Dr. Marianne-Land: An Eating Disorder Recovery Podcast

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

What if your sensory needs around food were not something to fix, but something to honor? In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores how taste, texture, and smell can shape food experiences for autistic people, especially those struggling with ARFID or longstanding selective eating. For many neurodivergent folks, eating is not just about hunger or nutrition. It is about navigating an overwhelming sensory world where food can trigger discomfort, distress, or shutdown. In this episode, Dr. Marianne challenges the idea that “picky eating” (not a fan of this term) is a behavioral issue. She instead centers a neurodivergent-affirming lens. Dr. Marianne explains why certain tastes may be too intense, why some textures are intolerable, and how even the smell of cooking can completely derail someone's ability to eat. Rather than dismissing these experiences, she offers a framework that respects the wisdom of the sensory system and centers bodily autonomy. Throughout the episode, Dr. Marianne also highlights how intersecting identities influence whose sensory needs get honored and whose get ignored. Fat autistic people are more likely to be accused of bingeing instead of being screened for ARFID. Autistic people of color may be labeled as oppositional instead of recognized as overwhelmed. Trans and nonbinary folks may feel especially vulnerable to dysphoria or sensory shutdown. When treatment spaces fail to consider these intersections, they increase the risk of harm and deepen eating-related trauma. Listeners will come away with a greater understanding of what sensory-based food aversions really are and how we can create supportive environments that do not rely on compliance, but rather collaboration, compassion, and choice. Content Caution About halfway through the episode, Dr. Marianne discusses common invalidating experiences autistic people have in treatment, including being coerced into eating foods that feel unsafe, ignored by providers, or misdiagnosed because of anti-fat bias or racism. There are no graphic food descriptions, but this part may be activating for folks who have experienced treatment trauma or food-related distress. Related Episodes on Autism and Eating 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. Ready to Learn More? If you or someone you care about is navigating ARFID or sensory-based eating struggles, Dr. Marianne's virtual, self-paced course, ARFID & Selective Eating offers an accessible and affirming starting point. Built on her NIT-AR model (Neurodivergent-Affirming Integrative Therapy for ARFID), this course is ideal for autistic individuals, parents, and providers alike. It offers tools for supporting sensory needs without shame, and helps you rebuild trust with food on your terms. Learn more at drmariannemiller.com Keywords for Searchability autistic sensory eating, ARFID sensory sensitivity, taste aversion autism, texture sensitivity eating, food smell sensory autism, selective eating autism, autistic ARFID treatment, neurodivergent eating disorder support, trauma-informed ARFID course, sensory food aversions, autism and feeding challenges, liberation eating disorder therapy, autism sensory tools for eating, affirming ARFID support

What happens when the most painful wounds from childhood were not physical but verbal (or were both)? In this solo episode, Dr. Marianne Miller explores how childhood verbal abuse shapes our relationship with food, body image, and self-worth. Words like "You're too much," "Are you really going to eat that?" or "You'd be pretty if you lost weight" do not just pass through us. They often take root and become beliefs that fuel restriction, binge eating, ARFID, and body distrust. These early messages are rarely named in traditional eating disorder care, yet they are at the center of how so many people learn to disconnect from their own needs. This episode also takes a close look at intersectionality and how verbal abuse is often amplified when it lands on marginalized identities. Fat children, neurodivergent kids, BIPOC youth, disabled teens, and queer or trans kids often receive more frequent and more punishing verbal messages about food, emotions, and appearance. These experiences are not isolated. They are shaped by broader systems that devalue certain bodies and behaviors while demanding compliance and control. Dr. Marianne outlines how those messages become internalized and how they show up decades later in eating struggles that are often misunderstood or minimized by standard care. Rather than framing recovery around food rules or rigid programs, this episode invites you to imagine a different path. One that centers truth, autonomy, compassion, and body liberation. Whether you are navigating ARFID, binge eating, restriction, or an unnameable discomfort with food, this conversation offers validation and a starting point for deeper healing. WHAT YOU'LL HEAR IN THIS EPISODE The many forms verbal abuse can take in childhood How shaming language around food and body shapes long-term eating patterns Why intersectionality matters in recovery How internalized shame drives disordered eating Why traditional eating disorder treatment often fails marginalized clients What a neurodivergent-affirming, sensory-attuned, liberation-focused approach looks like CONTENT CAUTION This episode discusses verbal abuse, body shaming, disordered eating, and childhood trauma. Please care for your nervous system while listening. Take breaks, skip, or pause when needed. THIS EPISODE IS FOR YOU IF . . . You were criticized or mocked for your body, eating habits, or emotions as a child You live in a larger body or identify as neurodivergent, BIPOC, disabled, queer, or trans You experience food restriction, binge eating, or fear-based eating You are seeking eating disorder recovery that respects your lived experience You want support that centers your nervous system and autonomy RELATED EPISODES Childhood Trauma and Eating Disorders on Apple & Spotify. How Childhood Trauma Shapes Eating Disorders & Body Shame (Content Caution) on Apple & Spotify. Using EMDR & Polyvagal Theory to Treat Trauma & Eating Disorders with Dr. Danielle Hiestand, LMFT, CEDS-S on Apple & Spotify. WORK WITH DR. MARIANNE Dr. Marianne Miller is a Licensed Marriage and Family Therapist (LMFT) who works with teens and adults in California, Texas, and Washington, D.C. She specializes in trauma-informed eating disorder therapy that is sensory-attuned, neurodivergent-affirming, and centered on body liberation. Her clients often come to her after feeling dismissed or harmed by traditional treatment models. Many are working through ARFID, binge eating disorder, bulimia, anorexia, or mixed experiences that do not fit neatly into diagnostic boxes. Dr. Marianne supports clients in larger bodies, those navigating chronic illness, sensory sensitivities, and those who live at the intersection of multiple marginalized identities. She believes recovery should not be about compliance or perfection. It should be about truth, autonomy, and building a relationship with food and body that is rooted in safety and dignity. If you are seeking a therapist who will honor your complexity and offer support that aligns with your values, you can schedule a free 15-minute consultation call at:

What does it mean for men to navigate eating disorders in systems often designed without them in mind? In this conversation, George Mycock, PhD student and founder of MyoMinds, returns to Dr. Marianne-Land for the third time to share the evolution of his research and lived experience. Together, Dr. Marianne and George unpack what his multi-year studies reveal about barriers men face in seeking help, how treatment systems may unintentionally exclude them, and what can be done to make services more inclusive and effective. From the absence of representation in outreach materials to clinician bias in diagnosing and treating men, George highlights systemic gaps—and the hope that comes from centering men's own voices in solutions. In This Episode: Why George has structured his PhD around muscularity-oriented issues such as muscle dysmorphia, exercise addiction, and disordered eating Findings from his studies on organizational and systemic barriers that prevent men from accessing eating disorder care How imagery and outreach materials often alienate men, and what services can do differently The importance of lived experience research and co-designing resources with men themselves How messages of “it's okay not to be okay” may fall short, and why men often need purpose-driven, hopeful framing instead Practical ways providers can support men without pigeonholing their experiences George reminds us that there is no one “male experience” of eating disorders, and shares why focusing on diversity, autonomy, and agency is essential in both research and treatment. Content Caution This episode discusses eating disorders, body image concerns, and systemic barriers to care. Please listen with care. Previous Episodes With George When we chatted about George's first wave of research on exercise, eating disorders, & muscularity-oriented issues on Apple or Spotify. When we discussed George's overall focus on muscularity-oriented issues, men, and eating disorders on Apple or Spotify. When we talked about George's second wave of research on men, muscularity, exercise, & eating disorder stigmas on Apple or Spotify. About George & Connect With George George consulted on these issues for the Netflix show Everything Now.   George lives and works out of Malvern, England, in the United Kingdom.   You can contact and follow George through the following links: Website: MyoMinds.com Twitter/X: @myominds Instagram: @myo_minds INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Follow me on Instagram @drmariannemiller Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Check out my blog. Want more information? Email me at hello@mariannemiller.com

Feeding yourself with ADHD often feels more complicated than it should. From standing in front of the fridge with a blank mind to forgetting groceries until they spoil, the everyday steps of planning, cooking, and cleaning can feel overwhelming. In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller shares practical strategies that make food less of a battle and more of a support. Building on episode 200, Creating an ADHD-Affirming Relationship With Food, this follow-up dives into seven tools for low-lift eating. These strategies are designed to lower barriers, reduce decision fatigue, and help you get fed with less stress. You will learn: How Two-Minute Meals provide quick nourishment when energy is low. Why Food Pairing simplifies nutrition into easy combinations. Ways to Outsource Decision-Making with default meals and visual lists. How Asking for Support and Practicing Shortcuts can save executive functioning energy. Why Environmental Cues help ADHDers remember to eat consistently. How Community and Body Doubles create accountability and connection. What to do on Zero-Spoon Days, including an explanation of spoon theory and survival strategies. ADHD and eating can be especially challenging because executive functioning, planning, and sensory processing all intersect with food. Low-lift eating tools are a way to meet your body's needs while honoring your neurodivergence. These strategies are helpful for ADHD meal planning, reducing overwhelm at mealtimes, and creating ADHD-friendly food systems that actually work in daily life. This episode offers ADHD-affirming, liberation-focused tools that honor your brain's reality instead of working against it. Eating does not have to be complicated, and low-lift supports are not just valid, they are essential. Content Caution: This episode discusses the challenges of eating with ADHD and includes mentions of executive functioning struggles, skipped meals, and the overwhelm that can come with food. Please take care while listening and skip this episode if today is not the right time for you. RELATED EPISODES Creating an ADHD-Affirming Relationship With Food (episode #200) on Apple & Spotify. Overexercising, ADHD, and Eating Disorders with @askjenup Jenny Tomei on Apple & Spotify. ADHD & Eating Disorders: The Overlooked Link on Apple & Spotify. If this conversation resonates with you, explore Dr. Marianne's ARFID and Selective Eating Course at drmariannemiller.com/arfid. The course is built on a neurodivergent-affirming, sensory-attuned framework and is helpful for both adults and parents of kids who struggle with eating, as well as providers wanting to learn more about how to treat ARFID. INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Follow me on Instagram @drmariannemiller Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Check out my blog. Want more information? Email me at hello@mariannemiller.com

