The Understory

Transforming What We Face Into How We Flourish

Summer 2026 | Issue 33

Short on time? Read the full piece on the blog here, or settle in and read it below.

When Food Becomes Another Battle

Eating disorders in kids with autism, ADHD, and dyslexia, and why the picture looks different for each

Renata found out almost by accident. She was packing her daughter's lunch and noticed, not for the first time but for the first time she really let herself notice, that the same five foods had been in that lunchbox for something like two years. Plain noodles, a specific brand of cracker, apple slices... but only if they were cut a certain way, because the wrong cut apparently changed something about how they felt in her daughter's mouth. Renata had always called it pickiness, and she had always assumed her daughter, who is eight and has autism, would grow out of it the way her older son had grown out of his own pickiness around age five. But her daughter wasn't growing out of it. And when Renata finally brought it up with the pediatrician, expecting to be told not to worry, she instead heard a phrase she'd never heard before: Avoidant Restrictive Food Intake Disorder, or ARFID.

I want to sit with that acronym for a minute, because I think at least a handful (if not many more) of you reading this have a version of Renata's story sitting somewhere in your own house, and it's possible that not enough of us have been told what it actually is.

Here is what the research is telling us these days, and it's worth exploring the shape of it, because eating disorders don't look the same across autism, ADHD, and dyslexia, even though all three of these kids are often lumped together under one broad neurodivergent umbrella.

For autistic kids, it's often sensory, not about weight at all

This is maybe the most important thing to understand, and it runs against almost everything we've been taught about eating disorders. ARFID doesn't involve body image or a desire to be thin. It's driven by sensory sensitivity, and sometimes by fear, around texture, smell, appearance, or the unpredictability of a new food. One large study of autistic kids and their parents found that roughly one in five of the children, and nearly as many of the parents, were at high risk for ARFID, but only about one percent had ever received an actual diagnosis. That gap matters. It means a huge group of families are quietly managing something clinical while believing it's just a personality trait, the way Renata did for two years.

And here's a detail from the research that I found genuinely useful: not every autistic kid with rigid eating is at risk in the same way. Kids who are highly sensitive to sensory input, or who actively avoid it, are the ones more likely to develop this kind of restriction. But kids who have low sensory registration, meaning they don't notice internal cues like hunger very strongly, sometimes show the opposite pattern. So the question isn't just "is my child a picky eater," it's "what is my child's nervous system actually doing around food," and that's a much more useful question to bring to a doctor or feeding specialist.

For kids with ADHD, it often looks like a different problem entirely

Where autism tends to show up as restriction, ADHD tends to show up as dysregulation in the other direction. Researchers describe it as externally driven eating, meaning the eating is less about sensory comfort and more about impulsivity as well as the ADHD brain's constant search for stimulation and reward. Some adults with ADHD describe bingeing almost as a strategy, a way of self-soothing or self-medicating in the absence of other regulation tools. And the numbers back up how real this is. One large national study found that both autism and ADHD significantly raise the odds of a co-occurring eating disorder diagnosis, with ADHD nearly doubling the risk and autism nearly tripling it.

For kids with dyslexia, the pathway is more indirect, and I think that's worth saying plainly

I looked for a direct biological link between dyslexia and eating disorders the way there is for autism and ADHD, and I couldn't find one, at least not one that's been well established in the research. What I found instead felt more honest, and maybe more useful. Kids with learning differences, dyslexia very much included, are at real and measurable risk for shame and a damaged sense of academic self worth, simply from years of struggling in a school system that wasn't built for the way their brains process language. And low self-esteem is one of the most consistently documented risk factors for eating disorders in adolescents, full stop, regardless of what's causing that low self-esteem in the first place. So a child with dyslexia may not be at elevated risk because of the dyslexia itself. She may be at risk because of what years of feeling not smart enough did to how she sees herself, and that's a distinction I think matters, because it points us toward a different kind of prevention. It's not about the reading. It's about protecting a child's sense of worth while the reading is still hard.

So what does a parent actually do with all of this?

I don't think the answer is to panic over every plain noodle dinner or every extra helping of dessert. Most picky eating is developmentally normal and most kids do outgrow it. What I'd invite you to pay attention to instead is whether the pattern is getting more rigid rather than less, whether it's affecting your child's growth or nutrition, whether new foods produce something closer to fear than mild reluctance, or whether you're noticing your child's sense of self quietly eroding around school or body or food, even if the eating itself still looks unremarkable. Those are the signals worth bringing to a pediatrician, a feeding specialist, or a therapist who understands neurodivergence, not because something is wrong with your child, but because catching this early tends to make everything gentler. If any of that is present in your family, please let a clinician be part of the picture. That part isn't optional, and nothing I offer is meant to replace it.

But there's another piece of this that lives entirely in your hands, and it has nothing to do with what's on the plate. Kids pick up on our nervous systems before they pick up on our words, and mealtimes are one of the places where that shows up most. If you're bracing every time a new food appears, or holding your breath waiting to see whether tonight is a good night or a hard one, your child feels that bracing, even when you think you're hiding it well. The work of staying regulated yourself, of bringing a calmer body to the table even when the food itself is still complicated, is real support, and it's something you can start learning regardless of where your child falls on this spectrum. This is much of what we work on together in Beyond Behavior and in our one on one sessions, not because you need permission to begin, but because this kind of nervous system work tends to land more gently once we've had a chance to understand what's actually happening for your specific child first.

And if you recognize your own family somewhere in Renata's story, I want you to know that noticing it two years in, the way she did, isn't a failure. Most of these patterns hide in plain sight precisely because they look so ordinary from the inside. You're not behind. You just noticed when you noticed.

If you want to talk through what you're seeing in your own child, and figure out together what kind of support makes sense, whether that's a referral, a conversation about co-regulation, or both, I'd love to be a sounding board. You can grab a spot on my calendar below, no pressure, just a conversation.

Book a free 30 minute conversation

With warmth,
Janine

What's coming over the next month or so

This eating disorder piece is the first of a few I've got in the works, and I wanted to give you a peek at what's ahead. I'll be writing about procrastination and why it so often has less to do with discipline and more to do with a nervous system that's trying to protect you, with some real overlap for parents managing their own follow-through alongside their child's. I'm also working on a piece about individuation in neurodivergent kids, which is really a piece about support, and how we figure out when we're helping and when we've quietly started doing too much for our children. And there are two more brewing as well, one on what it actually takes to communicate well with teachers, administrators, doctors, and therapists when you're the parent in the room, and another looking honestly at gluten, red food dye, and some of the other foods that so many of us wonder about, even where the science is still pretty thin. I'll be sending these out one at a time over the coming weeks, so keep an eye on your inbox.