Dr. Marianne-Land: An Eating Disorder Recovery Podcast

If you are in an activated state right now, this episode meets you where you are. You do not need to make decisions or figure anything out while you listen. The focus is on calming the body first, not fixing the behavior. Dr. Marianne guides you through simple, accessible grounding and nervous system regulation that can help reduce urgency without judgment or pressure. This episode is designed to be replayed during urge peaks and listened to in real time. Urges Are Signals, Not Commands Urges often show up when something feels overwhelming, unsafe, or out of control. This episode reframes urges as signals from the nervous system rather than failures or moral flaws. You will hear reminders that urges are learned responses meant to create relief, even when they no longer serve you. This compassionate perspective can help soften shame and create space for choice, even when the urge still feels loud. Support for Restricting, Bingeing, and Purging Urges Whether your urge is to restrict, binge, purge, compensate, avoid food, or delay eating, this episode centers safety and connection. It offers reassurance that you are not broken for having urges and that even small shifts in support can matter. This is a listen for one minute at a time. Five percent safer still counts. Listen When You Need Support Right Now You can return to this episode whenever urges spike. Let it keep you company. Let it remind you that this moment has edges and that you are not alone in it. If you need additional support beyond this episode, working with an eating disorder therapist can help you build more tools for navigating urges with care and compassion. Check out drmariannemiller.com for more resources. #EatingDisorderRecovery #UrgeSupport #NervousSystemRegulation

When ARFID is shaped by a PDA profile, eating challenges are not simply about sensory preferences, fear foods, or appetite. PDA, or a pervasive drive for autonomy, means the nervous system experiences demands as threats. Even gentle encouragement around eating can trigger shutdown, panic, or refusal. In this episode, Dr. Marianne Miller explains why PDA fundamentally changes how ARFID shows up and why traditional explanations often miss what is really happening beneath the surface. Food Refusal Is a Nervous System Safety Response Food refusal in PDA-driven ARFID is not defiance or manipulation. It is a protective response rooted in survival. When autonomy feels compromised, refusal becomes the fastest way to restore safety. This episode reframes refusal as communication and explores how control is not the goal, but a tool the nervous system uses to stay regulated. How Eating Becomes a Threat Instead of Nourishment For PDA nervous systems, eating can shift from a neutral or pleasurable act into a moment of danger. Being observed, reminded, praised, or monitored can turn food into a demand. Dr. Marianne breaks down how this happens in both children and adults with ARFID, and why eating often becomes harder the more support is applied. Case Examples of PDA and ARFID Across the Lifespan This episode includes clinical case examples that illustrate how PDA-driven ARFID can look very different on the surface while operating from the same nervous system logic. One example focuses on a child who eats until attention is placed on them. Another highlights an adult who deeply wants recovery but feels trapped by structured treatment approaches. These examples help clarify why motivation alone does not resolve PDA-related eating challenges. Why Traditional ARFID Treatment Often Fails PDA Nervous Systems Many standard ARFID interventions rely on structure, goals, exposure, and accountability. For PDA profiles, these tools can unintentionally increase threat and shutdown. Dr. Marianne explains why treatment plans that ignore autonomy often backfire and how mislabeling this response as resistance can cause harm. What Actually Supports PDA-Affirming ARFID Care Supportive care for PDA and ARFID prioritizes safety, consent, and flexibility. This does not mean removing all structure, but changing how structure functions. The episode explores what real choice looks like, why opt-out options matter, and how slowing down can create conditions where eating feels safer over time. A Neurodivergent-Affirming Reframe for Caregivers and Adults If ARFID has felt impossible to “fix,” this episode offers a compassionate reframe. PDA-driven eating challenges are not failures of willpower or commitment. They reflect a nervous system doing its best to survive. Understanding this opens the door to approaches that are more humane, effective, and sustainable. Related Episodes on ARFID and PDA ARFID Explained: What It Feels Like, Why It's Misunderstood, & What Helps on Apple & Spotify. Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify. ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Work With Dr. Marianne Miller Dr. Marianne Miller is a licensed marriage and family therapist who specializes in ARFID, binge eating disorder, and long-term eating disorder recovery. She offers therapy, consultation, and a virtual, self-paced ARFID course grounded in neurodivergent-affirming, sensory-attuned, trauma-informed care. Learn more at drmariannemiller.com

What if eating disorder recovery was not defined by a clean, linear arc, but by honesty, self-compassion, and forward movement even when setbacks happen? In this January 2026 conversation, Dr. Marianne Miller welcomes back journalist, author, and professor Mallary Tenore Tarpley, MFA, to reflect on how readers have responded to her book SLIP: Life in the Middle of Eating Disorder Recovery, and how the language of “slips” is quietly reshaping how people understand recovery. Mallary shares what has surprised her most since the book's release, including the volume of messages from readers who finally feel seen in what she calls the “middle place,” the gray space between acute illness and full recovery. Many readers describe relief in having language for a recovery that is still in progress, one that allows for growth without demanding perfection. Throughout the conversation, Mallary and Dr. Marianne explore why slips are not evidence of failure, but often signs that someone is actively engaging in recovery. They unpack how shame around setbacks can cause slips to turn into longer slides, and how naming them openly can interrupt that cycle. This reframing is especially important in 2026, as diet culture and resolution-driven thinking continue to dominate January narratives around control, discipline, and self-improvement. Mallary also discusses how the “middle place” framework has resonated far beyond eating disorder communities. Readers have applied it to grief, addiction, chronic illness, and other long-term healing processes where vulnerability remains even as life becomes fuller. She reflects on the power of shared language in helping loved ones understand ongoing recovery, including parents and partners who may struggle to grasp why symptoms can persist for years. The episode also touches on under-discussed risks during life transitions, including pregnancy and postpartum experiences, where socially reinforced behaviors can quietly reawaken eating disorder patterns. Mallary explains why speaking openly about these realities helps both individuals and clinicians respond with more nuance and care. As the conversation turns toward the new year, Mallary offers a gentler way forward. Instead of setting rigid, all-or-nothing goals, she encourages curiosity, small steps, and values-based intentions that support recovery over time. Slips, she reminds us, can coexist with progress, and often do. This episode is for anyone who feels caught between wanting change and fearing it, for those exhausted by perfectionism, and for anyone who needs permission to keep moving forward without pretending to be “all better.” Follow Mallary on Instagram: @mallarytenoretarpley Learn more about her book: SLIP: Life in the Middle of Eating Disorder Recovery Check out another episode with Mallary on Apple or Spotify.

This brief guided episode is designed for moments when eating disorder recovery feels unsafe, overwhelming, or frightening. It is meant to be listened to when fear spikes, urges intensify, or doubt about recovery takes over. Rather than offering education or advice, this guided moment focuses on nervous system support. Dr. Marianne gently names why fear can surge when eating disorder behaviors loosen and why this response does not mean recovery is failing. The episode centers the experience of being in the middle of recovery, when the body is adjusting to change and searching for safety. Listeners are invited to pause, slow down, and orient to the present moment without needing to make decisions, take action, or push through discomfort. This guided listen affirms that fear during recovery often reflects protection, not weakness, and that safety can come alongside change. This episode can be replayed as often as needed. It is especially supportive for people in eating disorder recovery who experience panic, urgency, or nervous system overwhelm when behaviors begin to shift. Content Caution This episode discusses eating disorder recovery and fear responses. No weights, numbers, or specific behaviors are described. This is a gentle, non-instructional guided listen. How to Use This Episode This guided moment is best used during periods of heightened anxiety, uncertainty, or fear related to eating disorder recovery. Listeners may choose to listen while seated, lying down, or moving gently. There is no requirement to follow instructions or reach a particular outcome. Who This Episode Is For This episode is for adults in eating disorder recovery who feel unsafe when change begins, people experiencing recovery anxiety or fear of letting go, and anyone who needs nervous system support rather than information. It may also be helpful for clinicians and providers to share with clients during acute moments of distress. About Dr. Marianne Miller Dr. Marianne Miller is a licensed marriage and family therapist, eating disorder specialist, and host of the Dr. Marianne-Land podcast. Her work centers neurodivergent-affirming, trauma-informed, and liberation-focused approaches to eating disorder recovery. Dr. Marianne also offers a self-paced course on ARFID and selective eating designed to prioritize safety, autonomy, and nervous system care. Learn more at drmariannemiller.com.

Why does eating disorder recovery sometimes feel more frightening after change has already begun? In this solo episode, Dr. Marianne Miller explores a critical but rarely discussed phase of eating disorder recovery: the point where behaviors start to loosen, yet fear, panic, and urges intensify instead of easing. This episode reframes eating disorders not as irrational habits to eliminate, but as safety systems shaped by the nervous system. Dr. Marianne explains how restriction, binge eating, purging, rigidity, and food avoidance can reduce threat, create predictability, and manage sensory or emotional overwhelm. When those behaviors begin to shift, the body may respond with alarm, even when recovery is wanted. Rather than focusing on early recovery or long-term outcomes, this conversation stays inside the middle of recovery. The place where letting go feels destabilizing, progress triggers panic, and people begin to question whether healing is actually safe. Dr. Marianne unpacks why fear at this stage does not signal failure, lack of motivation, or resistance, but reflects survival-based nervous system logic. This episode also centers how neurodivergence, trauma histories, and intersectional oppression amplify fear during recovery. For autistic and ADHD individuals, transitions, loss of structure, and sensory changes can intensify nervous system activation. For people with chronic trauma or marginalized identities, eating disorder behaviors may have provided protection in a world that felt unsafe long before recovery began. Listeners will hear why the belief that “safety comes after behaviors stop” often backfires, and why scaffolding, autonomy, pacing, and compassion are essential when eating disorder behaviors start to loosen. This episode is especially relevant for adults with long-term eating disorders, people feeling stuck in recovery, and clinicians seeking trauma-informed, neurodivergent-affirming approaches to eating disorder treatment. Content Caution This episode discusses eating disorders, recovery-related fear, and nervous system responses to change. No weights, numbers, or explicit behavioral instructions are included. Listener discretion is advised. What This Episode Covers Dr. Marianne discusses eating disorders as safety systems, fear of recovery, anxiety during eating disorder treatment, and why symptom spikes often occur after progress begins. The episode explores the role of the nervous system, trauma, neurodivergence, and intersectionality in eating disorder recovery, and explains why grief, panic, and doubt can emerge when behaviors that once felt protective start to loosen. This conversation also highlights why safety, autonomy, and nervous system support must come alongside behavior change, not after it. Who This Episode Is For This episode is for adults with eating disorders who feel afraid to let go of behaviors, people experiencing recovery anxiety or fear of change, and anyone who feels stuck in the middle of eating disorder recovery. It is also for therapists, providers, and caregivers who want to better understand why eating disorder behaviors can feel necessary, and why fear does not mean someone is failing at recovery. Related Episode An Open Letter to the Body: Listening to the Part That Fears Getting Better on Apple and Spotify. About Dr. Marianne Miller Dr. Marianne Miller is a licensed marriage and family therapist and eating disorder specialist offering therapy, consultation, and education rooted in neurodivergent-affirming, trauma-informed, and liberation-focused care. She is the host of the Dr. Marianne-Land podcast and the creator of a self-paced course on ARFID and selective eating for adults and providers. Learn more at drmariannemiller.com.

What does a low heart rate really mean in athletes? When is it a normal adaptation to training, and when is it a sign that something is medically wrong? In this interview, Dr. Marianne Miller speaks with Megan Hellner, RD and Katherine Hill, MD, co-founders of AthleatMD, about one of the most misunderstood issues in athlete health. Together, they unpack how low heart rate, underfueling, and performance pressure can intersect in ways that are often minimized or missed entirely in both sports medicine and eating disorder care. Content Caution This episode includes discussion of eating disorders, Relative Energy Deficiency in Sport (REDS), medical instability, low heart rate, weight loss, body image pressure, and athletic injury. Listener discretion is encouraged. What Is Relative Energy Deficiency in Sport (REDS)? Relative Energy Deficiency in Sport occurs when an athlete's energy intake does not meet the demands of training, daily functioning, and, for young athletes, growth and development. Dr. Hill explains that REDS can occur with or without an eating disorder and that many athletes develop REDS unintentionally due to intense schedules, high training loads, or lack of accurate nutrition guidance. Although REDS is a relatively new diagnostic framework, its medical consequences are not new. Energy deficiency affects nearly every system in the body, including the heart, bones, hormones, digestion, immune function, and mental health. Importantly, many athletes with REDS do not appear thin, which contributes to how frequently the condition is overlooked. Low Heart Rate in Athletes: Fitness or Medical Red Flag? A low resting heart rate is often praised as evidence of elite fitness, yet this episode challenges that assumption. Dr. Hill and Dr. Hellner explain the difference between mild athletic bradycardia and dangerous cardiac suppression related to undernutrition. They discuss why heart rates in the low 40s or 30s should never be automatically dismissed as “normal for athletes,” particularly when fatigue, injury, missed periods, or hormonal suppression are present. The conversation highlights how REDS and malnutrition can compound athletic adaptations, leading to serious medical risk while athletes are reassured that nothing is wrong. Where Eating Disorder Care and Sports Medicine Fall Short Athletes often exist in a gray area where eating disorder treatment programs and sports medicine settings fail to fully meet their needs. Drs. Hellner and Hill describe how eating disorder programs may underestimate the importance of athletic identity, while sports environments frequently minimize eating disorders and REDS altogether. This disconnect can result in rigid activity bans, delayed diagnosis, or false reassurance that prolongs harm. The episode emphasizes the need for individualized, multidisciplinary decision-making that considers medical stability, psychological safety, and the athlete's relationship with sport. Body Image Pressure and the Athletic Aesthetic Myth The conversation also explores how appearance-based expectations shape athlete health. Dr. Hellner introduces the concept of the athletic aesthetic myth, which falsely assumes that performance requires a specific body type. Dr. Marianne and her guests discuss how coaching culture, social media trends, and gendered body ideals increase risk for REDS and disordered eating. They also highlight the growing visibility of elite athletes across a wide range of body sizes, challenging the belief that leanness equals success. How AthleatMD Supports Athletes With REDS and Eating Disorders AthleatMD provides virtual medical and nutrition care for athletes across many states, serving competitive, recreational, and former athletes. Dr. Hellner explains how assessment focuses on weight history, growth patterns, labs, training load, injury history, and relationship with food and sport, without assuming intentional restriction. Treatment centers on nutrition restoration, medical stabilization, and education, with approaches tailored to the athlete's sport, goals, and developmental stage. For many athletes, restoring adequate energy intake improves both health and performance in ways they did not expect. Who This Episode Is For This episode is especially relevant for athletes experiencing fatigue, injury, or declining performance, as well as parents of young athletes, coaches, therapists, dietitians, and medical providers. It is also an important listen for anyone questioning whether “fit” always means healthy in sport. Related Episode Eating Disorders & Athletes: The Pressure to Perform on Apple & Spotify. About Today's Guests Dr. Megan Hellner and Dr. Katherine Hill are the co-founders of AthleatMD (@athleatmd), a virtual, multidisciplinary practice specializing in medical and nutrition care for athletes with eating disorders and Relative Energy Deficiency in Sport (REDS). Their work focuses on bridging the long-standing gap between sports performance and eating disorder treatment. About the Host Dr. Marianne Miller is a Licensed Marriage and Family Therapist and the host of Dr. Marianne-Land: An Eating Disorder Recovery Podcast. She provides neurodivergent-affirming, trauma-informed care for eating disorders, including anorexia, bulimia, binge eating disorder, and ARFID, and works with clients in California, Texas, and Washington, D.C. Learn more about working with Dr. Marianne and explore her courses and podcast at drmariannemiller.com.

Why do some eating disorders continue for years or even decades, despite treatment, effort, and a strong desire for change? Long-standing eating disorders are often misunderstood as personal failure or lack of motivation. In reality, persistence usually reflects unmet needs, nervous system strain, and environments that have not supported safety or regulation. What “Chronic” Really Means in Eating Disorder Care In clinical settings, the term chronic simply means persistent over time. It does not mean static, untreatable, or hopeless. Many people with chronic eating disorders experience periods of stability, partial recovery, or symptom shifts rather than full resolution. Progress often occurs in layers rather than in a straight line. Chronic eating disorders appear across diagnoses, including anorexia, bulimia, binge eating disorder, ARFID, and mixed presentations. What matters most is not the duration of symptoms, but the function those symptoms continue to serve. Eating Disorders as Nervous System Survival Strategies Eating disorder behaviors frequently operate as survival responses. They may regulate anxiety, reduce sensory overwhelm, create predictability, or provide relief from emotional distress. When behaviors serve a regulatory purpose, stopping them without replacing that function can feel destabilizing rather than healing. Persistence is rarely about effort. Many people with long-term eating disorders have engaged in extensive treatment and tried multiple approaches. Without safety, the nervous system will continue to rely on familiar strategies. Trauma, Chronic Stress, and Ongoing Threat Long-standing eating disorders often develop in the context of trauma that never fully resolved. Ongoing stressors such as medical trauma, anti-fat bias, racism, ableism, financial insecurity, chronic illness, or identity-based harm can keep the nervous system in survival mode. When threat remains present, recovery models that assume safety already exists often fall short. In these environments, eating disorder behaviors may remain necessary for coping. Neurodivergence and Unmet Support Needs Neurodivergent people experience chronic eating disorders at high rates, yet are frequently underserved by standard treatment models. Sensory sensitivities, executive functioning challenges, and interoceptive differences can make eating overwhelming in ways traditional care does not address. Without accommodation, eating disorder behaviors may persist because they reduce sensory or cognitive overload. Recovery requires adapting care to the person, not forcing the person to adapt to the model. Autonomy, Power, and Control in Recovery Eating disorders often become closely tied to autonomy, especially for people who have experienced chronic control or invalidation. Decisions about food can feel like the last remaining area of choice. When treatment removes autonomy without rebuilding agency, symptoms often intensify. Collaborative, consent-based care that honors choice can create safer conditions for change. What Actually Supports Long-Term Change Sustainable change in chronic eating disorders is built through safety, curiosity, and flexibility. Emotional, sensory, and relational safety allow the nervous system to shift. Curiosity replaces judgment by asking what the eating disorder provides rather than focusing only on stopping it. Accommodation, harm reduction, and connection play central roles. Reducing risk, improving quality of life, and supporting nourishment without demanding perfection create space for gradual change. Rethinking Recovery for Chronic Eating Disorders Recovery does not need to mean the complete absence of symptoms to be meaningful. Increased flexibility, reduced fear, fewer medical crises, and a fuller life matter. Chronic eating disorders reflect complexity, not hopelessness. Who This Episode Is For This episode is for people living with chronic eating disorders, providers working with long-term or complex cases, and anyone seeking a trauma-informed, neurodivergent-affirming perspective on eating disorder recovery. Content Caution Discussion includes eating disorder behaviors, long-term symptoms, trauma, and systemic barriers to care. Related Episodes Relapse in Long-Term Eating Disorders on Apple & Spotify. Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Navigating a Long-Term Eating Disorder on Apple & Spotify. Why Eating Disorder Recovery Feels Unsafe: Facing Ambivalence in Long-Term Struggles on Apple & Spotify. Perfectionism, People-Pleasing, & Body Image: Self-Compassion Tools for Long-Term Eating Disorder Recovery With Carrie Pollard, MSW @compassionate_counsellor on Apple & Spotify. Learn More Explore neurodivergent-affirming, trauma-informed resources for eating challenges at drmariannemiller.com.