Living with an eating disorder for years or even decades can feel overwhelming, discouraging, and isolating. In this solo episode, Dr. Marianne explores what it means to navigate a long-term eating disorder, including the grief of lost time, the way it shapes daily life and identity, and how neurodivergence and trauma often play a role in keeping patterns in place. Dr. Marianne also brings in two often overlooked dimensions: AGING AND EATING DISORDERS: how struggles can persist into midlife and older adulthood, and the ways ageism, body changes, and health conditions intersect with recovery. SYSTEMIC OPPRESSION: how racism, anti-fat bias, heterosexism, ableism, and other forms of marginalization amplify harm, delay diagnosis, and create barriers to care. This episode emphasizes that there is no timeline for recovery. Whether you have lived with anorexia, bulimia, binge eating disorder, or ARFID for a few years or many decades, your healing matters. Recovery may not erase every thought or behavior, but loosening the eating disorder's grip and reclaiming your life on your own terms is possible. In this podcast episode on long-term eating disorders, Dr. Marianne highlights the unique challenges of navigating eating disorders across the lifespan. Listeners will hear about aging and eating disorders, how neurodivergence and trauma influence recovery, and the role systemic oppression plays in prolonging symptoms. These insights are especially valuable for people who have struggled with eating disorders for decades and are seeking affirming, trauma-informed support. CONTENT CAUTION: This episode discusses eating disorders, long-term struggles, aging, and systemic oppression. Please take care while listening. WHAT YOU'LL LEARN IN THIS EPISODE Why recovery feels more complex after years of living with an eating disorder How grief shows up when looking back on time lost The connection between long-term eating disorders, neurodivergence, and trauma Why aging can both challenge and shift recovery How systemic oppression creates barriers and delays access to care What recovery can look like when you have been struggling long-term RELATED EPISODES ON LONG-TERM EATING DISORDERS Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Why is Anorexia Showing Up in Midlife? You're Not Imagining It on Apple & Spotify. Midlife Bulimia Recovery: Coping With the Internal Chaos on Apple & Spotify. Binge Eating in Midlife: Why It Starts (or Resurfaces) in Your 30s, 40s, 50s on Apple & Spotify. NEXT STEPS If today's episode resonates with you, explore my resources and support offerings. My work is rooted in a sensory-attuned, trauma-informed, neurodivergent-affirming approach. For adults navigating long-term eating disorders and parents supporting teens, I offer therapy in California, Texas, and Washington, D.C., as well as consultations worldwide. Check out my ARFID and Selective Eating Course, helpful for both adults and parents, at drmariannemiller.com/arfid. You deserve care that honors your lived experience and helps you reclaim peace with food and body at every age.

