ARFID and Fear of Weight Gain: It's Not "Just an Anorexia Thing"

When I tell people that I never had distorted body image or feared fatness, they often ask: “Did you have ARFID instead?” Was my restriction caused by sensory sensitivities and/or fear of negative consequences? Definitely. But where would counting calories, compulsive exercise, and other “classic” anorexia behaviors fit into this delineation? Would a dual diagnosis of ARFID and AN be appropriate in such cases?

Per usual, my autistic brain believes this conversation is a lot more nuanced than what our label-obsessed society has attempted to squeeze into diagnostic boxes. In this post, you’ll learn what ARFID is, how it’s traditionally distinguished from anorexia, why this distinction misses the mark, and how viewing all eating challenges through the lens of The Adaptive Eating Spectrum honors the fundamental human need for safety.

What is ARFID?

Avoidant/Restrictive Food Intake Disorder (ARFID) is defined as a restrictive eating disorder driven by sensory sensitivities, fear of negative consequences, and/or a lack of interest in food. What (supposedly) separates ARFID from anorexia is the absence of weight and shape concerns. 

But what if (some) people with ARFID do fear weight gain?

This question challenges the neat diagnostic boundaries society has constructed. And it’s a question worth exploring, because it opens the doors to a radically different understanding of eating disorders: not as distinct pathologies, but as points along what I call The Adaptive Eating Spectrum (TAES).

For Many Autistic People, Weight Gain is a Negative Consequence 

The DSM-5 acknowledges that individuals with ARFID may restrict food due to fear of negative consequences. These fears typically include choking, vomiting, or experiencing digestive issues. But if we’re recognizing that ARFID involves avoiding perceived threats, why wouldn’t weight gain qualify as a negative consequence?

For autistic individuals – who represent a significant portion of those diagnosed with ARFID – weight gain can be experienced as profoundly threatening:

Sensory Overwhelm: Weight gain changes how your body feels. Different parts touch, clothes fit differently, and new sensations emerge. For someone with heightened sensory sensitivity, this can feel like being trapped in an alien body.

Loss of Predictability: When your body changes in ways you can’t control, it disrupts the predictability that many autistic people rely on for safety. The unknown becomes a source of intense anxiety. 

Existential Disruption: Physical changes can feel like a fundamental threat to identity, especially when you’re already navigating the challenges of existing as a neurodivergent person in a neurotypical world.

Learn about 8 reasons autistic people fear weight gain here →

Beyond Diagnostic Boxes

The rigid distinction between ARFID and anorexia nervosa reflects our tendency to pathologize human behavior rather than try to understand it. When we focus on whether someone’s fears align with specific diagnostic criteria, we miss the deeper truth that all eating disorders represent adaptive responses to perceived threats. For this reason – and as I fully unpack in the Autistically ED-Free Academy – I believe in replacing the term eating “disorder” with eating adaptation.

Whether someone restricts food due to texture aversions, fear of choking, or fear of weight gain, the underlying mechanism is the same. The nervous system perceives danger and adapts accordingly. The eating disorder becomes a survival strategy – a way to create safety in an overwhelming world. Obviously, this doesn’t just apply to restriction! In the case of binge eating, overconsuming food serves so many protective functions, from attempting regulate to numbing from sensory overwhelm to using food as a stim – it’s all a way to escape this ongoing state of fight-or-flight mode due to feeling trapped not only a human body, but in “the system,” in this neurotypical world, and even this Universe at large – a concept that the subjective human mind will never be able to comprehend. 

The Adaptive Eating Spectrum

This adaptive view is what led me to develop the Adaptive Eating Spectrum. This framework acknowledges that:

1. All eating behaviors exist on a continuum of adaptation
2. These adaptations serve protective functions
3. And that the path to healing involves creating genuine safety, not forcing compliance through “normal” eating, that is to say, neurotypical expectations.

When someone with ARFID fears weight gain, they’re not “actually anorexic” or “misdiagnosed.” They’re demonstrating how artificial our diagnostic boundaries are. They’re showing us that human experience doesn’t conform to neat categories. I mean, how could it?

A Different Approach to Healing

What does all of this information mean in practice? How can we translate the view of eating disorders as eating adaptations into action? If you’ve already completed my Autistically ED-Free Academy, you know my philosophy is rooted in replacing judgment with curiosity. It’s not about claiming to have answers, but rather, it’s about asking questions that allow an individual’s answers to arise naturally. So instead of asking “Does this person have ARFID or anorexia?” (which honestly isn’t even really a question, because it already implies that the person can be squeezed into a box – in other words, we’re placing judgment on them from the start) we might ask:

• What is this person’s relationship with food trying to protect them from?
• How can we create an environment where food and body changes feel less threatening?
• What would genuine safety look like for this individual?

For autistic individuals especially, this might involve:

• Acknowledging sensory needs and being curious in how we can meet them without sacrificing overall well-being
• Creating predictability and certainty around food and eating – perhaps through adhering to food rules, weighing food, and yes, even counting calories!
• Addressing the existential anxiety that often underlies eating challenges
• And finally, recognizing that “recovery” looks different for everyone. In fact, this is why I prefer the term discovery: because finding freedom from ED isn’t actually about recovering from ED. It’s about discovering who you are without attempting to hide your abundant neurodivergent being.

All that being said, my own discovery journey taught me that healing wasn’t about figuring out which diagnosis fit best. It was about inviting curiosity to why my nervous system perceived weight gain as dangerous, and then slowly creating conditions where that danger felt less acute.

Moving Forward

The fear of weight gain in ARFID isn’t an anomaly or a diagnostic error. It’s a reminder that our current understanding of eating “disorders” is limited by our insistence on categorization. When we shift from pathology to curiosity and from diagnosis to listening to lived experience, that’s when we open the doors to more compassionate, more effective support. Because here’s the thing: no treatment for eating disorders “works.” True healing emerges in an environment where the individual feels safe enough to do the work.

If you’re committed to creating safety for yourself or someone you care for, I invite you to join us in the Autistically ED-Free Membership!