Why does eating sometimes feel distant, foggy, or unreal? Why do meals happen on autopilot, with little connection to hunger, fullness, or satisfaction? In this solo episode, Dr. Marianne Miller explores the often overlooked role of dissociation in eating disorders, especially when trauma and nervous system overwhelm are present. Many people experience eating as disconnected or numb, yet rarely receive language or support that explains why this happens. This episode breaks down how dissociation functions as a survival response, not a failure of recovery. Dr. Marianne explains how trauma, chronic stress, and loss of bodily autonomy can shape the nervous system and disrupt interoceptive awareness, making it difficult to sense hunger, fullness, and internal cues. Listeners will learn how dissociation connects to common eating disorder patterns such as restriction, binge eating, and rigid routines. Rather than viewing these behaviors as resistance or lack of motivation, this episode reframes them as nervous system strategies designed to manage overwhelm and threat. Dr. Marianne also centers neurodivergent experiences, including sensory processing differences and shutdown responses that often get missed in traditional eating disorder treatment. She explains why pressure-based approaches frequently fail neurodivergent people and why safety, accommodation, and choice are essential when eating feels unreal. This episode offers a trauma informed, neurodivergent affirming perspective on recovery, emphasizing that healing does not come from forcing embodiment. Instead, recovery unfolds when the nervous system learns that eating can be safe again. In this episode, you will hear about: Dissociation and eating disorders Trauma and nervous system responses around food Why eating can feel unreal or disconnected Interoception and disrupted hunger and fullness cues Neurodivergence, sensory overwhelm, and eating challenges Why traditional eating disorder treatment often misses dissociation What actually supports recovery when eating feels unreal Midway through the episode, Dr. Marianne shares more about her self-paced ARFID and Selective Eating course, designed for people whose eating struggles are shaped by sensory differences, trauma, and nervous system needs. Related Episodes How Childhood Trauma Shapes Eating Disorders & Body Shame (Content Caution) on Apple & Spotify. Childhood Trauma & Eating Disorders on Apple & Spotify. Using EMDR & Polyvagal Theory to Treat Trauma & Eating Disorders with Dr. Danielle Hiestand, LMFT, CEDS-S on Apple & Spotify. Trauma, Eating Disorders, & Levels of Care with Amy Ornelas, RD via Apple or Spotify. Content Caution This episode includes discussion of eating disorders, trauma, dissociation, sensory overwhelm, and nervous system responses around food. Although no specific behaviors or numbers are described, some listeners may find these topics activating. Please take care of yourself and listen in a way that feels supportive. This episode is for anyone who has felt confused, frustrated, or unseen in eating disorder recovery and wants a framework that finally makes sense.

What changes when an eating disorder has been part of someone's life for 10, 20, 30, even 40+ years? In this conversation, I'm joined again by my friend and longtime collaborator Jaren Soloff, RD, IBCLC, the founder of Whole Women Nutrition. Together, we talk about why nutrition work looks different in long-term eating disorders, and why the starting point is almost always the same: safety. Jaren shares how decades of reinforcement can make symptoms look “functional” on the surface, while the eating disorder quietly shapes identity, routines, and self-worth. We explore the common pattern of minimizing, the fear that can spike when restriction loosens, and the tender reality that for many people, the eating disorder has served as protection, especially in the context of criticism, attachment wounds, body-based judgment, and the impossible standards placed on women across the lifespan. We also get practical. Jaren walks through what it can look like to make food feel safer through small, doable steps, including DBT-informed tools, sensory supports, and intentionally planned “after-meal” structure that helps the nervous system ride out discomfort without snapping back to restriction. If breakfast feels impossible, or discomfort after eating feels like a dealbreaker, this episode offers compassionate, concrete ways to build tolerance and trust, slowly and steadily. Finally, we talk about the midlife reality so many people face: body changes through perimenopause and menopause, and the way those changes can collide with long-standing eating disorder beliefs. Jaren explains why metabolism may shift with long-term restriction and aging, how loss of lean muscle mass can affect energy needs and health, and why increased fat storage in midlife can be an adaptive, protective process for bone health. We also name the risks of GLP-1 medications for people with eating disorders, including concerns about appetite suppression and the potential for additional lean muscle loss, especially for women in perimenopause and menopause. If you have felt “broken” because your body doesn't respond the way it once did, or if you've carried an eating disorder for decades and wonder whether change is still possible, this conversation offers a grounded, compassionate path forward. You deserve care that moves at your pace, and support that treats safety as the foundation, not an afterthought. In this episode, we cover We discuss why long-term eating disorders require a different nutrition framework, how safety often sits at the center of recovery work, and why minimizing can keep patterns in place even when someone appears to be “functioning.” We talk about learning to tolerate discomfort after eating, building self-soothing skills, and using DBT-informed, sensory-based strategies to create new neural pathways. We explore perimenopause and menopause, including changes in estrogen, lean muscle mass, metabolism, and body fat distribution, and we name how ageism and sexism shape body fear in midlife. We also discuss GLP-1 medications and why they can be especially risky in the context of eating disorders. About Jaren Soloff, RD, IBCLC Jaren Soloff is a registered dietitian and international board-certified lactation consultant. She is the founder of Whole Women Nutrition, where she provides nutrition counseling and lactation support for adolescent girls and adult women, and supports families in raising competent, intuitive eaters. Jaren brings both professional experience and the wisdom of her own recovery journey to her work, with a steady emphasis on compassion, collaboration, and safety. Related Episodes Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Navigating a Long-Term Eating Disorder on Apple & Spotify. Why Eating Disorder Recovery Feels Unsafe: Facing Ambivalence in Long-Term Struggles on Apple & Spotify. Pregnancy, Postpartum, and Eating Disorder Recovery With Jaren Soloff, RD on Apple and Spotify. Connect with Jaren Website: WholeWomenNutrition.com Instagram: @wholewomennutrition

Anorexia does not disappear with age, and midlife is often when its deeper pain becomes impossible to ignore. In this solo episode, Dr. Marianne Miller explores why anorexia can resurface or intensify in midlife, especially when long-standing coping strategies stop working and the nervous system reaches its limits. This conversation names what so many people experience quietly: hormonal shifts, burnout, identity changes, and unprocessed trauma colliding with a culture that continues to demand shrinking, control, and silence. Dr. Marianne unpacks how perimenopause, menopause, chronic stress, and cumulative life demands can destabilize eating patterns that once felt manageable. She explains why restriction is not about willpower or vanity, but about protection, regulation, and survival, particularly for those who have lived for decades navigating pressure, responsibility, and internalized expectations. The episode also explores how midlife can awaken old wounds related to body, gender, sexuality, safety, and belonging, making anorexia feel like a familiar refuge during times of upheaval. This episode centers the emotional logic of midlife anorexia and highlights how neurodivergence, sensory processing differences, and reduced masking capacity can further complicate eating and recovery later in life. Dr. Marianne offers a compassionate reframe of what healing can look like in midlife, emphasizing nervous system support, steadiness over control, truth-telling, and sustainable care rather than rigid recovery ideals. Listeners will hear a vision of recovery that does not ask people to go back to who they were, but instead supports becoming someone who no longer needs old coping strategies to feel safe. This episode speaks directly to adults navigating long-term or chronic anorexia, relapse in midlife, and the quiet grief that can surface during major life transitions. It is also a vital listen for providers seeking a more humane, trauma-informed, and neurodivergent-affirming understanding of eating disorders across the lifespan. Dr. Marianne closes by reminding listeners that midlife can be a turning point not because of force or discipline, but because deeper understanding becomes possible. Recovery at this stage can mean honoring the body's needs, allowing rest, naming pain that was carried alone, and receiving support that fits one's lived experience. If this episode resonated, you are invited to explore therapy with Dr. Marianne Miller, who offers specialized support for people navigating anorexia, chronic restriction, ARFID, and eating disorders shaped by trauma and neurodivergence. Go to drmariannemiller.com for resources and help.

Have you ever wondered whether your eating disorder behaviors have shifted from coping and self-regulation into self-harm? In this solo episode, Dr. Marianne Miller explores the overlap between eating disorders and self-harm and explains how eating disorder behaviors can gradually become harmful even when they begin as attempts to cope. She examines eating disorder recovery through a trauma-informed, neurodivergent-affirming, and liberation-focused lens and offers clarity without shame or blame. WHAT YOU WILL LEARN IN THIS EPISODE Dr. Marianne explains how eating disorders can function as self-harm and how trauma, dissociation, sensory overwhelm, and chronic stress shape eating disorder behaviors. She discusses neurodivergence and eating disorders, including how autistic and ADHD individuals may rely on eating patterns for regulation. She explores common self-harm behaviors that often co-occur with eating disorders, including cutting, scratching, burning, and other forms of injury, and explains the shared emotional logic behind these behaviors. She clarifies the difference between self-regulation and self-harm and explains how eating disorder behaviors can shift between these roles over time. She outlines how to recognize when an eating disorder moves from regulation into harm by identifying warning signs such as rigidity, shame, dissociation, physical consequences, and isolation. She also describes what breaking the cycle can look like by focusing on safety, agency, and flexible coping rather than punishment or control. THIS EPISODE MAY RESONATE WITH YOU IF You question whether your eating disorder behaviors feel punishing or unsafe. You live with a long-term or chronic eating disorder. You experience self-harm urges alongside an eating disorder. You identify as neurodivergent and struggle with sensory or interoceptive overwhelm. You want a trauma-informed, non-shaming approach to eating disorder recovery. KEY TOPICS This episode explores eating disorders and self-harm, eating disorder recovery, self-harm behaviors and eating disorders, trauma and eating disorders, neurodivergence and eating disorders, dissociation and eating disorders, restriction and binge eating, ARFID and sensory overwhelm, building safety in eating disorder recovery, and trauma-informed eating disorder therapy. CONTENT CAUTION This episode includes discussion of self-harm, including cutting and other forms of injury, eating disorders, trauma, dissociation, and suicidal thinking. Please listen with care and take breaks as needed. RELATED EPISODES Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe via Apple & Spotify. Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify. Minding the Gap: The Intersection Between AuDHD & Eating Disorders With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify ABOUT DR. MARIANNE Dr. Marianne Miller is a licensed marriage and family therapist specializing in eating disorders, including ARFID, binge eating disorder, anorexia, and long-term eating disorder patterns. She takes a neurodivergent-affirming, trauma-informed, and liberation-focused approach and hosts the Dr. Marianne-Land podcast. WORK WITH DR. MARIANNE Dr. Marianne offers eating disorder therapy in California, Texas, and Washington DC, and provides coaching worldwide. Learn more at drmariannemiller.com.

In this episode of Dr. Marianne-Land, I speak with fat activist, TEDx speaker, author, DEI expert, and podcast host Vinny Welsby (they/them) about anti-fat bias in healthcare, weight stigma in medicine, and the real-world harm fat patients experience when seeking medical care. Vinny, who shares extensively about fat liberation, weight-inclusive care, and dismantling diet culture on Instagram at @fierce.fatty, brings both lived experience and data into this conversation. This episode centers on Vinny's survey of 270 fat people, in which 99.25% reported experiencing weight-based discrimination in healthcare. These findings expose how common medical weight stigma, anti-fatness, and provider bias truly are, and why so many fat people delay or avoid healthcare altogether. Weight Stigma in Healthcare: Survey Data and Lived Experience We break down what those survey results actually mean for patients. Vinny shares stories of medical dismissal, misdiagnosis, delayed treatment, and humiliation in healthcare settings, including being told to lose weight instead of receiving appropriate medical evaluation. We discuss how weight stigma shows up through provider assumptions, lack of size-inclusive equipment, routine weighing without consent, and dismissive or dehumanizing language. This section highlights how anti-fat bias in healthcare leads to worse physical health outcomes, increased medical trauma, and deep mistrust of medical systems. Medical Trauma, Nervous System Effects, and Avoiding Care We explore how repeated experiences of weight stigma activate the nervous system and create medical trauma. Even scheduling an appointment can trigger fear, shame, and exhaustion. Vinny and I talk about how this chronic stress contributes to people avoiding preventive care, delaying diagnosis, and experiencing worsening health conditions as a result. This conversation connects anti-fat bias, mental health, eating disorders, and healthcare avoidance, naming how the system often blames fat bodies for the very harm it causes. Intersectionality: Fatness, Gender, Queerness, and Neurodivergence A major focus of this episode is intersectionality. Vinny shares how anti-fatness intersected with being trans, nonbinary, queer, neurodivergent, and disabled, and how shame around body size limited access to identity exploration and self-expression. We talk about how weight stigma compounds oppression, especially for people with multiple marginalized identities. We also discuss how white privilege can reduce some harms while never eliminating weight-based discrimination, and why weight-inclusive healthcare must address racism, transphobia, ableism, and fatphobia together. What Weight-Inclusive Healthcare Actually Requires We challenge the idea that good intentions equal good care. This section explores what weight-inclusive healthcare truly requires, including provider education, consent-based weighing, size-inclusive furniture and equipment, respectful language, and accountability when harm occurs. We discuss why many providers believe they are weight-inclusive while continuing to practice weight-centered and stigmatizing care. Unlearning Anti-Fatness, Shame, and Diet Culture We close with guidance for beginning the process of unlearning anti-fatness. Vinny shares how shame thrives in isolation and how bringing it into the light reduces its power. We discuss diet culture, binary thinking, and how critical thinking helps people question harmful beliefs about weight, health, morality, and worth. This episode invites listeners to ask who benefits when people are taught to hate their bodies, and how compassion, curiosity, and community support healing. Who This Episode Is For This episode is for fat people, eating disorder survivors, clinicians, healthcare providers, and anyone who wants to understand how weight stigma in healthcare causes harm and what needs to change. About My Guest: Vinny Welsby (They/Them) Vinny Welsby is a fat activist, DEI leader, TEDx speaker, bestselling author of Fierce Fatty, and host of the Fierce Fatty Podcast. They work with individuals through Fierce Fatty and with organizations through Weight Inclusive Consulting, providing education and training on dismantling anti-fat bias in healthcare and beyond. You can find Vinny at fiercefatty.com and on Instagram at @fierce.fatty. Related Episodes When Doctors Harm: Medical Weight Stigma & Eating Disorders on Apple & Spotify. Having Anorexia in a Larger Body: Navigating Medical Anti-Fat Bias & Lack of Care with Sharon Maxwell @heysharonmaxwell on Apple & Spotify. Content Caution This episode includes discussion of medical trauma, weight stigma, eating disorders, healthcare discrimination, and systemic oppression. The harm described in this episode is real, widespread, and systemic.

In this solo episode of Dr. Marianne Land, Dr. Marianne Miller explores one of the most overlooked drivers of Avoidant Restrictive Food Intake Disorder, or ARFID: the powerful intersection of autonomy and sensory needs. This episode unpacks why pressure based approaches consistently fail people with ARFID and how choice, consent, and nervous system safety create real pathways toward healing. Rather than framing ARFID as defiance or avoidance, this conversation centers ARFID as a protective response rooted in sensory overwhelm and a deep need for bodily autonomy. Why Autonomy Matters in ARFID For many neurodivergent people, autonomy is not optional. It is a core safety requirement. Dr. Marianne explains how pressure around food activates threat responses in the nervous system, often leading to shutdown, panic, or increased food avoidance. When autonomy gets removed through medical pressure, family conflict, or exposure approaches that override consent, ARFID symptoms often intensify. This episode reframes autonomy not as resistance, but as a stabilizing force that helps people survive overwhelming eating environments. Sensory Processing and Nervous System Safety Sensory sensitivity plays a central role in ARFID. Texture, smell, temperature, and unpredictability can trigger immediate nervous system distress. In this episode, Dr. Marianne explains how these sensory reactions are involuntary and protective, not behavioral choices. Safe foods become anchors that help regulate the nervous system, and honoring sensory needs becomes essential for sustainable eating disorder recovery. When sensory experiences are respected, the body no longer needs to protect itself through restriction. Why Pressure Fails and Choice Heals Pressure based interventions often backfire in ARFID treatment. Dr. Marianne explores how even well-intentioned encouragement can teach the nervous system that eating is unsafe. Pressure increases fear, deepens avoidance, and damages trust. In contrast, choice restores safety. When people with ARFID control the pace, timing, and nature of food exploration, curiosity becomes possible. Choice supports regulation, builds self-trust, and creates space for gentle expansion without retraumatization. A Neurodivergent-Affirming Approach to ARFID Recovery This episode highlights what ARFID care can look like when it centers consent, collaboration, and sensory attunement. Dr. Marianne discusses how liberation-centered treatment prioritizes nervous system regulation over compliance, honors lived experience, and rejects one-size-fits-all exposure models. Recovery becomes sustainable when dignity, agency, and sensory truth guide the process. Intersectionality, Identity, and Autonomy Autonomy carries different weight depending on lived experience. Dr. Marianne addresses how fat individuals, disabled individuals, neurodivergent people, and those with chronic illness often experience repeated violations of autonomy in medical and social settings. For many, eating becomes another site of control and harm. This episode situates ARFID within broader systems of stigma and explains why restoring autonomy is especially critical for people with marginalized identities. Mid-Episode Invitation During the episode, Dr. Marianne shares more about her self-paced ARFID and Selective Eating Course. The course offers neurodivergent-affirming, trauma-informed tools that support autonomy, sensory safety, and nervous system regulation. It is designed for individuals with ARFID, caregivers, and clinicians seeking a more compassionate and effective framework for healing. Who This Episode Is For This episode is for anyone living with ARFID, supporting someone with ARFID, or working professionally with eating disorders and neurodivergence. It is especially relevant for listeners who have felt harmed by pressure based treatment, misunderstood by providers, or blamed for sensory needs they cannot control. Related Episodes on ARFID --ARFID Explained: What It Feels Like, Why It's Misunderstood, & What Helps on Apple & Spotify. --Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify. --ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify. --Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Listen and Learn More If ARFID has shaped your relationship with food, your body, or your sense of safety, this episode offers a validating and science-informed perspective. To learn more about Dr. Marianne's virtual, self-paced ARFID and Selective Eating Course or to explore therapy and educational resources, visit her website drmariannemiller.com.

Chewing and spitting is an eating disorder behavior that often remains hidden due to intense shame and misunderstanding. Many people do not know how to talk about it, and many providers never ask. In this solo episode, Dr. Marianne Miller offers a clear, compassionate explanation of chewing and spitting in eating disorders, naming why this behavior develops and why it deserves nuanced care rather than judgment. This episode centers eating disorder recovery, ARFID, neurodivergent sensory experiences with food, and the nervous system roots of eating behaviors that are often moralized or overlooked. Why Chewing and Spitting Is So Often Misunderstood Chewing and spitting is frequently framed as a single behavior with a single cause. This narrow understanding creates harm. When providers assume chewing and spitting always reflects restriction or compensatory behavior, people with ARFID and sensory-based eating challenges are misdiagnosed or pressured into unsafe treatment. When providers minimize chewing and spitting in restrictive eating disorders, people lose access to support at moments of increasing distress. This episode explains why chewing and spitting must be understood through multiple pathways to ensure accurate diagnosis and ethical care. Pathway One: Chewing and Spitting in Restrictive and Compensatory Eating Disorders In restrictive or compensatory eating disorders, chewing and spitting often functions as a way to avoid swallowing food while still experiencing taste. It may emerge during periods of significant restriction, intense hunger, or fear of weight gain. Some people use chewing and spitting to interrupt binge urges or as a purge-adjacent behavior. In this pathway, the behavior reflects deprivation, internal conflict, and rising eating disorder severity. Shame, secrecy, and fear of judgment frequently follow, making it harder for individuals to seek support or speak openly about what they are experiencing. Pathway Two: Chewing and Spitting in ARFID and Neurodivergent Sensory-Based Eating Chewing and spitting can also emerge in ARFID and neurodivergent sensory-based eating for reasons entirely unrelated to weight or dieting. In this pathway, the behavior reflects sensory overwhelm, swallowing discomfort, texture sensitivity, interoceptive differences, or nervous system safety needs. Autistic and ADHD individuals may chew food to explore taste while spitting to avoid gagging, panic, or sensory overload. When this pathway is misunderstood as compensatory eating disorder behavior, people often feel pathologized rather than supported. This episode explains how sensory wiring, disability, and safety needs shape this experience. Why Differentiating These Two Pathways Matters in Recovery Accurately identifying the function of chewing and spitting is essential for healing. Restrictive and compensatory pathways require approaches that address deprivation, shame, trauma, and rigid food rules. Sensory-based pathways require approaches that build safety, honor autonomy, and work with the nervous system rather than against it. Dr. Marianne explains why a one-size-fits-all model fails and how differentiation creates clarity, trust, and more sustainable eating disorder recovery. Intersectionality, Bias, and Systemic Harm This episode also explores how anti-fat bias, racism, ableism, and medical bias shape who receives care and who gets believed. People in larger bodies often experience intense pressure to restrict, which can intensify chewing and spitting behaviors. People of color frequently face delayed or missed eating disorder diagnoses. Neurodivergent individuals are often misunderstood or dismissed when their eating challenges are sensory-based. Understanding chewing and spitting requires naming these systemic harms rather than blaming individuals. A Compassionate Path Forward Chewing and spitting is not a moral failure or a sign of weakness. It is a behavior rooted in nervous system responses, lived experience, and survival. This episode offers language, validation, and clarity for anyone who has struggled with chewing and spitting, supported someone who has, or wants a more nuanced understanding of eating disorders and ARFID. Healing begins with understanding, safety, and compassion. About Dr. Marianne Miller Dr. Marianne Miller is a licensed marriage and family therapist specializing in eating disorder recovery, ARFID, binge eating, and neurodivergent-affirming therapy. She offers therapy for individuals in California, Texas, and Washington D.C., and teaches the self-paced, virtual ARFID and Selective Eating Course.