In this conversation, disability advocate, artist, and author Jayne Mattingly joins Dr. Marianne to explore body grief: the very real mourning that happens when your body, health, or identity do not match the life you imagined. Jayne traces how she coined the term from years of counseling work in eating disorders and body image, and from her own shift into disability after sudden illness and 19 brain and spine surgeries. Together, we unpack how ableism, intersectionality, and systemic oppression shape what we grieve about our bodies and how we heal. You will hear practical ways to name body grief, honor it, and build community care that creates room for joy, creativity, and resistance. This episode covers body grief, disability advocacy, chronic pain, eating disorders, antifat bias, medical dismissal, grief phases, and neurodivergent-affirming, sensory-attuned care. We discuss how ableism and overlapping identities influence recovery, why harm reduction and community care matter, and practical tools for regulation, access planning, and self-advocacy. CONTENT CAUTION We discuss medical trauma, dismissal in healthcare, chronic pain, disability, diet culture, and systemic oppression. Please listen with care and pause when needed. WHAT WE COVER What “body grief” means and why naming it matters How eating disorders can function as regulation and why recovery can feel like loss Jayne's personal story of sudden illness, surgeries, vision loss, and becoming a wheelchair user Everyday ableism and why language like “non-disabled” helps decenter harmful norms The seven phases Jayne observes in body grief and how people move through them Dismissal in medical settings, internalized dismissal, and how to advocate for yourself Why body grief grows inside systems of racism, antifat bias, sexism, homophobia, and ageism Neurodivergence, disability, and how a more accessible world would change the grief we carry Community care, harm reduction, and finding light without forcing a tidy destination KEY TAKEAWAYS Body grief is universal. We all live in bodies that change. Naming the grief opens space for honesty, compassion, and skills. Oppression intensifies grief. Systems teach us which bodies are “acceptable.” Healing includes unlearning those messages and changing the conditions around us. Hope and grief can coexist. Progress is nonlinear. You can move in and out of phases and still build a meaningful life. Language matters. Shifting to terms like “non-disabled” helps challenge ableist defaults. Community care is protective. Healing grows when we practice access, mutual support, and self-advocacy together. FAVORITE MOMENTS Jayne on seeing ableism inside “love your body for what it can do” messages and why that left disabled people out The dismissal chapter story that shows how easily young people internalize “you're fine” when they are not fine “If you design for disabled people first, everyone benefits.” Body grief as a unifier that crosses political lines through storytelling and clear psychoeducation PRACTICAL TOOLS MENTIONED Name your current phase of body grief and set one tiny supportive action for today Track dismissal patterns you have internalized and write one replacement script for your next appointment Build a personal access plan: sensory needs, mobility needs, communication needs, and who can help Use harm-reduction mindset for recovery work and daily life Create a small “joy and regulation” list that is available on hard days ABOUT JAYNE Jayne Mattingly is a nationally recognized disability advocate, body image speaker, and author of This Is Body Grief. She founded The AND Initiative to shift conversations around accessibility, ableism, and healing. Jayne is also the artist behind Dying for Art, a bold abstract series created in partnership with her changing body and chronic pain. She lives in Charleston, South Carolina with her service dog Wheatie. Find Jayne: Instagram @jaynemattingly, janemattingly.com, and Substack This Is Body Grief. RELATED EPISODES ON BODY GRIEF & ABLEISM Body Grief & Body Peace with Leslie Jordan Garcia @liberatiwellness on Apple & Spotify. Fat Positivity, Accessibility, Body Grief, & Emotions with @bodyimagewithbri Brianna Campos, LPC on Apple & Spotify. Size Inclusivity & Ableism: Why Body Acceptance is More Than Just "Loving Your Curves" on Apple & Spotify. Ableism and Common Myths About Diabetes with Kim Rose, RD @the.bloodsurgar.nutritionist on Apple & Spotify. RESOURCES & LINKS Book: This Is Body Grief by Jayne Mattingly — available wherever books are sold The AND Initiative: education and advocacy on accessibility and ableism Dying for Art: Jayne's abstract painting series CONNECT WITH DR. MARIANNE If you're struggling with restriction, food obsession, or atypical anorexia and are seeking affirming, experienced support, Dr. Marianne offers therapy in California, Texas, and Washington, D.C. Her approach is weight-inclusive, neurodivergent-affirming, sensory-attuned, and trauma-informed. Get started here:

Exposure therapy often emerges as the gold standard for ARFID treatment, but for many neurodivergent people it does not address the full picture. In this episode of Dr. Marianne-Land, Dr. Marianne Miller explains why exposure therapy on its own often fails and how sensory-attuned, trauma-informed, and autonomy-honoring care creates a more effective path forward. CONTENT CAUTION This episode discusses food-related trauma, including pressure and force-feeding. Please listen with care and step away if you notice yourself feeling overwhelmed. DIVING DEEPLY INTO THIS PODCAST EPISODE ON ARFID Many autistic and ADHD people experience eating through a sensory lens. The challenge is not only about fear of food, but also about the surrounding environment. A noisy cafeteria, bright lighting, or the stress of being watched while eating can all create overstimulation. In those moments, eating becomes almost impossible. Before trying new foods, individuals often need to regulate, calm their system, or spend time in a sensory safe space. When therapy ignores these realities and relies only on exposure, it can recreate earlier experiences of pressure and shame. That can retraumatize instead of heal. Sensory-attuned care honors nervous system needs, provides autonomy, and includes supports for executive functioning so that real progress becomes possible. ARFID treatment requires more than repetition. Many people searching for ARFID therapy or ARFID treatment options want approaches that are neurodivergent-affirming, sensory-attuned, and trauma-informed. This episode highlights why exposure therapy by itself often fails and what actually works for lasting ARFID recovery. If you are seeking ARFID treatment that respects autonomy and integrates executive functioning supports, this episode will give you the insights you need. If exposure therapy has not worked for you or your child, this episode will help you understand why it is not a personal failure. True recovery requires safety, sensory respect, and trauma-attuned strategies that recognize how neurodivergent brains and bodies experience food. RELATED EPISODES ON ARFID & SENSORY SENSITIVITIES 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. Navigating ADHD, Eating Disorders, & Sensory Sensitivities on Apple & Spotify. LEARN MORE Explore Dr. Marianne's self-paced ARFID and Selective Eating course at https://www.drmariannemiller.com/arfid INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Follow me on Instagram @drmariannemiller Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Check out my blog. Want more information? Email me at hello@mariannemiller.com  

