The Challenges of Avoidant/Restrictive Food Intake Disorder and Autism Spectrum Disorder Comorbidity: A Narrative Update of Course and Outcomes

There is increasing evidence highlighting the overlap between avoidant/restrictive food intake disorder (ARFID) and autism spectrum disorder (ASD). The purpose of this review is to give an updated picture of current knowledge about the comorbidity between ARFID and ASD focusing on the studies published in the last year (June 2023 – July 2024).

The number of ASD patients in ARFID samples ranges from 8.2 to 42% in recent works. Despite a 95% of abnormal feeding behaviours in autistic patients, ARFID screening in the ASD population is not common, and the scarce evidence sets the comorbidity around 20–30%, with different percentage for the three-driver subtypes. Both ASD and ARFID are highly heritable conditions that share common features as sensory sensitivity, so that the potential usefulness of a specific sensory processing pattern to detect ARFID comorbidity in the ASD population has been suggested. Several support strategies are available, considering specific neurodevelopmental needs and nutritional vulnerabilities.

Further studies are needed to address the conceptualization of ARFID-ASD comorbidity, especially focusing on the outcomes in adolescent and adult subjects affected. Given the eventuality of severe complications, screening for ARFID in the autistic population is mandatory.