Exercise is often framed as self-care, discipline, or proof that someone is “doing the right thing.” But for many people, exercise becomes tangled with shame, control, and self-worth. In this interview, Dr. Marianne Miller sits down with Dr. Lisa Folden, a weight-inclusive physical therapist and Health at Every Size ambassador, to explore how exercise shamefuels body image distress and disordered eating, even when it is disguised as wellness or health. Dr. Lisa shares her personal journey from overexercising, restriction, and rigid fitness rules to intuitive movement rooted in care rather than punishment. Together, they unpack how fitness culture, purity culture, and appearance-based health messaging teach people to judge their bodies and measure their worth through movement, weight, and discipline. This conversation reframes eating disorder recovery through a compassionate, weight-inclusive lens that separates exercise from morality and control. This episode is especially relevant for anyone struggling with eating disorders, chronic disordered eating, exercise guilt, or a painful relationship with movement. Content Caution This episode includes discussion of eating disorders, disordered eating behaviors, food restriction, binge eating patterns, overexercising, body image distress, weight stigma, and shame-based health messaging. Please listen in a way that feels supportive to you. Episode Overview In this conversation, Dr. Marianne and Dr. Lisa explore how exercise shame develops and why it is so deeply connected to body image and eating disorder recovery. Dr. Lisa explains how early experiences with discipline, structure, and purity culture shaped her relationship with food and exercise, reinforcing the belief that bodies must be controlled to be worthy. They discuss how fitness spaces often reward pain, consistency, and weight loss while ignoring mental health, accessibility, and individual needs. The episode also examines how intuitive movement becomes possible when exercise is no longer used to fix or punish the body. Dr. Lisa describes what shifted when she stopped exercising to change her body and began moving in ways that supported her nervous system, energy, and overall well-being. The conversation highlights how ableism and body size bias show up in gyms and wellness spaces, often through subtle judgments about who “belongs” and how bodies should move. Throughout the episode, Dr. Lisa emphasizes that exercise does not determine character and that body image healing requires separating movement from shame, worth, and identity. This reframing is central to sustainable eating disorder recovery and long-term healing. Why This Episode Matters Many people in eating disorder recovery were taught that exercising consistently meant they were good, disciplined, or successful, while rest or inconsistency meant failure. This episode challenges those beliefs and offers a more humane, evidence-informed approach to movement and self-care. It speaks directly to listeners who feel stuck in cycles of overexercising, restriction, binge eating, or chronic guilt around movement, and offers permission to relate to exercise in a way that supports healing rather than harm. About Dr. Lisa Folden Dr. Lisa Folden is a North Carolina–licensed physical therapist, NASM-certified behavior change specialist, and anti-diet, weight-inclusive coach. She is the owner of Healthy Phit Physical Therapy and Wellness Consultants and a Health at Every Size ambassador. Her work focuses on helping people heal their relationship with movement, body image, and food, particularly in the context of eating disorder recovery. She is also a writer, speaker, and mother of three. You can follow Dr. Lisa on Instagram at @healthyphit and read her writing on Substack at DrLisaFolden. Related Episodes --Breaking Up With Diet Culture with Dr. Lisa via Apple or Spotify. --Moralization of Exercise, Eating, & Body Size With Dr. Lisa via Apple or Spotify. About the Host Dr. Marianne Miller is a Licensed Marriage and Family Therapist and eating disorder specialist offering neurodivergent-affirming, trauma-informed support for binge eating disorder, ARFID, anorexia, bulimia, and long-term eating disorders. She hosts Dr. Marianne-Land: An Eating Disorder Recovery Podcast and provides therapy, education, and self-paced recovery programs. Check out her website at drmariannemiller.com or her Instagram @drmariannemiller. Listen Now If exercise has ever felt like punishment, obligation, or proof of worth, this episode offers a different path forward grounded in compassion, autonomy, and care.

In this solo episode, Dr. Marianne explores how autism shapes eating in ways that many providers overlook. Sensory needs, interoception, routines, and safety all influence how autistic people navigate food. Instead of seeing these challenges as resistance, Dr. Marianne reframes them as intelligent body signals that protect a sensitive nervous system. Dr. Marianne explains why autistic eating experiences often get misunderstood. She discusses how overwhelming textures, smells, and sounds affect tolerance for certain foods, how interoceptive confusion can disrupt hunger cues, and how predictability reduces chaos during meals. She also explores the deep need for safety and how early food trauma can lead to long-lasting protective patterns. This episode highlights how autistic people may develop ARFID due to sensory overload, fear, or confusion around internal cues. Dr. Marianne emphasizes the need for neurodivergent affirming care that respects autonomy, consent, and the right to eat in ways that support comfort rather than compliance. Dr. Marianne also examines intersectionality. Autistic people of color, LGBTQIA+ autistic people, and disabled autistic people often face additional barriers to care and experience higher rates of dismissal. Understanding these intersections helps us provide real support. Throughout the episode, Dr. Marianne offers a compassionate framework for supporting autistic eating. She centers curiosity, sensory awareness, co-regulation, predictable routines, and respect for safe foods. She encourages listeners to trust their bodies and seek environments that reduce overwhelm instead of increasing it. Key Topics Covered Sensory Needs and Autistic Eating How texture, smell, sound, and temperature influence food tolerance and how sensory overwhelm shapes avoidance patterns. Interoception and Hunger Cues Why autistic people often experience muted or confusing hunger cues and how supportive routines help. Predictability and Routine Why sameness offers safety during meals and how routine helps regulate the nervous system. Safety and Eating Trauma The long-term effects of force feeding, pressure, and food shame and how safety becomes essential for healing. Autism and ARFID How ARFID develops in autistic people and why care must support autonomy, sensory comfort, and consent. Intersectionality and Access to Care How race, gender, sexuality, class, and disability shape autistic eating experiences and influence the support people receive. Compassionate Support Strategies How validation, sensory awareness, predictable rhythms, and co-regulation improve access to nourishment. Content Caution In this episode, I discusseeating challenges, restriction patterns, sensory overload, trauma, and ARFID. Please listen gently and take breaks if needed. Who This Episode Supports This episode is for autistic adults, parents of autistic children, providers who want to offer neurodivergent affirming care, and anyone who wants a deeper understanding of autistic eating experiences. It is also supportive for people exploring ARFID symptoms rooted in sensory needs, trauma histories, or routines that feel protective. Related Episodes Autism & Eating Disorders Explained: Signs, Struggles, & Support That Works on Apple & Spotify. The Invisible Hunger: How Masking Shows Up in Eating Disorder Recovery on Apple & Spotify. How Masking Neurodivergence Can Fuel Eating Disorders on Apple & Spotify. Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe on Apple & Spotify. Work With Dr. Marianne If you want support that honors your sensory needs and your autonomy, you can learn more about my therapy services in California, Texas, and Washington, D.C., as well as global coaching options at drmariannemiller.com. You can also explore my ARFID and selective eating course and my binge eating and bulimia membership for additional tools. You deserve care that meets your body where it is.

TikTok reshapes the way people talk about bodies, beauty, and wellness. What looks like gentle self care often hides restrictive eating patterns, thinness pressure, and aesthetic rules that reward shrinking. In this episode, Dr. Marianne Miller explores how TikTok rebrands diet culture by disguising restriction inside trends like “anti bloat,” “glow up,” “clean girl body,” and “body recomposition.” Dr. Marianne explains why these trends spread quickly, why they create a strong pull for people with eating disorders, and why neurodivergent viewers may feel especially drawn to routines that promise control or calm. She describes how glow up narratives romanticize disappearance and how thinness becomes a transformation story. You will learn how to identify coded diet language and how to stay grounded while moving through online spaces that promote harmful messaging. What You Will Learn in This Episode 1. How TikTok Rebrands Diet Culture Dr. Marianne explains how “anti bloat” routines and glow up challenges present restriction as wellness. She highlights how these messages look soft and soothing even though they pressure people to shrink and control their bodies. 2. How Coded Restriction Language Shows Up Online You will learn how creators use soothing audio, soft visuals, and vague terms to disguise patterns that mirror disordered eating. Dr. Marianne names the phrases that quietly promote thinness. 3. Why Neurodivergent Viewers and People With Eating Disorders Feel Drawn In Structured routines and visuals can feel comforting or predictable. Dr. Marianne describes how this pull can feel stronger for neurodivergent listeners or anyone living with long-term food struggles. 4. How Glow-Up Culture Romanticizes Shrinking Dr. Marianne explores how glow up narratives frame thinness as success, transformation, or emotional strength. These stories reward disappearance and pressure people to strive for smaller bodies. 5. Intersectionality and Harmful Messaging Dr. Marianne names the ways thinness aesthetics reinforce cultural pressures for people in larger bodies, people of color, neurodivergent individuals, transgender and nonbinary people, and anyone who already experiences scrutiny or marginalization. 6. How to Strengthen Your Relationship With TikTok You will learn practical strategies to identify harmful patterns, curate your feed, follow body liberation voices, and stay centered in your own needs while using the platform. Content Caution This episode includes discussion of thinness trends, restrictive routines, and coded dieting messages on TikTok. If you feel overwhelmed or activated, please pause and return when you feel grounded. Who This Episode Supports This episode supports: • people recovering from eating disorders • neurodivergent listeners who feel drawn to routines or calming visuals • people in larger bodies who feel erased by glow up narratives • trauma survivors who feel pulled toward control-based content • clinicians, parents, and helpers who want to understand the pressures their clients or teens face online • anyone curious about how diet culture hides inside wellness language Resources Listeners may find support through: • body liberation and fat liberation educators • research on social media and disordered eating • neurodivergent-affirming eating disorder resources • trauma-informed recovery frameworks Related Episode SkinnyTok & Anorexia: How Harmful Trends Thrive Despite TikTok's Ban with Jen Tomei @askjenup on Apple and Spotify. Work With Dr. Marianne Miller Learn more about therapy, coaching, binge eating support, ARFID resources, and upcoming clinician trainings at drmariannemiller.com. Explore the blog, podcast show notes, and all available offerings.

What if the problem is not your motivation to recover, but a system that makes eating disorder treatment almost impossible to afford? In this conversation, I sit down again with Leslie Jordan Garcia @liberatiwellness. Leslie is a wellness strategist, certified eating disorder recovery coach, and Treatment Access Program Manager at Project HEAL. In this episode, we discuss real, concrete pathways to free and low-cost eating disorder care. We also talk about why you cannot separate eating disorder recovery from social justice, intersectionality, and body hierarchies. Leslie breaks down how Project HEAL removes financial and systemic barriers, how people from marginalized communities can apply, and how providers can join the Healer's Circle to offer justice-focused, values-aligned care. In this episode, we talk about What Project HEAL is and how it works to remove financial and systemic barriers to eating disorder care in the United States The four major Project HEAL programs and how to apply for: Community Care groups for BIPOC folks Cash assistance that covers tertiary costs like rent, pet boarding, and transportation Outpatient treatment placement with sliding scale and pro bono providers Insurance navigation support and help with single case agreements Who qualifies for Project HEAL services, including people in all U.S. states and territories, and how they prioritize folks from communities that are historically and systemically marginalized How Leslie matches people with “unicorn providers” who are fat positive, HAES aligned, queer affirming, trauma aware, and non Christian based when needed The difference it makes when someone helps you navigate insurance, access care, and complete applications, especially when executive functioning is low or things feel overwhelming How economic precarity, layoffs, food insecurity, and shifting insurance policies are driving an uptick in applications for eating disorder treatment assistance Why intersectional, identity affirming care is not optional in eating disorder recovery, especially for BIPOC, queer, trans, disabled, and fat clients How Leslie's social justice consulting work with universities, community colleges, and health organizations helps them: Reimagine intake forms and client facing processes Address promotion and salary inequities Create transformational circles where teams talk about harm, stereotypes, and systemic barriers How body hierarchies, food moralization, school fitness testing, and lunch shaming fuel eating disorders for kids and adults Why many people use eating disorders as a survival tool in the context of trauma, capitalism, surveillance, and unsafe systems What true equity and belonging could mean for decreasing the occurrence and severity of eating disorders About our guest: Leslie Jordan Garcia Leslie Jordan Garcia is a wellness strategist, certified eating disorder recovery coach, and social justice consultant dedicated to healing and liberation. She holds dual master's degrees in business and public health and has more than a decade of experience across military, public health, and nonprofit sectors. Through her practice, Liberati Wellness, Leslie offers HAES aligned eating disorder recovery support, inclusive movement support, and equity and identity affirming care. Leslie also partners with organizations like Austin Health Commons and the Hogg Foundation to embed equity and justice into health systems and helping professions. She currently serves as the Treatment Access Program Manager at Project HEAL, where she manages cash assistance and treatment placement and works to match clients with values aligned, culturally responsive providers. You can find Leslie's coaching and consulting work at Liberati Wellness and on Instagram at @liberatiwellness. Inside Project HEAL's pathways to care In this episode, Leslie explains how Project HEAL supports people who are struggling with eating disorders and facing financial and systemic barriers to treatment. She walks us through the main programs: Informed ED (for professionals) A learning program for clinicians and dietitians who are newer to eating disorder treatment. It helps them build skills, reduce harm, and align their work with justice focused values so they can better support clients whose eating disorders are uncovered in general mental health or medical settings. Community Care A free, BIPOC only, 8 week support and process group focused on body liberation, community care, and healing from white supremacist body hierarchies. Cash Assistance Program A program that does not pay individuals directly, but instead covers tertiary costs that often block access to care. This can include rent, transportation, pet boarding, or other essential expenses so that people can actually attend the level of care their team recommends. Treatment Placement Leslie coordinates outpatient treatment placement, connecting people with dietitians, therapists, and other providers who offer sliding scale or pro bono care, especially when insurance does not cover enough dietitian sessions or mental health support. Insurance Navigation Project HEAL helps people understand their insurance benefits, locate in network providers, and pursue options like single case agreements when an appropriate provider is out of network. Leslie also mentions a time limited clinical assessment program for people who know they are struggling in their relationship with food and body but have never had a formal diagnosis. All of these services are free to applicants, and one application can cover multiple programs at once. Who can apply to Project HEAL Leslie shares that Project HEAL is U.S. based, and that includes all 50 states, Alaska, Hawaii, and U.S. territories such as Guam. Anyone in those locations can apply. Project HEAL prioritizes people from communities that have been historically and systemically marginalized, including: BIPOC communities Queer and trans communities People in larger bodies Disabled and chronically ill folks People navigating religious trauma and other layered identities Leslie's role includes reading applications through an intersectional lens, tracking diversity demographics, and making sure that people who face the largest gaps in access are not overlooked. She also notes that if the application itself feels overwhelming, Project HEAL can connect applicants with someone who will help them complete it, which is especially important when executive functioning is low. Intersectionality, social justice, and eating disorder recovery Throughout the conversation, Leslie and I look at how eating disorders are never just about appearance. They are deeply tied to: Trauma and chronic stress How we perceive our bodies and how we believe others perceive our bodies Economic instability, job insecurity, and food insecurity Surveillance of bodies in workplaces, schools, and medical settings Racism, anti-fat bias, ableism, transmisia, and other forms of oppression Leslie talks about clients who restrict food so their children can eat when jobs cut hours, and how people in larger bodies often avoid eating at work because of constant surveillance and judgment, only to experience intense hunger and binge episodes later. We explore how body hierarchies, moralization of food, school fitness testing, and lunch policing create conditions where an eating disorder can become a primary coping strategy. Leslie describes how, over time, this can become deeply embedded, with the brain chemistry colluding with the eating disorder to create a sense of safety that the larger system fails to provide. For Leslie, social justice work is inseparable from eating disorder work. If people had secure access to food, safe housing, living wages, and genuine body equity, many would not need to rely on eating disorders to feel safer, visible, or invisible. Justice work inside systems Leslie also describes her justice work with institutions, including: Facilitating Transformational Circles where diverse team members connect as humans and then talk honestly about processes that exclude or harm people Supporting clinics that operate in queer neighborhoods yet do not see queer clients, and helping them examine what in their client facing processes is pushing people away Working with community colleges on salary and promotion inequities, examining reviews, ranking systems, and feedback processes that keep certain groups from advancing Helping organizations rework intake forms, policies, and internal culture so that equity, belonging, and justicebecome real practices rather than buzzwords She reminds us that what often gets labeled as “DEI” is actually about justice, accessibility, and belonging for everyone, including veterans, people who breastfeed, people who need ramps and accessible bathrooms, and more. How to connect with Project HEAL and Leslie To apply for Project HEAL's Treatment Access programs Visit the Project HEAL website at projectheal.org and look for the section on Treatment Access. One application lets you indicate which services you want, including cash assistance, treatment placement, insurance navigation, and clinical assessment while that program is still active. Both individuals seeking care and providers who want to join the Healer's Circle start on the same site. Providers can share their identities, specialties, body size, languages spoken, and communities they love to serve, which helps Leslie make strong intersectional matches. To work with Leslie as a coach or consultant You can learn more about Leslie's equity and identity affirming eating disorder recovery coaching and social justice consulting at: Website: Liberati Wellness liberatiwellness.com Instagram: @liberatiwellness She currently has a reduced capacity for one to one clients but continues to support individuals and teams through coaching, collaboration with therapists and dietitians, and organizational justice work. If this episode resonated with you If you are struggling with an eating disorder and feel blocked by money, insurance, or access, I hope this episode helps you feel less alone and more resourced. There are people and organizations actively working to break financial barriers to care. If you know someone who could benefit from free or low-cost eating disorder support, especially someone from a marginalized community, please consider sharing this episode with them. You can also support this work by: Following @liberatiwellness and @projectheal Sharing Project HEAL's application info with your community If you are a provider, applying to join the Healer's Circle and offering sliding scale or pro bono care And as always, thank you for listening and for being part of this conversation about justice, embodiment, and eating disorder recovery.