Have you ever reached for food when you were stressed, lonely, or overwhelmed, only to feel guilty afterward? In this episode of Dr. Marianne-Land, Dr. Marianne Miller, LMFT, explores the guilt so many people carry around emotional eating and why that guilt does more harm than the eating itself. She shares how comfort eating has always been a part of human connection, memory, and regulation, and why diet culture has twisted it into something we're told to feel ashamed of. CONTENT CAUTION This episode includes discussion of emotional eating, guilt, diet culture messages, and eating disorder recovery. Please take care while listening and step away if you need to. WHAT'S IN THIS PODCAST EPISODE ON EMOTIONAL EATING Dr. Marianne discusses what she's noticed while eavesdropping at restaurants when people turn down dessert by saying they “don't want to be bad.” This everyday example highlights how morality gets tangled up with food, especially with foods that often bring us joy and comfort. Instead of labeling emotional eating as wrong, Dr. Marianne reframes it as information about what we need in the moment. Listeners will learn practical strategies for releasing guilt, including naming emotions before and after eating, shifting language around food choices, and building a toolkit of regulation strategies that includes but isn't limited to food. Dr. Marianne also speaks directly to neurodivergent listeners, offering sensory-based and executive functioning supports like low-lift eating, grounding practices, and compassion for how food can play an important role in daily self-care. This episode is for anyone who has ever felt stuck in the cycle of eating for comfort, feeling guilty, and then eating again to soothe that guilt. Dr. Marianne offers a liberation-based perspective, showing how every act of compassion toward yourself is also resistance to diet culture, fatphobia, and ableism. If emotional eating has ever left you feeling guilty, this conversation will help you release shame and see food as a source of connection, care, and freedom. RELATED EPISODES ON SHAME & BINGE EATING Overcoming Shame in Eating Disorder Recovery on Apple & Spotify. How to Manage Triggers & Cravings During Recovery From Binge Eating & Bulimia on Apple & Spotify. Binge Eating Urges: Why They Happen & How to Manage Them Without Shame 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

What if recovery isn't about a finish line but about finding meaning in the messy middle? In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller welcomes journalist, professor, and author Mallary Tenore Tarpley to talk about her groundbreaking new book, Slip: Life in the Middle of Eating Disorder Recovery. Mallary shares her powerful story of developing anorexia at age 12 after her mother's death, navigating years of treatment, and later facing a decade-long cycle of bingeing and restricting. She describes how she reframed her experience through the concept of “The Middle Place,” which is a space between acute illness and full recovery where slips are not failures but opportunities for growth. Through her lens as a journalist and storyteller, Mallary highlights the importance of expanding the language of recovery. Instead of labeling experiences as “quasi-recovery” or “pseudo-recovery,” she offers a more compassionate and nuanced perspective...one that validates ongoing struggles while still holding space for progress and hope.

How do you feed yourself when cooking feels overwhelming, grocery shopping is exhausting, and you forget to eat until you're already past the point of hunger? In this episode, Dr. Marianne explores what it means to create a truly ADHD-affirming relationship with food. It isn't about meal plans or rigid rules. It's about honoring the way ADHD brains actually work and making food more accessible, sustainable, and compassionate. You'll hear why executive functioning challenges make traditional approaches to eating difficult for many ADHDers, and how time blindness, sensory sensitivities, and decision fatigue all contribute to inconsistent eating patterns. We'll also talk about the concept of low-lift eating—strategies that reduce steps and overwhelm—and why accommodations and external support are often the missing link to more stable nourishment. From meal delivery to co-eating with a friend, this episode is packed with options that honor your autonomy and needs. If you're looking for ADHD and food support, low-effort meals for ADHD, help with executive dysfunction and eating, or ADHD meal planning tools, this episode offers practical strategies through a neurodivergent-affirming lens. Learn how to reduce food-related overwhelm, support sensory needs, and embrace low-lift, realistic ways of eating without shame. This episode is a guide to creating sustainable food routines that center ADHD needs, not punish them. CONTENT CAUTION: This episode includes discussions of ADHD, disordered eating, and eating challenges related to executive functioning, decision fatigue, and internalized shame. RELATED EPISODES ABOUT ADHD & EATING: ADHD & Binge Eating Disorder on Apple & Spotify. Overexercising, ADHD, and eating disorders via Apple and Spotify. Set-Shifting, AuDHD, & Eating Disorders on Apple & Spotify. Navigating ADHD, Eating Disorders, & Sensory Sensitivities on Apple & Spotify. ADHD & Eating Disorders: The Overlooked Link on Apple & Spotify. WANT MORE SUPPORT? Want more support around ADHD and eating challenges? My ARFID and Selective Eating Course is designed for both adults with ARFID and parents of kids who struggle with eating. It's trauma-informed, neurodivergent-affirming, and sensory-attuned. Learn more at drmariannemiller.com/arfid. INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Follow me on Instagram @drmariannemiller Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Check out my blog. Want more information? Email me at hello@mariannemiller.com

