Eating Disorders Such as Pica and ARFID Are Common in Children with Autism Spectrum Disorder, Review Finds
Increased Risk of Specific Eating Disorders in Children with ASD
A recent systematic review highlights that children and adolescents diagnosed with autism spectrum disorder (ASD) are at a higher risk of developing certain eating disorders, particularly pica and avoidant restrictive food intake disorder (ARFID). These conditions, characterized by unusual eating behaviors not primarily driven by concerns about weight or body image, may lead to significant health challenges if not identified and managed early.
Scope and Methodology of the Review
Researchers conducted a comprehensive analysis of existing studies following PRISMA guidelines, searching major medical and psychological databases including MEDLINE, Embase, Cochrane, CINAHL, and PsycINFO up to January 2026. The inclusion criteria targeted peer-reviewed English-language studies involving children under 18 years with ASD and diagnosed eating disorders based on DSM or ICD criteria. From an initial pool of 8,678 articles, 23 met the criteria for detailed examination.
Key Findings on Pica, ARFID, and Rumination Disorder
- Ten studies focused on the co-occurrence of ASD and ARFID.
- Twelve studies examined ASD alongside pica.
- Only one study addressed rumination disorder (RD) in the ASD population.
The evidence suggests that pica and ARFID are notably more prevalent in children with ASD compared to the general pediatric population. Early detection and intervention appear crucial, as these disorders can lead to serious health consequences if left untreated. Conversely, rumination disorder remains less studied and may be underdiagnosed within this group.
Clinical Implications and Challenges
Unlike other eating disorders where body image concerns predominate, the eating difficulties in ASD-related pica and ARFID arise from different underlying factors. This distinction underscores the need for tailored diagnostic assessments and treatment approaches. However, the review points out that current research is limited by small sample sizes, inconsistent diagnostic methods, and a lack of standardized interventions.
What Families and Care Providers Should Know
Families and healthcare professionals should be aware that children with ASD may exhibit atypical eating behaviors warranting evaluation for disorders like pica and ARFID. Prompt recognition can facilitate timely support, potentially improving health outcomes and quality of life. Given the limited research on rumination disorder in ASD, vigilance for symptoms is also advisable.
Limitations and Future Directions
The review emphasizes the need for larger, methodologically robust studies to better understand the prevalence, diagnosis, and effective treatments of these eating disorders in the ASD population. Standardized diagnostic tools and intervention protocols would enhance clinical care and research consistency.
For more detailed information, the full systematic review is available at PubMed.
Download the images in this article