This solo episode explores the quiet places where anorexia meets identity and expression. Dr. Marianne Miller speaks to the lived moments where someone learns to hide parts of themselves and how restriction becomes a language for survival. She examines how identity formation, self-expression, and body-based fear interact in ways that often remain hidden. The episode centers queer, trans, gender-expansive, and questioning listeners along with anyone who has felt pressure to quiet their identity in order to navigate the world. Dr. Marianne describes how anorexia rises when identity feels unsafe, unrecognized, or tightly controlled. She explains how restriction becomes a strategy to manage visibility, vulnerability, dysphoria, and the cultural pressure to stay small. The episode invites listeners to imagine recovery as a process of expanding expression, reclaiming autonomy, and restoring connection to their authentic self. Key Themes in This Episode Dr. Marianne examines the links between anorexia, identity, and self-expression. She describes how gender expectations and cultural norms shape the body story. She explains how queer and trans people often restrict to soften dysphoria or to quiet unwanted attention. She explores the way over-performance and people-pleasing silence authentic expression and strengthen restrictive behavior. She looks at the sensory landscape of anorexia and describes how neurodivergent experiences influence embodiment and identity. She also highlights the role of intersectionality. Race, culture, queerness, disability, and body size shape how someone expresses themself and how safe that expression feels. These intersections help explain why anorexia often becomes a predictable response to environments that restrict identity or punish authenticity. Why This Episode Matters Mainstream conversations about anorexia often focus on food without addressing identity, expression, and cultural pressure. Many listeners learn early that their identity takes up too much space. Many learn that desire, gender expression, and emotional truth need to stay hidden. This episode challenges the idea that anorexia develops inside a vacuum. Instead, it shows how anorexia forms inside relationships, systems, and environments that silence real expression. The episode offers validation for anyone who felt forced to shrink in order to stay safe. It expands the understanding of anorexia so listeners can see their experiences reflected with accuracy, compassion, and liberation. Who This Episode Supports This episode supports listeners who navigate anorexia while holding queer, trans, or gender-expansive identities. It supports people who experience identity suppression or dysphoria and who use restriction to manage that conflict. It supports neurodivergent listeners whose sensory experiences shape their relationship with their body and their identity. It also supports clinicians, loved ones, and community members who want a more accurate and compassionate understanding of anorexia. Resources Mentioned Liberation-based healing models Trauma-informed care Queer embodiment research Neurodivergent eating disorder literature Content Caution This episode discusses anorexia, restrictive eating, identity conflict, gender dysphoria, sexuality, sensory overwhelm, and the lived experience of shrinking to stay safe. Please listen with care and pause whenever your body needs space. Related Episodes Queer Mental Health & Eating Disorders: How Stress Shows Up in the Body & Brain With Winter Groeschl, NCC, LPC (@eatingdisorderrevealed): Apple & Spotify. LGBTQIA+, the Coming Out Process, & Eating Disorders: Apple & Spotify LGBTQIA+ & Eating Disorders: Apple & Spotify Learn More and Get Support Dr. Marianne Miller provides therapy and coaching for anorexia, ARFID, binge eating disorder, bulimia, trauma, and body-based fear. She supports clients across California, Texas, Washington D.C., and internationally. Explore additional episodes of the Dr. Marianne Land podcast for conversations about eating disorder recovery, neurodiversity, identity, embodiment, and body liberation. Check out her website at drmariannemiller.com. Follow her on Instagram @drmariannemiller.

In this episode, Dr. Marianne Miller explores the reality that many people with lifelong eating disorders do not resonate with the traditional idea of full recovery. She explains why harm reduction can offer a compassionate and sustainable path for individuals who have lived with chronic anorexia, long term bulimia, binge eating disorder, ARFID, and other long standing eating disorders. This conversation centers trauma history, neurodivergence, sensory needs, oppression, and the intersectional barriers that prevent many people from reaching what treatment programs often define as full recovery. If you have lived with an eating disorder for decades, if you have experienced trauma or misdiagnosis, if you are neurodivergent, or if you live in a marginalized body that has faced medical discrimination, you may find this episode deeply validating. Harm reduction gives you realistic recovery goals that respect your lived experience, your nervous system, and your access needs. What You Will Learn in This Episode Dr. Marianne explains how harm reduction works in eating disorder recovery and how it differs from traditional recovery models. She shows how harm reduction supports safety, stabilization, and dignity for people who have navigated chronic eating disorders for most of their lives. You will learn why the nervous system sometimes cannot tolerate pressure toward full recovery and why a flexible, collaborative approach can feel more aligned for many people. You will hear how sensory issues, interoception challenges, executive functioning differences, autistic burnout, and ADHD related overwhelm shape eating patterns for neurodivergent individuals. You will learn how trauma history, attachment ruptures, racialized stress, gender based discrimination, medical fatphobia, and identity marginalization influence both the development of eating disorders and the recovery process. Key Topics Covered This episode covers a wide range of topics that matter deeply for people with chronic eating disorders. These topics include how harm reduction supports stabilization when the long term eating disorder has become intertwined with survival. You will hear why the phrase full recovery can feel unrealistic or even harmful for people who have lived with their eating disorder for decades. Dr. Marianne explains how harm reduction creates safety, reduces shame, increases autonomy, and supports people who need a gentler and more individualized approach. The episode explores the role of neurodiversity in eating disorder recovery. This includes how sensory sensitivities shape food choices, how interoception differences impact hunger awareness, how executive functioning challenges influence meal consistency, and why many autistic and ADHD individuals need accessible, predictable, and customized strategies. You will also learn how intersectional oppression shapes health outcomes for people of color, queer and trans individuals, disabled individuals, fat individuals, and anyone living across multiple marginalized identities. Dr. Marianne describes what harm reduction can look like in daily life, from maintaining safe foods to creating sensory friendly meals to reducing medical instability in small, sustainable steps. She shares how this approach honors personal history and current capacity and how it helps many people live with more stability and less suffering. Who This Episode Is For This episode is for anyone living with a lifelong eating disorder who has felt pressure to pursue full recovery even when that expectation does not align with their reality. It is for people with chronic anorexia, chronic bulimia, long term binge eating disorder, ARFID shaped by sensory needs, and individuals with complex trauma who feel overwhelmed by traditional treatment expectations. This episode is also for neurodivergent individuals who live with autistic sensory profiles, ADHD impulsivity, interoception challenges, and executive functioning struggles that interfere with eating. It is for people living in marginalized bodies who have experienced medical discrimination or misdiagnosis. It is for professionals who want to learn how to apply harm reduction to eating disorder treatment in inclusive, neurodivergent affirming, and identity informed ways. Why This Episode Matters Many people with chronic or lifelong eating disorders feel invisible in mainstream recovery culture. They hear messages that full recovery is the only worthy goal and feel ashamed when their body or nervous system cannot meet those expectations. This episode names that truth with compassion. Harm reduction is a valid and ethical approach that honors lived experience and brings relief to people who need safety more than perfection. This episode matters because it acknowledges the role of trauma, neurodivergence, sensory needs, and intersectionality in long term eating disorders. It challenges the idea that recovery must look the same for everyone. It shows that you deserve care even if your healing does not follow a traditional blueprint. Your life still holds value and possibility. Related Episodes Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Navigating a Long-Term Eating Disorder on Apple & Spotify. Why Eating Disorder Recovery Feels Unsafe: Facing Ambivalence in Long-Term Struggles on Apple & Spotify. Perfectionism, People-Pleasing, & Body Image: Self-Compassion Tools for Long-Term Eating Disorder Recovery With Carrie Pollard, MSW @compassionate_counsellor on Apple & Spotify. Resources and Support If you want more resources on lifelong eating disorders, harm reduction, ARFID, sensory based eating, and neurodivergent affirming care, visit drmariannemiller.com where you will find blog posts, guides, and links to specialized support. You can also explore my ARFID course and binge eating recovery membership options if you want deeper help with binge eating disorder, bulimia, ARFID, or long term eating disorder recovery. My work supports clients in California, Texas, Washington DC, and internationally through coaching. Join the Conversation If this episode resonated with your experience of a lifelong eating disorder or if you are curious about harm reduction as a recovery model, I would love to hear your thoughts. You can connect with me on Instagram at @drmariannemiller and share what stood out to you. For More Dr. Marianne-Land Podcast Episodes To explore more episodes on eating disorders, neurodiversity, trauma, and body liberation, listen to the full archive on your favorite podcast platform.

What happens when chronic illness meets wellness culture, diet culture, and the desperate search for answers in a system that continues to fail so many people? In this episode, I talk with Abbie Attwood, MS, @abbieattwoodwellness, an anti diet, weight inclusive nutrition therapist and host of the Full Plate Podcast. Abbie and I explore how chronic illness, medical gaslighting, and the pressure to find a cure can intersect with disordered eating. We talk about the ways wellness messaging pushes restrictive food rules, how OCD and anxiety deepen vulnerability to this messaging, and how food fear can feel like control when life feels unpredictable. We also discuss athlete identity, compulsive exercise, thin privilege, masking, neurodivergence, and the grief that comes when illness or injury forces people to rethink who they are. This conversation opens space for nuance, compassion, and the reality that healing happens inside context, not perfection. Content Caution We talk about chronic illness, disordered eating, exercise compulsion, and food restriction. Please take care of yourself as you listen. Key Topics We Cover 1. How wellness culture preys on vulnerability Abbie discusses how chronic illness created a perfect storm for disordered eating, especially when wellness messaging promised control, cures, and answers that science did not support. 2. Chronic illness and the search for control We talk about how desperation, medical dismissal, and misinformation make people more likely to turn to restrictive food rules and elimination diets. 3. OCD, anxiety, and increased vulnerability to wellness culture Abbie shares how her undiagnosed OCD and lifelong anxiety made the rigid, all or nothing tone of wellness culture feel reassuring, while actually deepening harm. 4. Athlete identity, loss, and compulsive movement We explore how losing movement due to chronic illness or injury can destabilize identity, trigger grief, and reignite disordered behaviors around exercise. 5. Masking, neurodivergence, and the pressure to perform wellness We discuss how neurodivergent masking can hide exhaustion and overwhelm, and how the pressure to perform health or discipline can push people deeper into food and exercise rigidity. 6. Chronic illness culture, shame, and blame We look at how chronic illness culture and wellness culture both place responsibility on the individual, leading to shame and self blame when bodies do not behave as expected. 7. What real nourishment looks like when illness limits capacity Abbie talks about the need for compassion, ease, adding rather than restricting, and honoring energy limitations instead of forcing strict food rules. Who This Episode Is For People navigating chronic illness and food anxiety Listeners recovering from eating disorders Neurodivergent folks who feel pressured to mask or follow rigid health rules Athletes or former athletes grieving changes in movement Anyone tangled in wellness culture messaging Clinicians who want a deeper understanding of how chronic illness intersects with disordered eating People who struggle with shame when illness reduces their capacity About Today's Guest Abbie Attwood, MS, is an anti diet, weight inclusive nutrition therapist, writer, and host of the Full Plate Podcast. She provides virtual nutrition therapy and body image support through Abbie Attwood Wellness and writes a widely loved Substack newsletter on healing our relationships with food and body. You can find her at @abbieattwoodwellness and abbieattwoodwellness.com. Links Mentioned Abbie Attwood Wellness Substack: abbieattwoodwellness.substack.com Abbie's website: abbieattwoodwellness.com Instagram: @abbieattwoodwellness Full Plate Podcast Related Episodes Breaking Up With Diet Culture with Dr. Lisa Folden, @healthyphit on Apple & Spotify. How Eating Disorder Recovery Heals Life Overall via Apple or Spotify. Overexercising, ADHD, & Eating Disorders with @askjenup Jenny Tomei on Apple & Spotify. How Diet Culture & Purity Culture Fuel Eating Disorders: Unpacking the Trauma Behind the Rules with Cassie Krajewski, LCSW @inneratlastherapy on Apple & Spotify. Work With Me If you want support for binge eating disorder, ARFID, chronic eating struggles, or complex eating disorder patterns shaped by trauma, neurodivergence, or chronic illness, you can connect with me at drmariannemiller.com for therapy in California, Texas, or Washington D.C. I also offer global coaching and specialized courses.

What happens when an eating disorder has been part of your life for years or even decades. In this solo episode, Dr. Marianne Miller explores what recovery can look like when anorexia or bulimia becomes chronic, persistent, or long-term. Drawing from her experience as a therapist specializing in eating disorders, Dr. Marianne offers trauma-informed, neurodivergent-affirming, and body-liberation tools that help people reconnect with their bodies, support their nervous systems, and rebuild trust when recovery feels unreachable. This episode provides compassionate guidance for anyone who has lived with an eating disorder for a long time and wonders if healing is still possible. It also supports clinicians, loved ones, and helpers who want to understand the realities of severe and enduring eating disorders with more depth, nuance, and humanity. Why This Episode Matters People with chronic anorexia or bulimia often feel overlooked by treatment models that expect rapid transformation or complete symptom remission. Many have cycled through recovery attempts and relapse, often carrying shame for not recovering quickly enough. Dr. Marianne reframes chronic eating disorders as endurance rather than failure. She introduces recovery approaches that honor the nervous system, acknowledge survival strategies, and center autonomy, safety, and dignity. Key Topics Covered This episode explores why chronic anorexia and bulimia develop and why they persist over time. It highlights how survival strategies become deeply wired into the nervous system and how shame, trauma, sensory overload, and systemic oppression shape long-term eating disorders. Listeners learn how to use persistence instead of perfection, how to rebuild interoceptive awareness, how to support sensory needs, and how to regulate the nervous system in ways that feel gentle and sustainable. The episode also introduces self-compassion as a powerful tool that helps soften shame and create the conditions for real healing. Dr. Marianne explains how relational safety, autonomy, and body trust become essential for long-term recovery. Listeners also hear how intersectionality influences chronicity and why marginalized people often face more barriers to care. Who This Episode Is For This episode supports people living with chronic anorexia or bulimia, people who feel exhausted by long-term recovery efforts, and people who wonder if healing is still possible after many years of struggle. It also supports therapists, dietitians, physicians, and loved ones who want to understand chronic eating disorders through a neurodivergent-affirming, sensory-attuned, and trauma-informed lens. Content Caution This episode discusses chronic anorexia and bulimia, including references to restriction, purging, and trauma. Please listen with care and take breaks if you need to ground or regulate. Your comfort and safety matter. Related Episodes on Lifelong Eating Disorders Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Navigating a Long-Term Eating Disorder on Apple & Spotify. Why Eating Disorder Recovery Feels Unsafe: Facing Ambivalence in Long-Term Struggles on Apple & Spotify. Perfectionism, People-Pleasing, & Body Image: Self-Compassion Tools for Long-Term Eating Disorder Recovery With Carrie Pollard, MSW @compassionate_counsellor on Apple & Spotify. Learn More and Get Support If this episode resonates with you, visit drmariannemiller.com to learn more about therapy, coaching, and resources for eating disorder recovery, including chronic anorexia and chronic bulimia. Dr. Marianne offers care that emphasizes autonomy, collaboration, and nervous system safety. You do not have to heal alone. You can also listen to more episodes of Dr. Marianne-Land on all major podcast platforms.

Most providers still don't recognize ARFID when it's right in front of them. In this episode, Dr. Marianne Miller unpacks why Avoidant/Restrictive Food Intake Disorder remains so misunderstood—and how that misunderstanding harms children and adults who live with it. Dr. Marianne explains what ARFID really is, how it shows up across neurotypes, and why messages like “just try harder” damage safety, trust, and nervous system regulation. Through a neurodivergent-affirming lens, she explores how bias, pressure, and diet-culture thinking keep ARFID invisible and why it's time for providers to see the reality of this eating disorder. Why This Episode Matters For too long, ARFID has been dismissed as “picky eating.” This episode reframes ARFID as a real, body-based eating disorder rooted in sensory processing, fear, or trauma—not defiance or willpower. Dr. Marianne highlights the emotional and physiological impact of being told to “try harder,” and how that phrase erodes autonomy, increases shame, and dysregulates the body. When we understand ARFID as a nervous-system and safety-based challenge, our entire approach to care changes. Listening replaces forcing. Collaboration replaces control. Compassion replaces shame. Key Topics Covered What ARFID Really Is: Understanding sensory-based, fear-based, and low-interest eating patterns that have nothing to do with dieting or body image. Why Professionals Miss It: How traditional training and diet-culture frameworks erase ARFID from diagnosis and treatment. The Harm of “Try Harder” Messages: Exploring what happens when people are shamed or pressured to eat against their nervous system's limits. The Neurodivergent Lens: How autism, ADHD, and other forms of neurodivergence intersect with eating, safety, and sensory regulation. The Role of Bias: Why marginalized identities—fat, BIPOC, neurodivergent, or gender-diverse people—are more likely to be misunderstood or dismissed. What Support Looks Like: How neurodivergent-affirming, sensory-attuned, and autonomy-based care creates safety and possibility. Who This Episode Is For Therapists, dietitians, and physicians who want to understand ARFID beyond stereotypes. Parents who feel blamed or overwhelmed by their child's restricted eating. Adults who have lived with food fear or sensory eating struggles and never had language for it. Neurodivergent people who want their experiences around food to be seen, validated, and supported. Content Caution This episode includes discussion of eating behaviors, sensory distress, and medical dismissal related to ARFID. Please take care of yourself and listen in a way that feels safe for your body and nervous system. Related Episodes ARFID Explained: What It Feels Like, Why It's Misunderstood, & What Helps on Apple & Spotify. Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify. ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Learn More and Get Support If you want to understand ARFID more deeply or build sensory-attuned support skills, check out Dr. Marianne's self-paced ARFID & Selective Eating Course. This training explores sensory processing, collaborative care, and trauma-informed strategies for clinicians, parents, and community members. Visit drmariannemiller.com/arfid to learn more.

