. The sense of overwhelm was so severe that I would unconsciously avoid eating after experiencing a reaction to a particular food.

I was diagnosed with ADHD in my mid-20s, and up until that point had no idea I was neurodiverse. Suddenly everything made sense — difficulties at school, being too talkative, struggling with focus and concentration, overthinking and anxiety, so many elements of my life made sense.

I had no idea just how severely ADHD had impacted my life, and how it affected my everyday experience. It was both a relief to finally have an answer for so many things I had experienced and incredibly frustrating and painful because I felt resentful about the difficulties I had faced.

I was upset because had I known sooner, I would likely have had better tools to deal with the disorder.

‘The texture, scent, consistency or appearance of a dish may unsettle me’

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My therapist and I discussed my issues with sensory overload, which manifested in multiple ways — sensitivity to lights, loud sounds, crowded spaces, and even textures of my clothes and blankets.

It dawned on me that my issues with textures, smells and consistencies in relation to food could absolutely be due to ADHD. I decided to consult the internet, and found out about avoidant restrictive food intake disorder (ARFID), an eating disorder associated with those with ADHD and autism.

The research indicated it was similar to anorexia but with a key difference — people with ARFID have no interest in body weight, size, shape, or body image, which is commonly seen in people who deal with anorexia.

I had no idea that ADHD could play any kind of role in the issues I had faced with food all my life. I couldn’t really understand it or find an abundance of resources for the lay person about the connection between ADHD and disordered eating.

Some research seems to indicate that sensory issues could be an important factor in ARFID. This is very much aligned with my experiences: I have no desire to lose weight, nor do I have any interest in my body image, but I tend to restrict my eating and lose weight anyway because of a severe reaction to food that causes major anxiety about eating.

I tend to worry and become anxious a long time before meals, when I go to new restaurants, or visit someone else’s home for a meal.

I worry that the texture, scent, consistency or even appearance of a dish may unsettle me to the point of not eating for hours on end.

‘It is so rare to hear about it‘

My therapist and I have discussed the issue at length and thankfully, as a neurodivergent woman herself, she truly understands and is able to speak and relate to me in a way that is comforting. Her recommendation to work with an occupational therapist to deal with the sensitivity has been helpful.

ARFID is exceptionally difficult to deal with because it completely shifts your life, and makes it difficult to socialize without being hyperfocused on the gaze of others. Generally speaking, people have no idea about ARFID so it can seem like someone is just being difficult or a picky eater, which is not the reality.

I wish I could just complete a meal without quitting because the smell was overwhelming — it is just not that simple to navigate.

It is a part of ADHD that is incredibly hard to navigate, it is difficult to explain to people. It is not something we talk about often when we speak about ADHD.

It is so rare to hear about ARFID that the general public seems puzzled when I attempt to explain my eating habits and their link to ADHD.

It isn’t seen as one of the main symptoms to look out for, and in my experience, it took multiple individuals commenting on my weight loss, and my own realization that I avoid multiple foods and often skip meals because I am overwhelmed by the sensory overload to become conscious of it.

After a significant battle with attempting to force myself to eat and just ending up overwhelmed and physically unwell, I decided to reach out to experts to discuss the experience I had been having.

My issues with eating and sensitivity around particular things seemed to be heightened when I was overwhelmed, in general. It seemed to exacerbate the symptoms.

One of the ways in which I have been able to manage my situation has been by consulting experts, prepping meals beforehand so I avoid feeling overwhelmed, and working with an occupational therapist to manage my sensory issues.

Talking about ADHD and restrictive eating ‘could be life-saving’

Neurodivergence is a complicated issue and one that is multifaceted. Our experiences would likely be easier, and our symptoms managed sooner if regarded holistically and not just as focus- and hyperactivity-related issues.

This would not make sensory issues go away entirely but it would provide the tools to better manage these sensitivities.

Assessing what situations I am fairly comfortable with and the things that distress me has allowed me to open up in a safe environment and slowly work on exposure therapy.

We need to have conversations about ADHD that are wide and varied. The condition isn’t the same for everyone, and it would help many if we viewed it holistically and treated the multiple parts of this disorder.

Having conversations about ADHD and comorbidities like ARFID could be life-saving to some, it could provide answers, and even encourage others to seek professional help for their disordered eating before it causes long-term effects on the body.

In my view, we have a long way to go in having open conversations without the stigma about these kinds of symptoms that everyone shies away from. No one wants to talk about disordered eating, yet it is stigmatized despite the fact that it is not a rarity.