What happens when you're no longer engaging in dangerous eating disorder behaviors, but food still feels like it controls your life? In this episode, Dr. Marianne Miller unpacks the concept of quasi-recovery, a space that can feel both safer than active illness and yet not fully free. Quasi-recovery often includes improved behaviors, such as more regular meals or weight restoration, but leaves behind the deeper work of healing food fear, body shame, and internalized rules. It can be an especially frustrating and lonely experience, because it is often praised by others even when it does not feel like real recovery on the inside. Dr. Marianne explores how quasi-recovery can shape lifelong eating struggles and why people often get stuck there. This episode also considers how neurodivergent and marginalized folks are particularly vulnerable to staying in quasi-recovery when treatment does not address trauma, sensory needs, systemic harm, or body autonomy. This episode covers: What quasi-recovery is and how it shows up in daily life Why healing requires more than just behavior change How fear and food rules quietly persist in this phase Why some people believe they will struggle with food forever What a more liberating vision of recovery can look like If you have ever wondered whether you are truly recovered or just surviving in a different way, this episode offers clarity, compassion, and hope. You do not have to stay stuck in a version of recovery that does not meet your full needs. There is more available to you. CONTENT CAUTION: This episode discusses eating disorder behaviors, body image distress, and systemic oppression. Please take care while listening. RELATED EPISODES ON QUASI-RECOVERY & ORTHOREXIA: Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Orthorexia Uncovered: Causes, Challenges, & Pathways to Healing on Apple & Spotify. An Orthorexia Recovery Story with Sabrina Magnan, @sabrina.magnan.health on Apple & Spotify. LEARN MORE: Dr. Marianne Miller is a fat, neurodivergent eating disorder therapist and ARFID educator. She supports individuals recovering from ARFID, binge eating disorder, anorexia, bulimia, and quasi-recovery. Her work centers autonomy, sensory attunement, and liberation. It is also neurodivergent-affirming and trauma-informed. She provides Queer-affirming and gender-affirming care. Dr. Marianne is late-diagnosed autistic. For those who connect with this discussion and suspect ARFID may be part of their experience, or for clinicians seeking to better understand this overlap, Dr. Marianne offers her ARFID and Selective Eating Course. This self-paced program provides neurodivergent-affirming strategies and tools to address ARFID, including its intersection with anorexia, in both teens and adults. INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Go to my website https://www.drmariannemiller.com Follow me on Instagram @drmariannemiller Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Check out my blog. Want more information? Email me at hello@mariannemiller.com  

What happens when perfectionism, academic pressure, and athletics collide with body image struggles? In this powerful episode of Dr. Marianne-Land, I sit down with Dr. Amanda Marie, a psychologist, educator, and mental health advocate who shares her story of battling bulimia throughout her teen years, college, and into her PhD program. Amanda opens up about how her eating disorder began at 15, fueled by a drive for perfect grades, external validation, and the pressure to perform. She talks about how restriction, bingeing, and purging shaped her daily life and how she balanced secrecy, martial arts training, and academic achievement while silently struggling. We explore: How perfectionism and self-worth tied to grades, sports, and appearance can feed into disordered eating The hidden toll bulimia took on Amanda's body, mind, and relationships How academia and high-achieving environments can intensify eating disorders The turning point that inspired Amanda to pursue recovery after years of secrecy and shame The importance of support systems, therapy, and using determination as a strength in healing What Amanda would say to her 15-year-old self and to anyone listening who feels stuck in their eating disorder Amanda's story is one of survival and transformation. She explains how she reclaimed her grit and perseverance, once tied to her eating disorder, and redirected them toward recovery, authenticity, and compassion.

Why does pressuring someone to eat often make things worse, especially when they are neurodivergent? In this solo episode, Dr. Marianne Miller explores the intersection of ARFID (Avoidant/Restrictive Food Intake Disorder) and PDA, which can be understood as either Pathological Demand Avoidance or Pervasive Drive for Autonomy. She breaks down how demands around eating, even gentle ones, can increase distress and shut down the nervous system for people with this profile. You will learn why pressure often intensifies food refusal and how honoring autonomy can become a foundation for safety, regulation, and healing. Dr. Marianne shares what helps instead, from sensory-attuned environments to co-regulation to collaborative care that supports autonomy instead of undermining it. This episode is especially relevant for those searching for support with ARFID and PDA, whether you're navigating a Pervasive Drive for Autonomy or supporting someone with autism and food refusal challenges. Dr. Marianne discusses key elements of ARFID therapy in California, Texas, and Washington, D.C., with attention to neurodivergent-affirming approaches for sensory-based eating challenges. Topics include autonomy-centered care, the connection between PDA and eating avoidance, sensory accommodations, and how pressure around food can disrupt progress. This conversation is ideal for anyone exploring eating disorder support that moves beyond compliance and toward collaboration. Whether you are someone navigating ARFID and PDA yourself, or a clinician or caregiver offering support, this episode will offer a compassionate, liberation-focused, neurodivergent-affirming lens on what really helps and why.

Why does letting go of food restriction feel unsafe, even when you're ready to recover? In this solo episode, Dr. Marianne explores how restriction can become a form of survival. She discusses the ways restriction may provide a sense of control, structure, or identity, especially for those who are neurodivergent, live in marginalized bodies, or have trauma histories. You will learn about the difference between egosyntonic restriction, which feels aligned with your values, and egodystonic restriction, which feels distressing. This insight can help make sense of your internal conflict and guide you toward a more compassionate approach to healing. This episode offers a perspective rooted in liberation, not compliance. Dr. Marianne invites you to honor the role restriction has played in your life while also creating new ways to feel safe and supported in your body.