What happens when you live with a severe eating disorder in a larger body yet the medical system refuses to see it? In this powerful conversation, Sharon Maxwell (she/they) shares her story of surviving anorexia in a fat body, advocating for herself inside medical systems that consistently denied her care, and reclaiming joy, autonomy, and embodiment after years of harm. Sharon is an educator, speaker, and fat activist who dedicates her work to dismantling anti fat bias and eradicating weight stigma in healthcare and society. Their story and activism have been featured in the New York Times Magazine, The Tamron Hall Show, The Wall Street Journal, NPR, 60 Minutes, and more. Together, we explore the realities of receiving medical care while fat, why compassionate providers save lives, how weight stigma shaped Sharon's early life and nearly cost her her life, and why reclaiming joy becomes an act of resistance. This episode holds so much wisdom, solidarity, and truth telling for anyone in eating disorder recovery, anyone harmed by medical weight stigma, and anyone committed to building a safer world for people in larger bodies. What We Cover in This Episode Sharon's Early Story and Reclaiming Joy Sharon shares a surprising fun fact about being a lifelong pianist and how taking jazz lessons helped them reclaim creativity after growing up in a restrictive religious cult that controlled every aspect of music, expression, and embodied joy. They describe how jazz has become part of their healing and identity reconstruction. Growing Up Fat, Undiagnosed, and Unseen Sharon lived in a fat body their entire life and struggled with anorexia for nineteen years. They went undiagnosed because medical providers only saw their body size. When Sharon arrived with obvious symptoms of an eating disorder, providers dismissed the symptoms and blamed their body. They describe how weight stigma prevented treatment and reinforced eating disorder patterns. The Doctor Who Changed Everything Sharon describes the first doctor who recognized the eating disorder and offered real compassion. That moment shifted the trajectory of their life. We discuss how rare this experience is and why truly compassionate medical care can be lifesaving for people living in larger bodies. Medical Trauma and the Cost of Weight Stigma Sharon shares painful stories about: Being denied necessary medical procedures because of body size. Experiencing trauma at gynecological appointments. Nearly dying from untreated tonsillitis because providers assumed weight was the cause rather than treating the actual condition. The emotional and financial toll of weight stigma across childhood and adulthood. We discuss how the healthcare system misattributes the financial cost of weight stigma to the O-word and how this distorts public health narratives and patient care. Eating Disorders in Larger Bodies Sharon explains how anti fat bias prevents providers from seeing eating disorders in fat patients. They highlight how common anorexia is in larger bodies and how life threatening it becomes when medical systems refuse to diagnose or treat it. How Anti Fat Bias Harms Everyone Sharon and I talk about how dismantling anti fat bias supports every person in eating disorder recovery. Recovery requires divesting from anti fat bias, reconnecting with the body, and understanding how these biases shape thoughts and behaviors across all sizes. Intersectionality and Medical Harm We explore how harms escalate for people with multiple marginalized identities, including Black patients, Indigenous patients, trans patients, and fat patients who also face racism, transphobia, or medical gatekeeping. Advocacy, Boundaries, and Medical Self Protection Sharon shares concrete strategies for preparing for medical appointments, including: Bringing notes to stay grounded when hyperarousal hits. Recording appointments for recall and safety. Bringing a support person. Taking intentional rest time afterward. Establishing boundaries and walking out when providers violate consent. We discuss how exhausting it is to prepare for appointments that should be safe and how necessary these strategies become for survival. Why Sharon Became a Fat Activist After nearly dying because of weight stigma, Sharon left the classroom to educate clinicians, providers, and communities about anti fat bias. They now work with medical systems and general audiences to deconstruct bias, build safer care practices, and illuminate the threads of anti fat culture that harm everyone. Imagining an Ideal World Sharon answers the signature Dr. Marianne Land question. Their ideal world includes accessible spaces for play, joy, rest, and creativity for all bodies. It includes medical care rooted in compassion, humanity, and dignity, and it includes ice cream for everyone with options for all bodies and needs. Who This Episode Is For This episode supports: People in fat bodies who have experienced medical trauma. Listeners who lived with eating disorders in larger bodies without diagnosis or care. Providers wanting to unlearn weight stigma and offer safer treatment. Clinicians seeking to understand the intersection of eating disorders and anti fat bias. Anyone navigating healthcare systems that dismiss or harm them. People exploring intersectionality, fat liberation, and neurodivergent affirming care. Key Themes Eating disorders in larger bodies are real, severe, and often missed. Anti fat bias in healthcare prevents accurate diagnosis and lifesaving treatment. Medical trauma compounds over years and affects every modality of care. Compassionate providers save lives. Medical self advocacy is necessary but exhausting. Intersectionality affects both access to and quality of care. Joy and play become powerful acts of resistance. People in larger bodies deserve safety, dignity, and accurate medical treatment. Related Episodes Atypical Anorexia Explained: Why Restriction Happens at Every Body Size on Apple or Spotify. Atypical Anorexia: Mental & Physical Health Risks, Plus How the Term is Controversial on Apple or Spotify. What Is Atypical Anorexia? Challenging Weight Bias in Eating Disorder Treatment with Emma Townsin, RD @food.life.freedom on Apple or Spotify. When Doctors Harm: Medical Weight Stigma & Eating Disorders on Apple & Spotify. Fat Vulnerability & Our Eating Disorder Recovery Stories on Apple & Spotify. Connect With Sharon Maxwell Follow Sharon on Instagram and all social platforms at @heysharonmaxwell. Learn More and Get Support For therapy, courses, and resources on eating disorders, ARFID, binge eating, and neurodivergent affirming care, visit my website at drmariannemiller.com and explore support options inside my binge eating recovery membership and ARFID programs.

In this solo episode, Dr. Marianne Miller, LMFT, speaks directly to the body that carries fear, memory, and longing for safety. Through a poetic open letter, she explores why recovery can feel unsafe even when life begins to stabilize. Instead of treating fear as resistance, she reframes it as communication and wisdom. In this episode, she invites listeners to move from fighting their bodies to listening to them. Dr. Marianne explores how trauma, neurodivergence, and systemic oppression live in the body, and how tenderness can become a bridge between fear and trust. It is not a set of instructions. It is an act of witnessing. Why This Episode Matters Many people in eating disorder recovery are told that getting better should feel empowering. But for those whose bodies have been sites of trauma, shame, or disconnection, recovery can feel unbearable. This episode reframes that discomfort as an intelligent response from the body, not as failure or lack of willpower. By turning recovery into a dialogue instead of a demand, listeners learn how to approach healing at the pace of safety. Dr. Marianne shares how fear is not the opposite of progress but a sign that the body is asking for gentler evidence that the world can hold it safely. Her trauma-informed, neurodivergent-affirming, and liberation-based approach helps listeners replace control with curiosity and build trust with the body through compassion. Key Topics Covered In this episode, Dr. Marianne reflects on: The nervous system's memory of trauma and how it interprets safety Why the body resists calm and how to rebuild trust slowly The grief that comes with letting go of control and perfectionism How sensory sensitivities and neurodivergence affect recovery pacing The intersectional realities that make safety harder for fat, queer, trans, BIPOC, and neurodivergent people What it means to redefine “getting better” as coming home to yourself Listeners will come away with a new way to understand their bodies. They will learn that healing does not require pushing through fear but learning to listen to what fear is trying to protect. Who This Episode Is For This episode is for anyone who has ever felt frightened by their own progress in recovery. It will resonate with: People in eating disorder recovery who feel ambivalent about healing Neurodivergent listeners who experience overwhelm or shutdown during recovery Fat, queer, trans, and BIPOC individuals navigating systems that equate safety with conformity Clinicians and caregivers who want to understand the embodied realities of fear and healing It is also for those who need permission to slow down, to stop performing readiness, and to honor the body as a partner in recovery rather than an obstacle. Content Caution This episode includes discussion of eating disorder recovery, body distrust, trauma, and the emotional experience of fear during healing. It also references restriction, bingeing, and body-based distress without graphic detail. Please take care while listening. Pause or return to the episode later if it feels overwhelming. You are encouraged to have support in place as you engage with this material. Related Episodes How Childhood Trauma Shapes Eating Disorders & Body Shame (Content Caution) on Apple & Spotify. Perfectionism, People-Pleasing, & Body Image: Self-Compassion Tools for Long-Term Eating Disorder Recovery With Carrie Pollard, MSW @compassionate_counsellor on Apple & Spotify. Why Letting Go 0f Restriction Feels Unsafe in Eating Disorder Recovery on Apple & Spotify. Learn More and Get Support To continue exploring how to build safety with your body, visit drmariannemiller.com. There you will find: The ARFID & Selective Eating Course, a self-paced program offering sensory-attuned and neurodivergent-affirming tools for individuals and caregivers. The Binge Eating Recovery Membership, a space for ongoing support, education, and compassionate community that moves beyond diet culture. Blog posts, podcast episodes, and free resources on trauma-informed, consent-based, and liberation-centered recovery. Each offering is grounded in curiosity, respect, and collaboration.

What happens when your survival strategy becomes the thing standing between you and full recovery? In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores how masking and camouflaging shape the lives of neurodivergent people living with eating disorders. Through a trauma-informed, neurodivergent-affirming lens, she unpacks how chronic masking affects body trust, executive functioning, and safety in recovery. This conversation goes beyond the surface, offering insight into the deep intersection between identity, safety, and healing for autistic and ADHD people navigating disordered eating. Why This Episode Matters Masking, also known as camouflaging, is often praised as adaptability, but for many neurodivergent people it is a survival response that comes at a high cost. When you spend years performing normalcy, you can lose touch with your body's natural rhythms, sensations, and needs. This episode reveals how masking contributes to disordered eating patterns and burnout, and why many neurodivergent individuals struggle to connect with hunger, fullness, and safety cues. Dr. Marianne explains how unmasking can become an essential part of recovery when it is grounded in safety and choice. She also highlights the collective responsibility of clinicians, families, and communities to create environments where authenticity does not come with punishment. Key Themes Covered What masking and camouflaging look like for autistic and ADHD people How chronic masking disconnects you from body cues and emotions The relationship between executive function burnout and chaotic eating Masking inside therapy and recovery spaces How unmasking becomes a healing process when safety is prioritized The crucial role of neurodivergent-affirming, sensory-aware support The realities of intersectionality and why unmasking is not equally safe for everyone The Big Intersectionality Caveat Unmasking can be freeing, but it is not always safe. For people living at the intersections of multiple marginalized identities, such as people of color, fat people, queer and trans individuals, and those with disabilities, authentic self-expression often carries real risks. Systems rooted in racism, fatphobia, ableism, and heteronormativity still punish difference. In this segment, Dr. Marianne offers guidance on how to navigate those risks without self-betrayal. She invites listeners to think of unmasking as a gradual and relational process rather than a demand for constant transparency. Authenticity must coexist with safety, and strategic masking can be a legitimate survival tool. Recovery is not about abandoning the mask everywhere; it is about finding and creating spaces where the mask can come off without harm. Who This Episode Is For This episode is for: Neurodivergent adults and teens in eating disorder recovery Autistic and ADHD individuals struggling with food, body image, or ARFID Therapists seeking to provide neurodivergent-affirming, sensory-informed care People navigating multiple marginalized identities who feel unsafe unmasking in treatment Parents and partners who want to better understand masking, executive functioning, and sensory needs in eating behaviors Content Caution This episode includes discussion of eating disorder behaviors, masking fatigue, and systemic oppression. Listener discretion is advised, especially if you are in early recovery or working through trauma related to identity or body shame. Related Episodes Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe via Apple & Spotify. Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify. Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat via Apple & Spotify Minding the Gap: The Intersection Between AuDHD & Eating Disorders With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify Our Personal Neurodivergent Stories via Apple & Spotify. Learn More and Get Support If today's episode resonated with you, explore Dr. Marianne's ARFID & Selective Eating Course, a self-paced, neurodivergent-affirming resource that supports sensory-based eating, autonomy, and compassion in recovery. Learn more at drmariannemiller.com.

What happens when a physician, trained to prioritize science and performance, discovers that her own healing requires compassion, spirituality, and trust in her body? In this powerful interview, we explore one woman's story of recovering from binge eating disorder while navigating the pressures of medicine, diet culture, and systemic weight bias. You'll hear how early messages about food and scarcity shaped her relationship with eating, how medical training reinforced body shame, and how she ultimately reconnected to herself through self-compassion, intuitive eating, and body trust. This episode offers both a deeply personal narrative and a professional perspective on how healthcare can move toward weight-neutral, compassionate care. Key Topics Covered How childhood scarcity and fear can shape lifelong eating patterns The pressures physicians face to conform to body ideals in medicine How chronic stress and sleep deprivation in residency can trigger binge eating Why self-compassion—not willpower—became the turning point in recovery What it takes to unlearn diet culture within the healthcare system The rise of GLP-1 medications and how they complicate conversations about body autonomy Healing the disconnect between professional identity and personal recovery Building a weight-neutral, compassionate approach to health and wellbeing Who This Episode Is For This episode is for anyone who has struggled with binge eating, body shame, or internalized weight stigma—especially those in helping professions. It's also for clinicians, therapists, and healthcare providers seeking to understand how medical culture perpetuates harm and how to bring more compassion into patient care. If you've ever felt like your professional role or perfectionism made recovery harder, this episode will remind you that you're not alone—and that healing is possible, even in systems that don't always make room for it. Why This Conversation Matters In a world where doctors are often seen as immune to body image struggles, this story reveals how deeply systemic fatphobia and diet culture reach—even into the halls of medicine. It challenges the myth that knowledge alone heals disordered eating and instead centers nervous system safety, self-compassion, and intuitive wisdom as the foundation for recovery. Resources Mentioned Intuitive Eating by Evelyn Tribole and Elyse Resch Reclaiming Body Trust by Hilary Kinavey and Dana Sturtevant Wayza Health (wayzahealth.com)--Dr. Michelle's website Research on GLP-1 medications and long-term outcomes Center for Body Trust Related Episodes  When Doctors Harm: Medical Weight Stigma & Eating Disorders on Apple & Spotify. Fat Vulnerability & Our Eating Disorder Recovery Stories on Apple & Spotify. Challenges of Weight-Loss Surgery & Medical Anti-Fat Bias on Apple & Spotify. Learn More and Get Support If you or someone you love is navigating binge eating, emotional eating, or recovery after years of dieting, visit drmariannemiller.com to explore specialized support. You'll find resources for binge eating recovery, ARFID support, and neurodivergent-affirming therapy and courses.

What if your nighttime eating isn't a failure of willpower but your body's way of asking for safety, nourishment, and rest? In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores the misunderstood world of Night Eating Syndrome (NES)—a condition that often hides behind shame and silence. Rather than framing night eating as a “bad habit,” Dr. Marianne offers a compassionate, neurodivergent-affirming lens that reveals what your body and brain are truly communicating when nighttime hunger takes over. She unpacks how executive-function challenges, sensory processing differences, and disrupted circadian rhythmscan contribute to Night Eating Syndrome. You'll learn how to distinguish between waking up at night to eat versus staying up late and bingeing, and why that difference matters for healing. Dr. Marianne also shares practical ways to support your body's natural rhythms using executive-function tools—like creating transition meals, supporting sensory needs, and building low-lift nourishment systems that actually work with your brain. Finally, she offers self-compassion strategies that help calm shame, regulate the nervous system, and restore trust in your body's signals. Key Topics Covered What Night Eating Syndrome really is—and why it's not a moral failure The role of executive-function fatigue in late-night eating cycles How neurodivergent people may have different hunger and sleep patterns than neurotypicals Practical, low-lift tools to support nighttime regulation and nourishment How to distinguish between Night Eating Syndrome and binge eating The importance of self-compassion and curiosity in healing the shame cycle Who This Episode Is For This episode is for anyone who finds themselves eating late into the night and feeling stuck in shame or confusion afterward. It's especially for neurodivergent adults, trauma survivors, and anyone who struggles with inconsistent eating or sleep patterns. Clinicians who work with eating disorders, ARFID, or binge eating may also find this episode helpful for supporting clients with neuroaffirming and compassion-based approaches. Content Caution This episode discusses eating disorder behaviors related to Night Eating Syndrome and binge eating. Listener discretion is advised. Please take care of yourself and pause if you need to. Related Episode on Night Eating Syndrome Night Eating Syndrome on Apple & Spotify (my most popular podcast episode of all time!) Why Am I Eating at Night? Understanding Night Eating Syndrome in Your 30s, 40s, & 50s on Apple & Spotify. Learn More and Get Support If Night Eating Syndrome or binge eating feels familiar to you, support and recovery are possible. Inside my virtual Binge Eating Recovery Membership, you'll find a self-paced, compassionate space to explore the roots of your eating behaviors while building executive-function skills, sensory supports, and self-trust. Learn more at drmariannemiller.com.

Why does recovery from an eating disorder feel so fragile, even after years of hard work? In this episode of Dr. Marianne Land, Dr. Marianne Miller unpacks the realities of relapse in long-term eating disorder recovery—what causes it, how to navigate it, and why recovery doesn't stick in a culture that constantly reinforces shame, anti-fat bias, and unrealistic expectations of healing. Episode Overview This eating disorder relapse podcast episode explores the complexity of staying recovered after years or decades of healing. Dr. Marianne explains how relapse is not a personal failure but rather an opportunity to understand what your body and nervous system are communicating. Through a neurodivergent-affirming and body-liberation lens, she breaks down why recovery ebbs and flows and how you can rebuild stability with compassion instead of judgment. Listeners will learn what it really takes to sustain long-term eating disorder recovery, how trauma and stress can reignite old coping mechanisms, and how to approach relapse as part of the process—not the end of it. Key Topics Covered The real meaning of recovery and why “staying recovered” forever is an unrealistic expectation. How the nervous system and trauma memory create vulnerability to relapse. Why life transitions, burnout, and chronic stress often trigger eating disorder relapse. How anti-fat bias, weight stigma, and cultural messaging undermine sustainable recovery. The unique challenges of neurodivergent eating disorder recovery and how to meet sensory and executive-function needs. How to rebuild body trust after relapse through curiosity, safety, and self-compassion. Practical tools for sustainable recovery strategies that evolve as your life changes. Who This Episode Is For This episode is for anyone living with a long-term eating disorder who feels discouraged by relapse or fears they are “backsliding.” It's also for therapists, dietitians, and family members who want to understand why recovery doesn't stickfor everyone—and how to provide affirming, compassionate support. Why This Episode Matters In a world where recovery is often portrayed as a linear journey, this episode challenges that myth. Relapse in long-term eating disorder recovery is common, but few people talk about it without shame. Dr. Marianne brings honesty, education, and hope to a topic that deserves care. Relapse is not failure, it's feedback. And when you learn to listen to what your body needs, you can rebuild a recovery that truly fits your life. Related Episodes on Long-Term Eating Disorders Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Navigating a Long-Term Eating Disorder on Apple & Spotify. Why Eating Disorder Recovery Feels Unsafe: Facing Ambivalence in Long-Term Struggles on Apple & Spotify. Perfectionism, People-Pleasing, & Body Image: Self-Compassion Tools for Long-Term Eating Disorder Recovery With Carrie Pollard, MSW @compassionate_counsellor on Apple & Spotify. Learn More and Get Support For more on long-term eating disorder recovery, ARFID, binge eating, body trust, and sustainable recovery strategies, visit drmariannemiller.com.

Can anxiety about food safety quietly shape the way an entire family eats, lives, and loves? In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller, LMFT, talks with Tamara Hubbard, LCPC, founder of The Food Allergy Counselor and The Academy of Food Allergy Counseling. Together, they explore how food allergy anxiety can affect both children and parents, sometimes leading to ARFID-like eating patterns and significant emotional distress. Tamara shares her journey from being a parent of a child with a peanut allergy to becoming a national leader in the field of food allergy mental health. She discusses how chronic fear and misinformation can cause families to become trapped in cycles of hypervigilance and restriction. She and Dr. Marianne also examine how therapy can help families move toward flexibility, autonomy, and connection at the table. Listeners will hear how Acceptance and Commitment Therapy (ACT) and values-based approaches support parents in balancing safety with freedom, and how addressing anxiety can improve both emotional well-being and quality of life. Key Topics Covered The difference between food allergies and food intolerances and why accurate understanding matters How food allergy anxiety can spread through families and mimic ARFID symptoms The role of parental fear in shaping a child's own food relationship and daily life The risks of restriction-based medical advice, including some functional medicine practices How ACT and mindfulness tools can help parents tolerate fear and stay connected to their values Ways to calm the fight-or-flight response and reduce hypervigilance around food and safety Why collaboration between therapists and allergists creates stronger, safer support for families Who This Episode Is For This episode is for parents and caregivers who want to understand how food allergies, anxiety, and ARFID intersect in family life. It is also for therapists, dietitians, and healthcare providers who want to learn how to support families with evidence-based, trauma-informed, and values-driven care. Food Allergy Resources Mentioned Book: May Contain Anxiety: Managing the Overwhelm of Parenting Children With Food Allergies by Tamara Hubbard, LCPC (Johns Hopkins University Press, 2025) Website: The Food Allergy Counselor for educational articles, therapeutic resources, and directories of food allergy-informed therapists Organization: The Academy of Food Allergy Counseling for clinician training and professional community Article: Allergic Living Magazine Airline Allergy Travel Guide for details on how major airlines handle food allergy policies Advocacy Resource: No Nut Traveler by Leanne Mandelbaum, advocating for safer air travel for people with food allergies Therapeutic Framework: Acceptance and Commitment Therapy (ACT) for managing anxiety and values alignment Cultural Reference: We Can Do Hard Things by Glennon Doyle as a reminder of resilience and self-compassion Content Caution This episode includes discussions of allergic reactions, anaphylaxis, and eating challenges. Please take care while listening if these topics may feel activating or distressing. Learn More and Get ARFID and Selective Eating Support Visit ARFID and Selective Eating Course. This virtual program provides a compassionate, neurodivergent-affirming framework that helps families and clinicians create safety, flexibility, and understanding around food.

