Episode 234

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Published on:

14th Feb 2026

Episode 234: Beyond Picky Eating: How to Recognize and Treat ARFID [featuring Dr. Marianne Miller]

In this episode, Patrick Casale and Dr. Marianne Miller break down critical myths about Avoidant/Restrictive Food Intake Disorder (ARFID) and offer practical, compassionate approaches for clinicians, parents, and anyone supporting neurodivergent folks with eating challenges.

Here are 3 key takeaways:

  1. ARFID is not “picky eating”: Labeling someone as a “picky eater” implies willfulness or stubbornness, when ARFID is in fact a complex, involuntary experience often tied to sensory processing and interoceptive cues.
  2. A collaborative, sensory-affirming approach matters: Treating ARFID requires asking nuanced questions about sensory preferences, hunger awareness, and family dynamics. Pressure, shame, and coercion do more harm than good—compassion and understanding are the foundation of effective support.
  3. Education is essential—for providers and families: Ongoing education and unlearning old beliefs is vital. There are fantastic resources and training for therapists, parents, and adults living with ARFID to build understanding and empathy.

More about Dr. Marianne:

Dr. Marianne is a licensed therapist with nearly 30 years in mental health and 13 years specializing in eating disorders. She spent 12 years as a full-time academic before moving into full-time private practice in 2018. She is the host of the Dr. Marianne-Land podcast and creates online education, including her ARFID and Selective Eating course. Her work centers a non-diet, liberation-focused, Health at Every Size (HAES®) approach and supports people of all genders and neurotypes. She is neurodivergent and LGBTQIA+ affirming.

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Thanks to The Receptionist for iPad for sponsoring this episode.

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The Receptionist for iPad

 The Receptionist for iPad is a HIPAA-ready digital check-in system that eliminates the need to walk back and forth from your office to the waiting room to see if your next appointment has arrived. Clients or patients can check in for their appointments, and you'll be immediately notified by text, email, or your preferred channel. Break free from interruptions and make the most of your time, because it is valuable. Start a free 14-day trial of the Receptionist for iPad by going to https://thereceptionist.com/privatepractice. Make sure to start your trial with that link to get your first month free if you decide to sign up.

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About the Podcast

The Neurodivergent Entrepreneur
Honest conversations about building a business while Autistic, ADHD, or both — the self-doubt, the chaos, and everything in between.
The Neurodivergent Entrepreneur is a podcast for ADHD, Autistic, and otherwise neurodivergent entrepreneurs who are building businesses, creative work, and lives that actually fit how their brains work. Hosted by Patrick Casale, this show is for people who
want to create meaningful work, make money, grow their impact, and build something sustainable without losing themselves in the process.

Being a neurodivergent entrepreneur can feel like holding a lot of contradictions at once. You may have big ideas, deep passion, creative energy, and a strong desire to do things differently. You may also be navigating burnout, masking, self-doubt, perfectionism, rejection sensitivity, executive dysfunction, inconsistent energy, and the pressure to keep showing up when your capacity is already stretched. This podcast speaks to that reality honestly, because building a business around your brain, your values, and your lived experience can be powerful, complicated, messy, and deeply personal.

Patrick Casale is a therapist, entrepreneur, speaker, retreat host, group practice owner, and neurodivergent business owner who has built, grown, burned out, pivoted, and kept going. His work brings together clinical insight, lived experience, business perspective, and real conversation about what it actually takes to create something that feels aligned. His conversations are direct, compassionate, unfiltered, and practical, with room for both the emotional reality of entrepreneurship and the concrete decisions that shape a sustainable business.

New episodes drop every Wednesday and feature honest conversations with neurodivergent entrepreneurs, creators, therapists, business owners, and leaders. Together, Patrick and his guests explore entrepreneurship, identity, mental health,
creativity, leadership, systems, money, visibility, community, sustainable growth, and the behind-the-scenes reality of creating work that matters.

Build the business. Protect your capacity. Create work that actually fits.