In this inspiring and candid interview, Dr. Marianne Miller speaks with psychiatric mental health nurse practitioner Kirsten Book @bookconciergepsych about her powerful journey from living with bulimia for more than a decade to building a successful career in mental health care. Kirsten reveals how her early struggles were shaped by inadequate treatment, provider misconceptions, and the absence of neurodivergent-affirming approaches, especially before her ADHD diagnosis at age 30. Kirsten describes the turning point that came when she became pregnant with her son, which motivated her to pursue lasting recovery. She discusses her imperfect but determined healing process, her career change from business to nursing, and her passion for treating eating disorders, ADHD, anxiety, depression, and substance use disorders. Content Caution: This episode contains discussions of eating disorders, bulimia, anorexia, substance use, and experiences with psychiatric care. Key Topics Covered Early signs of bulimia and anorexia, and how puberty shaped her body image and self-esteem The emotional toll of being dismissed or misunderstood by treatment providers Why early emotional education should be part of every child's learning experience How hope can sustain recovery even in the most difficult moments The role of a late ADHD diagnosis in helping her maintain stability in recovery The connection between undiagnosed ADHD, eating disorders, and substance use Why thorough assessments are essential beyond the presenting symptoms Benefits of collaborative treatment teams in both higher levels of care and private practice Designing a concierge psychiatric practice with a focus on quality and accessibility About Kirsten Book, PMHNP-BC Kirsten is a board-certified psychiatric mental health nurse practitioner treating children, adolescents, and adults. She has worked at every level of care and now runs a concierge-style integrative psychiatric practice in Illinois, Arizona, Washington, and California. Her lived experience in recovery shapes her hopeful, compassionate, and personalized care. Connect with Kirsten: Website: kirstenbook.com Email: @bookconciergepsych Related Episodes on Bulimia & ADHD: A Bulimia Recovery Story + How Weight-Neutral Fitness Can Help Eating Disorder Recovery With Abbey Griffith @claritydecatur on Apple or Spotify. Understanding Bulimia: Causes, Solutions, & Coping Strategies on Apple & Spotify. ADHD & Eating Disorders: The Overlooked Link on Apple & Spotify. Overexercising, ADHD, and Eating Disorders via Apple and Spotify. Resources & Support If you or someone you know is struggling with an eating disorder, you are not alone. In the U.S., you can reach the National Eating Disorders Association (NEDA) Helpline at 1-800-931-2237 or visit nationaleatingdisorders.org. 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

Have you ever wondered why binge eating can suddenly begin or return in your 30s, 40s, or 50s, even if you thought you had moved past it? In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores why binge eating often emerges or resurfaces during midlife and why this experience is far more common than most people realize. She unpacks the combustive mix of hormonal changes, long-term dieting, stress, trauma, cultural pressures about aging, and neurodivergence that collide during this stage of life. You will learn why midlife binge eating is not about willpower or lack of discipline but about unmet needs in the body and nervous system. Dr. Marianne also offers practical steps for interrupting the binge-restrict cycle, cultivating nervous system regulation, and reclaiming a compassionate relationship with food. If you are feeling shame about binge eating in midlife or are wondering why it has become harder to manage now than it was in earlier years, this episode will help you understand what is happening and what recovery can look like. Content Caution This episode discusses binge eating, dieting, weight stigma, hormonal changes, and the effects of midlife stressors on eating behaviors. It also includes references to trauma and emotional regulation challenges. Please take care of yourself while listening and pause if you notice discomfort or distress. What You'll Learn in This Episode Why binge eating often begins or resurfaces in your 30s, 40s, and 50s The connection between chronic dieting, hormonal changes, and binge eating urges How midlife stress, caregiving, and identity shifts influence eating patterns The role of trauma and emotional regulation in binge eating behaviors How neurodivergence and sensory sensitivities affect midlife eating cycles Why diet culture and medical weight stigma intensify binge-restrict patterns What sustainable, non-diet recovery can look like at this stage of life Check Out Related Episodes: How to Manage Triggers & Cravings During Recovery From Binge Eating & Bulimia on Apple & Spotify. Binge Eating Urges: Why They Happen & How to Manage Them Without Shame on Apple & Spotify. Midlife Bulimia Recovery: Coping With the Internal Chaos on Apple & Spotify. Welcome to the Jungle: Eating Disorders in Midlife & Our Personal Recovery Stories with Amy Ornelas, RD on Apple & Spotify. INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Go to my website https://www.drmariannemiller.com Follow me on Instagram @drmariannemiller Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Check out my blog. Want more information? Email me at hello@mariannemiller.com  