Do people praise your discipline while ignoring your struggle with a long-term eating disorder? In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller, LMFT, unpacks the cultural myth of the “high-functioning” eating disorder and explores why so many lifelong eating disorders go unnoticed, untreated, or mislabeled as willpower or success. Episode Overview So many people live for decades with an eating disorder that never fully goes away—because the world keeps rewarding them for being productive, disciplined, or “healthy.” Dr. Marianne explains how functioning can become a form of masking, how trauma and safety patterns reinforce chronic disordered eating, and why recovery often requires dismantling the very systems that taught us to perform instead of rest. This episode brings honesty and compassion to those who have felt unseen by treatment models that only recognize crisis, and validation to those who have carried invisible pain behind competence and control. Key Topics Covered What “high-functioning” really means and why it's a harmful label How lifelong eating disorders become normalized and overlooked The hidden costs of functioning and perfectionism Trauma, safety, and why control feels protective How privilege shapes who gets labeled “high-functioning” Recovery pathways for long-term and late-stage eating disorders The difference between surviving and actually living Who This Episode Is For This episode is for anyone who has lived with chronic disordered eating, for those who have been told they “don't look sick,” and for clinicians seeking to better understand the quiet suffering that hides behind high performance. It's also for neurodivergent listeners and those in larger bodies who have felt unseen in traditional eating disorder spaces. Related Episodes   Learn More and Get Support for Lifelong Eating Disorders You can explore therapy, coaching, and recovery resources at drmariannemiller.com. If you're ready to deepen your healing, check out Dr. Marianne's virtual, self-paced ARFID and Selective Eating Course, designed to support autonomy, sensory needs, and manageable recovery. You can also follow Dr. Marianne on Instagram @drmariannemiller.

In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, fat-positive therapist and eating disorder specialist Dr. Marianne Miller, LMFT explains why she no longer uses the label “Atypical Anorexia.” She discusses how anti-fat bias, weight stigma, and systemic discrimination in eating disorder treatment have shaped the diagnostic criteria for anorexia and harmed people in larger bodies. Listeners will learn how the term “atypical” upholds thinness as the standard for illness, why that belief leads to delayed diagnoses, and how shifting our language can expand access to inclusive, weight-neutral, and neurodivergent-affirming eating disorder care. Through clinical insight, real-world examples, and liberation-focused analysis, Dr. Marianne reframes what anorexia recovery truly means: healing one's relationship with food, body, and self without hierarchy, shame, or size bias. Key SEO Topics Covered What Is “Atypical Anorexia”? Understanding the origins of the term and how it reinforces weight stigma and anti-fat bias. Why Thinness Shouldn't Define Anorexia: How body diversity challenges outdated diagnostic models. The Role of Weight Stigma in Anorexia Recovery: How medical bias limits access to eating disorder therapyand treatment coverage. Cultural and Systemic Bias in Eating Disorder Diagnosis: How fatphobia, whiteness, and ableism distort who gets diagnosed. Intersectionality and Neurodivergence: How autism, ADHD, race, and gender identity affect the experience and recognition of anorexia. What Inclusive Eating Disorder Treatment Looks Like: How clinicians can provide weight-inclusive, trauma-informed, neurodivergent-affirming care. Body Liberation and Recovery: Why reclaiming the word “anorexia” for all bodies fosters belonging and healing. Who This Episode Is For This episode is for anyone interested in inclusive anorexia recovery and liberation-centered eating disorder treatment. It's especially for: People in larger bodies who have experienced restriction or medical dismissal. Clinicians seeking to decolonize their approach to eating disorder therapy. Neurodivergent listeners navigating food restriction or sensory challenges. Individuals recovering from anorexia who were told they are “not sick enough.” Advocates, parents, and students learning about anti-fat bias and weight-inclusive recovery models. Why This Conversation Matters The label “Atypical Anorexia” perpetuates harmful myths about body size, illness, and worthiness. It tells people in larger bodies that their pain is less valid and their recovery less urgent. In reality, anorexia occurs in every body size, race, gender, and neurotype. By challenging the term “atypical,” Dr. Marianne advocates for body-liberation-aligned, anti-bias eating disorder therapy that validates all lived experiences. This conversation helps listeners unlearn weight stigma and invites the eating disorder field to adopt inclusive, evidence-based, fat-positive practices that honor every body's right to care and nourishment. Other Episodes on "Atypical Anorexia" Atypical Anorexia Explained: Why Restriction Happens at Every Body Size on Apple or Spotify. Atypical Anorexia with Amy Ornelas, RD on Apple or Spotify. Atypical Anorexia: Mental & Physical Health Risks, Plus How the Term is Controversial on Apple or Spotify. What Is Atypical Anorexia? Challenging Weight Bias in Eating Disorder Treatment with Emma Townsin, RD @food.life.freedom on Apple or Spotify. Learn More and Get Support Visit drmariannemiller.com to learn more about Dr. Marianne Miller's eating disorder therapy, coaching, and educational resources. Her website offers blog posts, podcast transcripts, and tools for people seeking anorexia recovery support, ARFID education, and neurodivergent-affirming treatment.

In this powerful and affirming conversation, Dr. Marianne Miller welcomes Dr. Emma from Divergent Life, a UK-based neuroaffirming clinical psychologist and thought leader. Together, they explore the intersections of neurodivergence, eating disorders, masking, trauma, and embodiment, examining what true safety and self-trust look like in recovery. Dr. Emma shares her journey toward becoming an eating disorder specialist, her resistance to standardized and compliance-based treatment models, and how her activist, trauma-informed, and social justice-oriented approachshapes her work. Listeners will hear both clinicians reflect on their lived experiences, discuss the harm of medicalized narratives, and explore how therapy can become a form of activism, embodiment, and reclamation. Who This Episode Is For This episode is for anyone who has ever felt unseen or invalidated by traditional eating disorder treatment systems. It is especially meaningful for: Neurodivergent individuals who have struggled with masking, sensory sensitivities, or feelings of disconnection from their bodies People in eating disorder recovery who have not found healing in standardized or compliance-based programs Clinicians and therapists who want to practice from a neurodivergent-affirming, trauma-informed, and social justice lens Parents and caregivers of neurodivergent loved ones seeking compassionate, autonomy-honoring approaches Anyone interested in embodiment, body trust, and authentic recovery Key Topics Covered Why standardized and compliance-based eating disorder treatments can be retraumatizing The effects of masking and self-abandonment in neurodivergent people How embodiment and sensory awareness support authentic healing Understanding neurodivergent trauma and nervous system responses Reclaiming autonomy and agency in recovery How therapy can serve as a tool for social justice and liberation The importance of lived experience in guiding compassionate care About the Guest Dr. Emma (she/her) is a neuroaffirming clinical psychologist, coach, and founder of Divergent Life, a UK-based service that challenges outdated mental health systems and centers neurodivergent and trauma-informed care. Through her work, she helps clients move from masking and compliance toward embodiment, agency, and trust in their own inner wisdom. Instagram: @divergentlives Website: divergentlife.co.uk Why This Episode Matters This conversation redefines what healing can look like for neurodivergent people with eating disorders, particularly those who have felt unseen or misunderstood by traditional models. Dr. Marianne and Dr. Emma discuss how masking and system-based approaches can lead to disembodiment and how safety, trust, and agency can guide recovery instead. If you have ever questioned why “one-size-fits-all” therapy has not worked for you, or if you are a clinician seeking to practice in a way that honors autonomy and lived experience, this episode offers deep insight, compassion, and hope. Related Episodes on Neurodivergent Needs & Experiences Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify. Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat via Apple & Spotify Minding the Gap: The Intersection Between AuDHD & Eating Disorders With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify Our Personal Neurodivergent Stories via Apple & Spotify. Learn More and Get Support Check out  drmariannemiller.com for blog posts, therapy services, more podcast episodes, and other offerings. To learn about Dr. Marianne's ARFID and Selective Eating Course, visit drmariannemiller.com/arfid.

In this episode of Dr. Marianne-Land, Dr. Marianne Miller explores one of the most misunderstood experiences in eating disorder recovery: binge eating and shame. She explains why binge eating is not caused by lack of willpower. It develops from deprivation, unmet emotional needs, and internalized shame. You will learn how restriction fuels binge urges, how shame keeps you stuck, and how compassion-based recovery helps you rebuild trust with food and your body. Why Binge Eating Isn't About Willpower Many people believe binge eating happens because they lack control. In truth, binge eating is a biological and emotional response to restriction. When your body senses scarcity, it does what it was designed to do: it pushes you to eat. Dr. Marianne discusses how diet culture and fear-based food rules create deprivation and shame. The body responds to this deprivation by seeking safety through eating, sometimes in large quantities. The solution is not to control yourself more, but to give your body the consistent nourishment and compassion it needs. How Shame Fuels the Binge Cycle Shame is one of the strongest emotional drivers of binge eating. After a binge, thoughts like “I failed again” or “I'll start over tomorrow” appear. Those thoughts lead to more restriction, which triggers another binge. Dr. Marianne explains how shame disconnects you from your body and keeps you in a cycle of punishment and control. The shift begins when you replace blame with curiosity. Asking “What does my body need right now?” helps you reconnect to your needs instead of silencing them. The Biology Behind Binge Eating Binge eating is a predictable response to restriction. When your body does not receive enough food, hunger hormones increase, reward pathways in the brain intensify, and cravings become urgent. Binge eating is your body's attempt to restore balance. Mental restriction has the same effect. When you label foods as bad or forbidden, your body perceives danger and increases urgency around those foods. Regular meals, adequate nutrition, and permission to eat satisfying foods restore body trust and calm the nervous system. Emotional Safety and Recovery Binge eating is often a way to self-soothe when emotions feel too big or overwhelming. If you have been taught that sadness, anger, or fear are unsafe, food may have become your most accessible form of comfort. Dr. Marianne talks about creating emotional safety through self-soothing, sensory grounding, and compassion. When your nervous system feels supported, the intensity of binge urges begins to soften. From Control to Compassion Recovery is not about fighting yourself into change. It begins when you stop using control as protection and start practicing compassion. Dr. Marianne shares ways to replace critical self-talk with kind, curious reflection. Instead of saying “I have no willpower,” try “My body is asking for care.” That language shift helps rewire your nervous system to expect gentleness instead of punishment. Reclaiming Pleasure and Satisfaction Food is meant to be enjoyable, not a test of discipline. When you allow yourself to experience satisfaction without guilt, eating becomes calmer and more connected. Dr. Marianne encourages listeners to practice mindful eating, notice textures and flavors, and reconnect with the sensory experience of food. Pleasure is not indulgence; it is information that helps you understand what your body needs. Content Caution This episode includes open discussion about binge eating and emotional distress related to food and body image. Please listen with care and take breaks as needed. Who This Episode Helps This episode is for anyone who feels stuck in binge-restrict cycles or wants to understand the emotional roots of binge eating. It is also helpful for clinicians supporting clients with binge eating disorder, and for neurodivergent listeners who need a sensory-attuned and trauma-informed approach to recovery. Related Episodes on Binge Eating Binge Eating in Midlife: Why It Starts (or Resurfaces) in Your 30s, 40s, 50s on Apple & Spotify. Binge Eating Urges: Why They Happen & How to Manage Them Without Shame on Apple & Spotify. How to Manage Triggers & Cravings During Recovery From Binge Eating & Bulimia on Apple & Spotify. Join the Binge Eating Recovery Membership If you are ready to heal your relationship with food, Dr. Marianne invites you to join her Binge Eating Recovery Membership at drmariannemiller.com. This membership offers accessible lessons, community support, and practical tools to help you move beyond shame, regulate emotions, and create consistency with food without dieting or control. Inside, you will learn how to rebuild body trust, reduce binge frequency, and practice compassionate recovery at your own pace.

Parenting a child with ARFID (Avoidant/Restrictive Food Intake Disorder) can feel confusing and overwhelming. In this episode, Dr. Marianne Miller shares practical and compassionate strategies for parents who want to help their children eat with less fear and more confidence. You will learn why pressure and negotiation tend to backfire, how to create low-stress mealtimes that build safety, and how to attune to your child's sensory needs through a neurodivergent-affirming approach. Whether your child experiences food texture issues, fear of choking, or intense sensory overwhelm, this episode provides grounded, actionable steps for supporting eating with care and collaboration. Key Topics Covered Understanding ARFID beyond “picky eating” and recognizing it as a real eating disorder rooted in fear, sensory distress, or trauma Why pressure and negotiation can increase distress and decrease trust How sensory context affects eating and what small environmental changes can help Transitioning from authoritative to consent-based parenting that prioritizes autonomy and emotional safety Building trust through predictable, transparent, and compassionate mealtime practices Knowing when to seek professional ARFID-informed, trauma-aware, and neurodivergent-affirming support Who This Episode Is For This episode is for parents, caregivers, and family members who are trying to understand and support a child living with ARFID or selective eating. It is also helpful for therapists, dietitians, educators, and healthcare providers who want to better understand the family dynamics that shape mealtime stress and recovery. Why This Episode Matters Many families are told to use pressure or rewards to encourage eating. While this advice may seem helpful, it often increases distress for children with ARFID. In this episode, Dr. Marianne explains why traditional approaches like “one more bite” or “if you eat your veggies, you can have dessert” can erode trust and worsen fear. Instead, you will hear how shifting toward collaboration, sensory awareness, and emotional safety supports genuine progress. Learning to trust your child's signals and prioritize consent around food can transform your home and restore connection at the table. Content Caution This episode includes discussion of children's eating distress, food avoidance, and anxiety around eating. Please listen with care if these topics may be sensitive for you or your family. Related Episodes ARFID Explained: What It Feels Like, Why It's Misunderstood, & What Helps on Apple & Spotify. Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify. ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Get Additional ARFID Help To learn more about supporting your child's eating with compassion, visit drmariannemiller.com/arfid to explore Dr. Marianne's ARFID & Selective Eating Course. This self-paced, online course provides practical tools, scripts, and real-world examples to help parents reduce mealtime stress, build trust, and approach food in a supportive, neurodivergent-affirming way.

What should every therapist truly understand before working with clients who have eating disorders? In this insightful interview, Dr. Marianne Miller talks with Edie Stark, LCSW (@ediestarktherapy) about what ethical, inclusive care really means. Together, they explore why “gold standard” approaches like Family-Based Treatment (FBT) often miss the mark for neurodivergent, fat, queer, and BIPOC clients. The conversation highlights the importance of cultural humility, anti-fat bias awareness, trauma-informed care, and intersectional understanding in every therapeutic setting. Whether you are a clinician, a student, or someone in recovery who wants to understand what quality treatment should look like, this episode offers a thoughtful look at how therapists can grow, unlearn, and create safe, collaborative spaces for healing. Key Topics Covered Why “gold standard” models like Family-Based Treatment (FBT) do not fit everyone How anti-fat bias and wellness culture shape eating disorder care The importance of cultural humility and intersectionality in therapy Ways to create trauma-informed, consent-based, and collaborative care What ethical practice looks like when working with neurodivergent and marginalized clients How therapists can identify and challenge their own internalized biases Why eating disorder work requires humility, continual learning, and self-reflection Who This Episode Is For Therapists and dietitians who want to provide ethical and inclusive eating disorder care Students and early-career clinicians who are beginning to work with eating disorders Supervisors and consultants who guide others in complex clinical cases People in recovery who want to understand what to expect from truly affirming treatment Anyone curious about how bias, culture, and power dynamics affect eating disorder recovery Other Episodes With Edie The Hidden Risks of Non-Specialized Eating Disorder Treatment on Apple & Spotify. The Diet/Wellness Industry, Accessibility, & Diet Culture on Apple & Spotify. Anti-Fat Bias & the Importance of Advocacy on Apple & Spotify. About My Guest Edie Stark, LCSW, is the founder of Stark Therapy Group in California and Edie Stark Consulting, where she supports therapists through business consulting, case consultation, and supervision. She's also a feature writer for Psychology Today and advocates for ethical, media-accurate portrayals of eating disorders. Connect with Edie on Instagram at @ediestarktherapy and @edies_edits, or visit ediestark.com. About Dr. Marianne Miller Dr. Marianne Miller is a Licensed Marriage & Family Therapist specializing in eating disorders, ARFID, and binge eating disorder. She practices in California, Texas, and Washington D.C., and teaches self-paced, virtual courses through her binge eating recovery membership and her course ARFID and Selective Eating. Learn more at drmariannemiller.com or follow her on Instagram @drmariannemiller.

Many people discover they are autistic only after years of struggling with eating disorders. This episode explores how a late autism diagnosis can reshape recovery by offering new understanding, compassion, and practical tools that fit the neurodivergent brain. Understanding a Late Autism Diagnosis Receiving an autism diagnosis in adulthood can bring both clarity and grief. It helps explain lifelong struggles with sensory overload, food textures, or social expectations, while revealing how years of misdiagnosis delayed meaningful support. In recovery, recognizing autism can change everything by connecting eating patterns to sensory differences and masking rather than willpower or motivation. Masking, Sensory Needs, and Food Autistic masking often overlaps with eating disorder behaviors. Restricting food, eating “normally” in social settings, or following rigid meal plans can become ways to hide difference and avoid judgment. This chronic effort to appear typical creates exhaustion and disconnection from true needs. At the same time, sensory experiences around food are often intense. Taste, smell, temperature, and texture can feel overwhelming or unpredictable. Foods that others find pleasant may feel unsafe or even painful. Sustainable recovery begins when we make space for sensory preferences and allow eating to feel safe rather than forced. ARFID and Autism Overlap Avoidant or Restrictive Food Intake Disorder (ARFID) frequently occurs alongside autism. This overlap reflects sensory sensitivities, fear of choking or nausea, and low appetite rather than body image concerns. Recognizing this link shifts the goal of recovery away from compliance and toward creating safety, autonomy, and predictability in eating. Intersectionality in Diagnosis and Recovery Autism and eating disorders cannot be separated from the realities of race, gender, body size, class, and sexuality. Marginalized people are less likely to be diagnosed early and more likely to experience bias in treatment. Fat, BIPOC, and queer autistic people are often labeled as resistant when their needs are simply misunderstood. A liberation-based approach to recovery asks how we can build care that honors the whole person. It challenges systems that pathologize difference and reframes healing as a process of reclaiming identity and dignity, not just changing eating behaviors. Case Example Dr. Marianne shares the story of a fat, queer woman of color who learned she was autistic in her late 30s after years of being told she was noncompliant in treatment. Providers dismissed her sensory distress and focused only on weight loss. She masked constantly, pretending to eat foods that overwhelmed her senses in order to appear cooperative. Her diagnosis transformed her recovery. She began to design meals that respected her sensory needs, sought affirming providers, and connected with other neurodivergent women of color. Once her care aligned with her full identity, shame gave way to self-trust, and recovery finally felt sustainable. Pathways Toward Neurodivergent-Affirming Recovery A late autism diagnosis does not make recovery harder, but it does require reframing what recovery means. Sensory-attuned approaches allow individuals to choose foods that feel safe rather than forcing exposure to distressing ones. Predictable meal routines and gentle flexibility can replace pressure to eat intuitively when interoception is limited. Executive functioning supports such as reminders, meal prep systems, and visual cues make daily nourishment possible. These tools are not crutches; they are accommodations. Recovery also involves boundary-setting and self-advocacy after years of masking needs. Finding autistic and intersectional community can turn isolation into belonging, making recovery not just about food but about identity and connection. Who This Episode Is For This episode is for autistic adults in recovery, clinicians learning to support neurodivergent clients, and anyone who has realized that standard eating disorder treatment does not fit. It also speaks to people exploring how autism, sensory processing, and identity intersect with food and body experiences. Related Episodes for Autistics With Eating Disorders Autism & Eating Disorders Explained: Signs, Struggles, & Support That Works on Apple & Spotify. Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe on Apple & Spotify More Autism Resources for Eating Issues If these experiences sound familiar, explore Dr. Marianne's ARFID & Selective Eating Course. This self-paced course teaches consent-based and sensory-attuned strategies for reducing eating distress and building a more supportive relationship with food at your own pace.

When eating disorders overlap with anxiety, OCD, or depression, recovery can feel especially complex. In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller, LMFT, explores how co-occurring mental health conditions interact with disordered eating and body image struggles. She explains how anxiety often fuels food rules and avoidance, how OCD rituals can merge with eating rituals, and how depression can make nourishment feel almost impossible. Throughout the episode, Dr. Marianne shares intersectional case examples that reflect the diversity of real-world experiences. You will hear about a Black nonbinary person whose anorexia and depression are dismissed by medical providers, a South Asian immigrant coping with OCD and bulimia in a culture where discussing mental health is taboo, and others whose experiences reveal how systemic bias and identity shape recovery. This episode offers understanding, compassion, and realistic tools for healing when multiple conditions overlap. What You'll Learn You will learn how anxiety, OCD, and depression intersect with eating disorders, why eating disorders rarely exist alone, and how each condition influences the recovery process. Dr. Marianne explains why addressing only food behaviors is not enough and how integrative treatment supports both the mind and body. You will also hear about sensory-attuned strategies and community-based care that help people move toward safety, nourishment, and autonomy. Key Takeaways Eating disorders often coexist with anxiety, OCD, or depression because they share common roots in trauma, nervous system overwhelm, and attempts to create safety. Anxiety drives control and rigidity, OCD fuels compulsive rituals around food and body, and depression slows motivation and energy, making self-care harder. True recovery acknowledges these overlaps and treats the whole person. Healing does not mean erasing anxiety, OCD, or depression. It means building a life that includes these realities while reducing their control over food and self-worth. Recovery becomes more sustainable when treatment honors a person's full identity, including body size, race, gender, and neurotype. Who This Episode Is For This episode is for anyone who lives with an eating disorder and another mental health condition such as anxiety, OCD, or depression. It is also for clinicians, family members, and supporters who want to understand how co-occurring challenges interact and how to provide compassionate care. Content Caution This episode includes discussion of eating disorders, anxiety, OCD, and depression. Please take care while listening and pause if you need to. Related Episodes Anxiety, Meltdowns, Neurodiversity, & Eating Disorders on Apple & Spotify. Food, Fear, & Fixation: How OCD Shapes Eating Disorders on Apple & Spotify. Depression & Eating Disorders on Apple & Spotify. Connect and Learn More For deeper guidance, visit drmariannemiller.com/arfid to explore Dr. Marianne's ARFID and Selective Eating Course. The course offers neurodivergent-affirming, sensory-attuned strategies that apply to a wide range of eating struggles. To learn about Dr. Marianne's therapy services in California, Texas, and Washington, D.C., or to explore additional blog posts and podcast episodes, visit drmariannemiller.com.  

In this insightful conversation, Dr. Marianne Miller sits down with Dr. Heather Rosen, a licensed clinical psychologist and certified Family-Based Treatment (FBT) supervisor and trainer, to explore how evidence-based treatments for eating disorders can evolve to meet the needs of neurodivergent clients and their families. Dr. Rosen shares her background working in major hospital settings including Stanford University, Lucile Packard Children's Hospital, and Mount Sinai Hospital, and now in private practice in Westchester County, New York. Together, she and Dr. Miller unpack the heart of FBT—how involving families in treatment can strengthen recovery for adolescents and young adults with anorexia, bulimia, binge eating disorder, and ARFID. This episode highlights how food becomes a metaphor for emotional pain, safety, and connection, and why treatment must go beyond meal plans to address the underlying need for autonomy, co-regulation, and family healing. Key Topics Covered What Family-Based Treatment (FBT) is and how it supports adolescent recovery The role of parents in managing eating disorder behaviors at home How FBT differs from other evidence-based treatments like CBT-E Adapting FBT for ARFID (Avoidant/Restrictive Food Intake Disorder) and neurodivergent clients Why flexibility and curiosity are essential when traditional exposure-based methods don't fit Understanding food as communication: how eating (or not eating) expresses pain, fear, and the need for control Shifting from compliance-based models to collaborative, consent-based, and neuroaffirming care The importance of reducing mental health stigma and improving access to effective treatment Who This Episode Is For This conversation is for therapists, dietitians, parents, and educators who want to understand FBT in practice and how to make eating disorder treatment more inclusive for autistic and otherwise neurodivergent youth. It's also for anyone curious about integrating compassion, family systems awareness, and sensory attunement into recovery work. Guest Info Dr. Heather Rosen, PhD Licensed Clinical Psychologist | Certified FBT Therapist & Supervisor Psychology Partners Group – Westchester County, NY Website: psychologypartnersgroup.com Instagram: @hrrosen Related Episodes Family-Based Treatment and Eating Disorders in Schools With JD Ouellette of Equip Health on Apple & Spotify. The Nitty Gritty on Family-Based Treatment for Anorexia (Maudsley Method) With Kelly McCullough @mytherapistkelly on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. About Dr. Marianne Miller Dr. Marianne Miller, PhD, LMFT, is a fat, neurodivergent eating disorder therapist specializing in ARFID, binge eating disorder, and complex recovery care. She offers therapy in California, Texas, and Washington, D.C., and provides global support through online courses and resources. Learn more about Dr. Miller's work and self-paced course on ARFID and Selective Eating at drmariannemiller.com/arfid.

Have you ever wondered why recovery feels stuck, no matter how hard you try? When eating disorder behaviors keep returning despite your best efforts, unresolved trauma may be part of the reason. In this episode of Dr. Marianne-Land, Dr. Marianne Miller, LMFT, explores the deep connection between trauma and long-lasting eating disorders. Unresolved trauma often lives in the body, shaping the nervous system and influencing how we cope, eat, and relate to ourselves. Many people discover that their eating disorder was never just about food or control—it was about safety, survival, and protection. This episode helps you understand why that makes sense and how healing is possible when both trauma and the eating disorder are addressed together. Through compassionate storytelling and clinical insight, Dr. Marianne shares how trauma-informed therapy and body-based healing can help release long-held survival patterns. She also discusses how intersectionality, identity, and oppression influence the way trauma shows up in eating disorder recovery. Who This Episode Is For This episode is for anyone who has struggled with eating disorder symptoms that seem to linger, shift, or return over time. It will especially resonate with: People who have been in treatment before yet still feel stuck in their eating disorders Those who sense their eating disorder is connected to trauma, anxiety, or chronic stress Neurodivergent individuals navigating sensory or emotional overwhelm around food Survivors of emotional, physical, or systemic trauma seeking trauma-informed recovery Clinicians, helpers, or loved ones who want to better understand how trauma and eating disorders overlap If you have ever wondered why recovery feels unsafe, inconsistent, or incomplete, this episode will offer language and insight to help you make sense of your experience. What You'll Learn in This Episode How unresolved trauma keeps eating disorder symptoms active for years or decades Why eating disorders are often survival strategies, not failures of willpower The role of the nervous system in trauma and long-term eating disorder recovery How trauma-informed therapy helps create new pathways to safety and regulation Why intersectionality matters in trauma and eating disorder treatment Practical ways to rebuild safety, trust, and connection with your body Content Caution This episode includes discussion of trauma, eating disorders, and long-term recovery. Listen with care and pause if needed. If you are in distress, reach out to a trusted support person, therapist, or the 988 Suicide and Crisis Lifeline (U.S.) for immediate help. Related Episodes How Childhood Trauma Shapes Eating Disorders & Body Shame (Content Caution) on Apple & Spotify. Childhood Trauma & Eating Disorders on Apple & Spotify. Using EMDR & Polyvagal Theory to Treat Trauma & Eating Disorders with Dr. Danielle Hiestand, LMFT, CEDS-S on Apple & Spotify. Trauma, Eating Disorders, & Levels of Care with Amy Ornelas, RD via Apple or Spotify. Work With Dr. Marianne Miller If this conversation resonates with you, therapy can help you begin to heal from trauma while working toward eating disorder recovery. Dr. Marianne Miller, LMFT, @drmariannemiller, offers trauma-informed, neurodivergent-affirming therapy for individuals navigating eating disorders, trauma, and body image distress. Her approach centers on nervous system regulation, sensory attunement, and consent-based care to help you build safety and trust within your body. She offers therapy in California, Texas, and Washington, D.C. Learn more or schedule a consultation at drmariannemiller.com.

Self-compassion is a powerful, learnable skill in eating disorder recovery. In this conversation with registered social worker, grain farmer, and mom of five, Carrie Pollard, MSW, we explore how compassion lowers shame, supports motivation, and helps people replace harmful coping with kinder, sustainable care. We talk about trauma-informed treatment, somatic awareness, DBT skills, and what self-compassion looks like in real sessions and real life. What You'll Learn What self-compassion really is: noticing suffering and responding to it with care, based on the Mindful Self-Compassion model by Kristin Neff and Christopher Germer. Why “the why” matters: exploring roots like trauma and chronic stress helps people understand why symptoms once protected them and how to meet those needs differently. Behavioral tools and deeper work together: how CBT, FBT, and skills work can sit alongside bottom-up, body-based approaches and insight-oriented therapy. Backdraft in self-compassion: why big feelings can surge when kindness finally lands, and how to ride emotional waves safely. Somatic cues and capacity: using body signals, boundaries, and micro-pauses to prevent overload, especially for high-achieving, people-pleasing clients. Rural and farmer mental health: unique barriers to care, higher anxiety and depression in farm communities, and why accessible, virtual support matters. Key Takeaways Self-compassion reduces shame and increases motivation, which supports behavior change in anorexia, bulimia, binge eating, ARFID, and long-term recovery. You can ask two steady questions throughout healing: What am I feeling? and What am I needing? Emotional waves peak and pass. Skills from DBT and mindful self-compassion help you surf them without self-criticism. Recovery grows when systems of care address trauma, body image, diet culture, and access barriers faced by rural, disabled, neurodivergent, and larger-bodied people. Guest Carrie Pollard, MSW is a registered social worker in Ontario, Canada, @compassionate_counsellor. She brings two decades of clinical experience, deep community ties in agriculture, and a trauma-informed lens to eating disorder treatment. She co-founded a national farmer mental health initiative and participates in the Waterloo-Wellington Eating Disorder Coalition. Instagram: @compassionate_counsellor Counseling for Ontario, Canada residents: flourishwithcompassion.com Waterloo-Wellington Eating Disorder Coalition: search the coalition site to find therapists, physicians, and dietitians, plus details for the professional development day on diversifying eating disorder perspectives (happening October 24, 2025). Notable Moments Naming self-compassion backdraft so clients can expect it and feel less afraid. Using hand-over-heart and paced breathing when words are hard. Reframing symptoms as once-useful survival strategies, then building new supports. Embracing imperfection in therapy and life to align with authenticity and values. Who This Episode Supports People in eating disorder recovery who feel stuck in shame or fear that kindness will make them “stop trying.” Clinicians seeking to integrate mindful self-compassion, somatic work, and DBT with behavioral protocols. Rural and farming families who need accessible, culturally aware care options. Neurodivergent folks and anyone navigating sensory overload, perfectionism, or people-pleasing. Resources Mentioned Mindful Self-Compassion Workbook by Kristin Neff and Christopher Germer DBT skills for emotion regulation and distress tolerance Waterloo-Wellington Eating Disorder Coalition directory and events Carrie's counseling: flourishwithcompassion.com Instagram: @compassionate_counsellor Related Episodes Self-Compassion in Eating Disorder Recovery with Harriet Frew, MSc @theeatingdisordertherapist_ on Apple & Spotify. Perfectionism & Eating Disorders on Apple & Spotify. Work With Dr. Marianne Miller If you are in California, Texas, or Washington, D.C., I offer therapy for binge eating, ARFID, anorexia, bulimia, OCD, and trauma. Learn more and book a consult at drmariannemiller.com. If ARFID is part of your story or your family's story, explore my self-paced ARFID & Selective Eating Course for practical, neurodivergent-affirming tools. Share This Episode If this conversation helped you, share it with a friend, a clinician, or a family member. Your share helps more people find self-compassionate, trauma-informed eating disorder support.

Clinical psychologist Dr. Dana Harron joins me to discuss how couples can approach difficult conversations about eating disorders with honesty, care, and mutual respect. Together we explore what makes these conversations emotionally charged, how to prepare for them, and how partners can support each other without taking on the role of therapist or monitor. Dr. Harron offers practical guidance from her book Loving Someone With an Eating Disorder and her work at Monarch Wellness & Psychotherapy. You'll learn what helps these conversations go more smoothly, how to create safety before and after hard talks, and when to bring in a therapist who understands both eating disorders and couples dynamics. Content Caution This episode discusses eating disorders, disordered eating behaviors, and relationship stress that can arise during recovery. Some listeners may find certain details activating. Please take care of yourself while listening, and pause or skip ahead as needed. About Our Guest Dana Harron, PsyD is a clinical psychologist and founder of Monarch Wellness & Psychotherapy in Washington, D.C. She specializes in trauma, parenting, and eating disorders. She is the author of Loving Someone With an Eating Disorder: Supporting, Nurturing, and Connecting With Your Partner and is currently writing Parenting Beyond Trauma. You can find her work at monarchwellness.com and on Instagram at @monarchwellnesspsychotherapy. What You'll Learn How to prepare before opening up about your eating disorder to a partner Why I-statements and emotional honesty matter more than having all the answers The best times and places for difficult conversations about food and body image What to say when your partner asks questions you cannot answer yet How to plan a follow-up discussion and build routine check-ins Why post-conversation decompression helps the nervous system reset What couples therapy can look like when one partner struggles with an eating disorder How to balance support and autonomy without creating a power differential Conversation Highlights Dr. Harron shares how her book was inspired by the lack of resources for partners of adults with eating disorders. Tips for partners on when to speak, when to listen, and how to avoid meal-time conversations about food behaviors. The importance of humor, co-regulation, and small moments of levity in recovery. How systemic patterns in relationships can reinforce eating disorder behaviors. Why “honesty” in recovery is about emotional congruence, not just full disclosure. Key Takeaways for Couples Prime the moment: Let your partner know a sensitive topic is coming and ask for what you need—listening, reassurance, or space. Avoid high-stress times: Skip conversations around meals or when one partner is emotionally depleted. Plan ongoing conversations: Short, consistent check-ins build predictability and reduce tension. Use shared recovery language: I-statements and gentle curiosity create safety and understanding. Involve professionals: A therapist or dietitian trained in eating disorders can guide communication and prevent relational burnout. Related Episodes You're Not Too Much: Setting Boundaries & Asking for What You Need in Eating Disorder Recovery on Apple & Spotify. "Boundaries, Therapy While Black, & Eating Disorders" on Apple & Spotify Work With Dr. Marianne If you or your partner are navigating eating disorder recovery and want support that honors both of your needs, I offer therapy in California, Texas, and Washington, D.C., and global coaching for couples and individuals. My approach is neurodivergent-affirming, sensory-attuned, trauma-informed, and consent-based. Learn more or schedule a consultation at drmariannemiller.com. Learn With Me Explore my ARFID & Selective Eating Course to understand sensory challenges, reduce distress around meals, and improve communication within your household. Episode Credits Host: Dr. Marianne Miller, LMFT Guest: Dr. Dana Harron, Monarch Wellness & Psychotherapy (@monarchwellnesspsychotherapy) If this episode resonates, share it with a partner, therapist, or loved one who may benefit from a more compassionate way to talk about eating disorders and recovery.

Is ARFID genetic? In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores the newest 2025 research on Avoidant/Restrictive Food Intake Disorder (ARFID) and what it means for diagnosis and treatment. You will hear how twin studies show that ARFID has a strong genetic component, why large projects like EDGI2 and the ARIES study are changing the research landscape, and how updated diagnostic criteria in 2025 are helping clinicians better identify and support people with ARFID. The episode also highlights brain scan findings that explain why food can feel overwhelming, threatening, or unappealing, and treatment studies that show real recovery progress through virtual care and ARFID-specific tools. Key Findings from ARFID Research Genetics play a big role in ARFID but do not determine your destiny 2025 research reveals important connections between ARFID, brain differences, gut health, and sensory processing Updated diagnostic criteria are improving accuracy and access to treatment ARFID-specific tools such as the PARDI-AR-Q and EDY-Q provide a more accurate picture of progress Treatment outcomes for children, teens, and adults are encouraging, including in virtual care settings Why ARFID Diagnosis and Treatment Matter ARFID is not caused by poor parenting or lack of willpower. It reflects the way a sensitive brain and body respond to the world. With consent-based, sensory-attuned, and neurodivergent-affirming care, meaningful recovery is possible. Related Podcast Episodes on ARFID Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify. ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Adult ARFID Explained: Real-Life Strategies for Managing Food & Nutrition with Caroline Holbrook, RD on Apple & Spotify. ARFID and Selective Eating Course If you are ready for practical, step-by-step tools to support ARFID, explore my ARFID and Selective Eating Course at drmariannemiller.com/arfid. This course is designed for families and professionals who want compassionate and effective strategies for ARFID care.

What if your body size determined whether or not doctors believed you had anorexia? In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller, LMFT, challenges the diagnosis of atypical anorexia and reveals why this label fails people who deserve to be taken seriously. This category is not about atypical symptoms. It is about anti-fat bias. People in larger bodies who restrict food, obsess about weight, and experience medical complications are often told they cannot truly have anorexia because they do not look emaciated. This episode explains why that belief is harmful, how it delays treatment, and the real medical risks that exist at any body size. Dr. Marianne also explores how anti-fat bias, weight stigma, and cultural stereotypes erase the experiences of marginalized people, especially fat, queer, neurodivergent, disabled, and BIPOC communities. She challenges providers and listeners to recognize anorexia for what it is: a serious illness in every body, not only in those that match the stereotype. If you have ever been given the label “atypical anorexia,” this episode will affirm what you may already know. Your suffering is valid, you deserve care, and you do not need to prove how sick you are in order to receive treatment. What You'll Learn in This Episode Why the label “atypical anorexia” exists and how it reinforces anti-fat bias The medical risks of anorexia that occur across all body sizes How stereotypes harm people in larger bodies with eating disorders The role of intersectionality in who gets overlooked and dismissed How to move toward weight-inclusive eating disorder treatment Who This Episode Is For People in recovery from atypical anorexia or restrictive eating Families supporting a loved one with an eating disorder Providers seeking to understand anti-fat bias in treatment settings Anyone who has ever been told they were not “sick enough” Related Episodes Atypical Anorexia Explained: Why Restriction Happens at Every Body Size on Apple or Spotify. Atypical Anorexia with Amy Ornelas, RD on Apple or Spotify. Atypical Anorexia: Mental & Physical Health Risks, Plus How the Term is Controversial on Apple or Spotify. What Is Atypical Anorexia? Challenging Weight Bias in Eating Disorder Treatment with Emma Townsin, RD @food.life.freedom on Apple or Spotify. Connect With Dr. Marianne Miller I am Dr. Marianne Miller, LMFT, a fat eating disorder therapist specializing in anorexia, ARFID, bulimia, and binge eating disorder. I provide therapy in California, Texas, and Washington, D.C., and offer online resources worldwide.

In this candid conversation, couples and sex therapist Dr. Nicole Van Ness, LMFT joins Dr. Marianne to explore how developmental trauma shapes attachment styles, body image, sexual desire, and day-to-day intimacy. Nicole explains what developmental trauma is, how it differs from or overlaps with complex PTSD, and why chronic misattunement in childhood can echo through adult relationships, stress responses, and self-regulation. You will hear practical, compassionate strategies to rebuild safety, agency, and connection in your body and with your partner. What You'll Learn Developmental trauma 101: How repeated misattunement and lack of repair in childhood influence trust, safety, and the nervous system in adulthood. Attachment and sex: How anxious and avoidant patterns can create desire pursuer–withdrawer cycles, sensitivity to rejection, and misaligned invitations for sex. Body image and pleasure: Why self-loathing, dissociation, and low interoceptive awareness can shift sex from pleasure to performance and how to return to embodied enjoyment. Masturbation as self-care: Ways self-pleasure can restore agency, support trauma recovery, and improve partnered intimacy through curiosity, consent, and pacing. Desire discrepancy: How to reframe a declined invitation as information rather than personal rejection and how to stay connected when desire levels differ. Pelvic and sexual pain: How chronic stress and hypervigilance can contribute to issues like vaginismus and pelvic floor tension and why relaxation and safety matter. Neurodivergence and RSD: Tools for identifying rejection sensitive dysphoria in the moment and naming it with your partner to reduce spirals and repair faster. Eroticism and aliveness: Gentle, stepwise practices that rebuild embodiment and pleasure, from sensing music and movement to sharing desire with a partner. Key Takeaways Trauma adaptations are creative survival strategies. They deserve respect while you learn new options that fit your current life. Pleasure requires enough safety, agency, and self-worth to receive and enjoy it. These ingredients can be rebuilt. Honest conversations about boundaries, pacing, and permission support intimacy more than duty or performance. Small, consistent body-based practices help restore interoception, reduce hypervigilance, and widen your window of tolerance during sex and affection. Gentle Practices to Try Name your nervous system state: Am I keyed up, shut down, or settled. Choose regulation first. Solo exploration with care: Treat self-pleasure like self-nurture. Slow it down. Focus on sensation, comfort, and curiosity. Low-stakes embodiment: Sway to a favorite song, notice breath, enjoy soft fabrics, or feel grass under your feet. Build from neutral to pleasant sensations. Clear invitations and exits: Ask for what you want. Offer options. Affirm that no is welcome. Agree on easy ways to pause or change course. Rejection reframe: A no is information about timing or capacity, not your worth. Validate disappointment and stay connected. Terms and Resources Mentioned Developmental Model of Couples Therapy by Pete Pearson and Ellyn Bader Complex PTSD conversations influenced by Bessel van der Kolk Codependency concepts associated with Pia Mellody Cultural touchpoints about sexuality education and agency referenced in feminist media history About Our Guest Dr. Nicole Van Ness, LMFT is a couples and sex therapist who practices virtually in Texas, California, and Florida. She integrates attachment science, nervous system education, differentiation, and sexuality counseling to help clients cultivate secure intimacy and erotic connection. She works affirmatively with diverse relationship structures and identities. Connect with Nicole: connected-couples.com Apple & Spotify. Sex & Body Image (Part 2) with Sex Therapist Dr. Nicole Van Ness, LMFT on Apple & Spotify. Work With Dr. Marianne If you want trauma-informed, neurodivergent-affirming support for eating concerns, body image, or intimacy challenges, you can work with me in therapy in California, Texas, and Washington, D.C. Learn more and schedule a free consult at drmariannemiller.com. Share the Episode If this conversation helped you, rate and review the show, share it with a friend, and subscribe so you never miss an episode.

Standard eating disorder treatment often assumes that one model will work for everyone. But for neurodivergent people, such as autistic folks, ADHDers, and those with sensory processing differences, this approach can feel like being handed a map that doesn't match the terrain you're actually walking. Instead of support, clients often experience shame, retraumatization, or the sense that recovery is out of reach. What's In This Episode In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores why one-size-fits-all treatment fails neurodivergent clients and what affirming, individualized care looks like. She discusses how sensory sensitivities shape eating experiences, how ADHD executive functioning challenges complicate meal planning and follow-through, and how trauma and systemic oppression create additional effects that amplify struggles. She also outlines what neurodivergent-affirming eating disorder treatment looks like in practice: sensory-attuned, trauma-informed, flexible, and rooted in autonomy and consent. Content Caution In this episode, I discuss eating disorder treatment, recovery challenges, and the effects of trauma. Please listen with care and step away if needed. If you or someone you love lives with ARFID, selective eating, or eating struggles connected to autism, ADHD, or have other types of neurodivergent traits, know that recovery is possible with the right support. Check Out Related Neuroaffirming Episodes How Masking Neurodivergence Can Fuel Eating Disorders on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple and Spotify. ARFID & Neurodiversity on Apple and Spotify. Minding the Gap: The Intersection Between AuDHD & Eating Disorders With Stacie Fanelli, LCSW on Apple and Spotify. Get Neurodivergent-Affirming Eating Disorder Help For deeper guidance, check out Dr. Marianne's ARFID and Selective Eating Course, which offers practical, compassionate strategies that are neurodivergent-affirming, trauma-informed, and sensory-attuned. If you're located in California, Texas, or Washington, D.C., you can work directly with Dr. Marianne in therapy to create a path to recovery that actually fits your life. Learn more at drmariannemiller.com.

Recovery is often described as freedom, joy, and relief. But for people who have lived with eating disorders for many years or even decades, the reality is much more complicated. In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne explores why recovery can feel unsafe and why ambivalence is such a common part of the process. You will hear about how eating disorders become entangled with identity, daily routines, and survival, and why letting go can feel destabilizing even when it is necessary for healing. Dr. Marianne explains how trauma, systemic oppression, sensory sensitivities, and executive functioning struggles can all make recovery feel threatening to the nervous system. She also shares how grief and ambivalence show up in long-term recovery and why both deserve compassion instead of shame. This episode highlights the importance of trauma-informed, neurodivergent-affirming, and fat-affirming care, and it offers practical ways to build a sense of safety through sensory supports, executive functioning tools, and pacing change. What You Will Learn in This Episode: Why recovery often feels unsafe instead of freeing How ambivalence is a normal and intelligent survival response The role of trauma in making recovery feel threatening How intersectionality and systemic oppression shape recovery experiences Why grief is an important but overlooked part of long-term recovery Sensory and executive functioning strategies that can support safer eating experiences Related Episodes Stages of Change & Ambivalence Around Change in Eating Disorder Recovery with Harriet Frew, MSc, @theeatingdisordertherapist_ on Apple & Spotify. Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Navigating a Long-Term Eating Disorder on Apple & Spotify. Work With Dr. Marianne If this episode resonates with you and you are ready for support, Dr. Marianne Miller offers eating disorder therapy in California, Texas, and Washington, D.C. Her approach is trauma-informed, sensory-attuned, and affirming of neurodivergent and marginalized identities. Learn more and connect with her at drmariannemiller.com.

Licensed clinical psychologist Dr. Courtney Crisp (@drcourtneycrisp) joins Dr. Marianne to talk about eating disorders during pregnancy and postpartum. We discuss how body changes, medical weight stigma, breastfeeding pressure, and sensory sensitivities can trigger old patterns or spark new struggles. Dr. Courtney shares insights from her work with athletes and perinatal clients, along with lived experience of pregnancy nausea, food aversions, and postpartum adjustment. We also explore how neurodiversity, ADHD, and autistic sensory needs shape care, and why weight-inclusive, consent-based support matters for parents. What You'll Learn How pregnancy, medical monitoring, and rapid body changes can activate perfectionism, control seeking, and body dissatisfaction The effects of weight stigma in prenatal and postpartum care, and what weight-inclusive providers do differently Why severe nausea and food aversions can persist after birth, and how to support flexible, adequate nourishment Breastfeeding, pumping, and formula choices through a nonjudgmental, mental health first lens Sensory overload in pregnancy and the fourth trimester, including smell sensitivity and tactile overwhelm Athletes, performance culture, and disordered eating patterns that can resurface in the perinatal period How to protect recovery when social media pushes “bounce back” messages Building a trusted, affirming care team that honors intersectionality and neurodiversity Key Takeaways Your body will change during pregnancy and after birth, and that reality deserves compassion, not comparison. Weight-inclusive prenatal and postpartum care improves outcomes by removing shame and centering consent. Feeding decisions work best when they support the caregiver's mental health and the baby's needs, not a rigid ideal. Sensory supports reduce distress. Use smell blockers, quieter environments, comfortable fabrics, and predictable routines. Curate your feeds. Unfollow “get your body back” influencers and follow licensed, values-aligned clinicians. Recovery helps you show up for your baby and for yourself. Nourishment and rest are part of caring for your family. Timestamp Guide 00:00 Meet Dr. Courtney Crisp and her background in athletics and psychology 06:40 Why sports culture can model both body awareness and perfectionism 10:45 Pregnancy triggers, medical encounters, and weight stigma 14:40 Severe nausea, limited safe foods, and lingering food aversions 18:55 Postpartum body image, grief, and the pressure to snap back 21:40 Breastfeeding, pumping, formula, and mental health first choices 24:30 Sensory sensitivities in pregnancy and postpartum 26:45 Building a trusted, affirming care team for your unique family 28:20 Neurodiversity, ADHD, and autistic masking in assessment and care 29:30 Where to find Dr. Crisp online Resources Mentioned Guest site: drcourtneycrisp.com Instagram: @drcourtneycrisp Substack: The Pop Culture Psychologist at drcourtneycrisp.substack.com For Listeners in Recovery Create a simple postpartum nourishment plan with two or three easy options per meal, low lift snacks you tolerate, and a backup shelf-stable choice. Add sensory aids you find regulating. Ask your care team to avoid blind weighing and to discuss numbers only with consent. Invite a partner or friend to support meals, hydration, and rest. Work With Dr. Marianne If you want weight-inclusive, neurodivergent-affirming therapy for eating disorders, OCD, and body image concerns in California, Texas, or Washington, D.C., learn more and connect through my website. I also offer specialized support for ARFID, binge-type patterns, and long-term recovery. Suggested Episodes To Queue Next Eating Disorders & Athletes: The Pressure to Perform on Apple & Spotify. Pregnancy, Postpartum, & Eating Disorder Recovery with Jaren Soloff, RD on Apple & Spotify. Overexercising, ADHD, and Eating Disorders with @askjenup Jenny Tomei on Apple & Spotify.

Eating in the morning sounds simple, but for many people in eating disorder recovery it feels nearly impossible. Breakfast can bring up anxiety, sensory overwhelm, executive functioning struggles, and old diet culture narratives that equate delaying food with being “good.” In this episode, Dr. Marianne Miller explores why breakfast is so hard, what's happening in the body and mind during mornings, and how oppression and neurodivergence can amplify these challenges. WHAT THIS EPISODE COVERS Why hunger cues may be blunted in the morning for those healing from anorexia, ARFID, binge eating disorder, bulimia, or atypical anorexia. How anxiety, sensory sensitivities, and executive functioning difficulties make mornings especially tough. Why low-lift and “zero spoons” food strategies are key for ADHDers and neurodivergent folks. How systemic oppression and diet culture messages intensify morning eating struggles. Practical steps for making mornings less overwhelming and building breakfast into your routine. CONTENT CAUTION This episode discusses eating disorder recovery challenges and mentions binge urges, food avoidance, and systemic oppression. Please take care of yourself as you listen. WHY THIS MATTERS Morning eating struggles are not a personal failing. They're a reflection of body rhythms, trauma, and cultural messages around food and bodies. Understanding the intersection of physiology, psychology, and oppression allows recovery to be rooted in compassion rather than shame. Whether you're working on ARFID recovery, managing binge urges, or navigating long-term eating disorder challenges, starting the day with nourishment can support stability and healing. EXPLORE MY ARFID & SELECTIVE EATING COURSE If mornings feel like an impossible hurdle, I created the ARFID & Selective Eating Course to support you. It's designed for people who struggle with food avoidance, sensory sensitivities, or anxiety around eating, as well as for parents and providers seeking neurodivergent-affirming strategies. The course is self-paced and packed with practical tools to make eating less overwhelming and more possible. Dr. Marianne Miller, an eating disorder therapist based in San Diego, California, as well as serving eating disorder clients in Los Angeles, the San Francisco Bay Area, Texas, and Washington, D.C., unpacks the biology, psychology, and cultural conditioning that make morning eating so difficult. With a neurodivergent-affirming lens, she offers low-lift strategies for ADHD and autistic folks, highlights how systemic oppression and anti-fat bias amplify these struggles, and provides practical tools for building safety and consistency with food in the mornings. CHECK OUT OTHER EPISODES ON MECHANICAL AND INTUITIVE EATING: Anorexia, Accessibility to Care, & Intuitive Eating with @the.michigan.dietitian Lauren Klein, RD on Apple & Spotify. Intuitive vs. Mechanical Eating: Can They Coexist? on Apple & Spotify. From Diet Rock Bottom to Intuitive Eating & Fat-Positive Care: A Eating Disorder Recovery Story with Chelsea Levy, RDN @chelsealevynutrition on Apple & Spotify. ABOUT DR. MARIANNE MILLER & HER WORK Struggling with eating breakfast is a common challenge in eating disorder recovery, whether you're healing from anorexia, bulimia, binge eating disorder, ARFID, or atypical anorexia. In this episode, Dr. Marianne Miller, an eating disorder therapist based in San Diego, California, as well as serving eating disorder clients in Los Angeles, the San Francisco Bay Area, Texas, and Washington, D.C., unpacks the biology, psychology, and cultural conditioning that make morning eating so difficult. With a neurodivergent-affirming lens, she offers low-lift strategies for ADHD and autistic folks, highlights how systemic oppression and anti-fat bias amplify these struggles, and provides practical tools for building safety and consistency with food in the mornings.

Avoidant/Restrictive Food Intake Disorder (ARFID) is one of the most misunderstood eating disorders. Although many people assume it is about being a “picky eater,” the truth is far more complex. ARFID can involve overwhelming sensory sensitivities, intense fears of choking or vomiting, and nervous system responses that make eating feel unsafe. For those living with ARFID, every meal can feel like navigating a minefield. Shame, isolation, and years of being dismissed by others often add to the struggle. WHAT'S IN THIS EPISODE In this episode, Dr. Marianne Miller explores what ARFID really feels like from the inside, why it is so often overlooked or misdiagnosed, and how to shift from shame to self-compassion. She discusses the intersectional barriers that people with ARFID face, from fat folks being dismissed by providers, to autistic and ADHD individuals being mislabeled as “quirky eaters,” to cultural stigma in BIPOC communities. By unpacking these misconceptions, Dr. Marianne shines a light on why ARFID deserves serious recognition and care. Midway through the episode, Dr. Marianne shares details about her self-paced ARFID and Selective Eating Course at drmariannemiller.com/arfid. This resource supports parents, adults, and providers alike with a neurodivergent-affirming, sensory-attuned, and trauma-informed framework. It includes practical tools for creating safety around food, reducing shame, and building flexibility without force. Listeners will also hear about strategies that actually help people with ARFID: validating experiences instead of minimizing them, using sensory-based bridges to expand safe foods, providing trauma-informed care that honors fear as protective, and integrating low-lift routines that work with executive functioning needs. Dr. Marianne explains how true healing is not about eating everything, but about gaining more freedom, more nourishment, and more autonomy. ARFID is not a choice, and it is not a phase. It is a real eating disorder that deserves respect, compassion, and effective support. Tune in to learn why understanding ARFID matters, and how shifting the conversation can open new pathways for care. LISTEN TO OTHER EPISODES ON ARFID ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Adult ARFID Explained: Real-Life Strategies for Managing Food & Nutrition with Caroline Holbrook, RD on Apple & Spotify. Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat on Apple & Spotify. INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Follow me on Instagram @drmariannemiller Check out my virtual, self-paced ARFID and Selective Eating course Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Live in California, Texas, or Washington D.C. and interested in eating disorder therapy with me? Sign up for a free, 15-minute phone consultation HERE or via my website, and I'll get you to where you need to be! Check out my blog. Want more information? Email me at hello@mariannemiller.com

Author and fat liberation advocate Amanda Martinez Beck @thefatdispatch joins me to share what it's like to navigate eating disorder treatment while taking a GLP-1 medication for diabetes care. She opens up about her lived experience with atypical anorexia in a larger body, the challenges of muted hunger cues on Ozempic, and how she's learning to embrace nourishment with compassion. This conversation highlights the nuance of recovery, the complexities of body change, and the importance of choosing curiosity over judgment. CONTENT CAUTION This episode discusses eating disorders, fat stigma, and experiences with GLP-1 medications. Please take care while listening. WHAT WE COVER How atypical anorexia is often overlooked in larger bodies Why Ozempic can suppress hunger cues and mimic anorexia symptoms Building structured meals and snacks when appetite cues are muted Holding nuance in fat liberation while navigating diabetes care Practicing curiosity instead of judgment when bodies change Fat accessibility in professional settings and advocating for support The creation of Nozempic Mondays as a community resource on Substack KEY TAKEAWAYS Eating disorder recovery requires intentional nourishment, regardless of body size. GLP-1 medications are not a “miracle cure” and can complicate eating disorder treatment. Choosing curiosity over judgment creates space for healing and body acceptance. Accessibility and advocacy matter in workplaces and communities. GUEST Amanda Martinez Beck is a fat author, disability advocate, and fat liberationist whose work centers on embodiment, faith, and justice. She writes The Fat Dispatch on Substack and is the author of Lovely: How I Learned to Embrace the Body God Gave Me and More of You: The Fat Girl's Field Guide to the Modern World. She also hosts Nozempic Mondays, a resource for people navigating GLP-1 medications in weight-stigmatizing environments. CONNECT WITH AMANDA Substack: thefatdispatch.com Instagram: @thefatdispatch Threads: @thefatdispatch OTHER EPISODES WITH AMANDA AND ON ATYPICAL ANOREXIA Diabetes in a Fat Body: Navigating Stigma, Care, & Self-Trust with Amanda Martinez Beck @thefatdispatch on Apple or Spotify. Atypical Anorexia with Amy Ornelas, RD on Apple or Spotify. Atypical Anorexia: Mental & Physical Health Risks, Plus How the Term is Controversial on Apple or Spotify. What Is Atypical Anorexia? Challenging Weight Bias in Eating Disorder Treatment with Emma Townsin, RD @food.life.freedom on Apple or Spotify. RESOURCES MENTIONED Dr. Rachel Milner's comparison of GLP-1 side effects and anorexia symptoms SUGGESTED CHAPTERS 0:00 Welcome and introduction 3:20 Atypical anorexia in a larger body 9:10 Hunger cues, food noise, and Ozempic 14:40 Starting eating disorder treatment 20:00 Choosing curiosity over judgment 25:30 Accessibility and fat advocacy at work 35:00 Nozempic Mondays and community care 39:30 Closing reflections and resources QUOTABLE “Curiosity instead of judgment has been the most valuable part of my journey. I ask if I am nourished, and I let my body be.” – Amanda Martinez Beck WHO THIS EPISODE IS FOR People navigating eating disorder recovery while on GLP-1s for diabetes Those in larger bodies seeking validation and support Clinicians interested in fat-affirming, non diet, and neurodivergent-aware treatment Families and loved ones supporting someone through recovery WORK WITH DR. MARIANNE If you're seeking eating disorder therapy and anorexia treatment that is fat-positive, sensory-attuned, and neurodivergent-affirming, I offer services in California, Texas, and Washington, D.C. INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Follow me on Instagram @drmariannemiller Check out my virtual, self-paced ARFID and Selective Eating course Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Live in California, Texas, or Washington D.C. and interested in eating disorder therapy with me? Sign up for a free, 15-minute phone consultation HERE or via my website, and I'll get you to where you need to be! Check out my blog. Want more information? Email me at hello@mariannemiller.com