Have you ever wondered why recovery feels unsafe if you are autistic, or why masking can look like restriction? In this episode, Dr. Marianne examines the overlooked intersection of autism and anorexia. She explains how autistic masking, the survival strategy of hiding or suppressing traits to “fit in,” can overlap with food restriction and why recovery often feels unsafe in treatment spaces that center neurotypical experiences. Dr. Marianne explores how sensory sensitivities, alexithymia, executive functioning challenges, and monotropism can shape eating patterns for autistic individuals and how traditional recovery models fail to accommodate these realities. She also addresses intersectionality in recovery, highlighting that unmasking is riskier for BIPOC, disabled, fat, queer, and trans individuals whose overlapping identities increase the dangers of being fully visible in systems that marginalize them. She emphasizes why neurodivergent-affirming, sensory-attuned, and intersectional recovery spaces are essential. Recovery cannot be one-size-fits-all when it must account for layered oppression, systemic barriers, and the complex ways autistic traits interact with anorexia. Dr. Marianne also discusses the overlap between anorexia and ARFID (Avoidant/Restrictive Food Intake Disorder), particularly among autistic people, and explains why understanding this overlap is crucial for effective and sustainable healing. If recovery has felt unsafe, Dr. Marianne wants listeners to know it is not because they have failed. It is because treatment often fails to recognize autism, honor intersecting identities, and adapt care to meet those realities. She believes every person deserves support that not only accommodates differences but celebrates them as integral to the healing process.

Dr. Marianne Miller is joined by Chelsea Levy, RDN (@chelsealevynutrition), a certified intuitive eating counselor, registered dietitian nutritionist, and fat-positive healthcare provider based in New York City. Chelsea shares her powerful journey from "diet rock bottom" to embracing intuitive eating and becoming a leading advocate for weight-inclusive and fat-positive care in eating disorder treatment and chronic illness support. Chelsea opens up about her career shift from the art and production world to dietetics, how she discovered intuitive eating, and why she now rejects the weight-centric medical model. Together, Marianne and Chelsea discuss the harms of weight stigma in healthcare, why fat-positive spaces are essential for healing, and how weight-inclusive care improves outcomes for eating disorder recovery, diabetes management, PCOS, and more. Content Caution: This episode discusses eating disorders, chronic dieting, medical weight stigma, and anti-fat bias. Listeners will learn: Why intuitive eating is transformative for eating disorder recovery How weight stigma in healthcare creates harm and barriers to treatment The difference between weight-inclusive care and fat-positive care How Chelsea integrates gender-affirming, fat-affirming, and evidence-based approaches in her practice What it means to dismantle anti-fat bias in medical and therapeutic spaces Chelsea also shares how validating clients' grief around body image and holding space for autonomy are essential parts of her approach. This conversation is a must-listen for anyone seeking liberation from diet culture, professionals wanting to integrate fat-positive care into their work, and anyone navigating recovery in a world steeped in anti-fat bias. Check Out Other Episodes About Intuitive Eating & Fat Positivity: 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. Fat Positivity, Accessibility, Body Grief, & Emotions with @bodyimagewithbri Brianna Campos, LPC on Apple & Spotify. Diabetes in a Fat Body: Navigating Stigma, Care, & Self-Trust with Amanda Martinez Beck @thefatdispatch on Apple & Spotify.

Content Caution: This episode discusses childhood trauma, eating disorders, and body shame. Please listen with care and take breaks if needed. Episode Overview: Eating disorders are not about willpower or personal failure. They are survival responses rooted in trauma, body shame, and environments where safety or acceptance were missing. In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, I explore how childhood trauma and eating disorders are connected, and why understanding this link is essential for true healing. We'll talk about how early emotional invalidation, conditional love, medical or religious trauma, anti-fat bias, racism, ableism, and other forms of oppression shape our nervous systems and our relationships with food and our bodies. Key Topics in This Episode: How Childhood Trauma Shapes Eating Disorders Trauma is not only abuse or neglect. It includes emotional neglect, growing up where love felt conditional, being shamed for your body or identity, and living in oppressive environments. These experiences teach the nervous system that the world is unsafe, leading to food-based coping strategies like restriction, binge eating, or obsessive control. Why Eating Disorders Are Survival Strategies Eating disorders are intelligent adaptations to trauma and distress. They are not choices or flaws but protective responses from a body trying to survive unsafe conditions. The Role of Shame and Oppression Shame reinforces eating disorders by convincing people they are weak or broken. Systems like fatphobia, racism, and ableism magnify this shame, making recovery harder. Understanding how body shame and systemic oppressionintersect with trauma is crucial for healing. A Trauma-Informed Approach to Recovery Recovery is not about force or willpower. It is about compassion, safety, and nervous system regulation. Healing involves body liberation, trauma-informed care, and neurodivergent-affirming practices that honor each person's story and needs. What You'll Learn in This Episode: The connection between childhood trauma and eating disorders Why eating disorders are survival mechanisms, not failures How shame and body image distress perpetuate disordered eating The impact of oppression, fatphobia, and ableism on body shame How trauma-informed eating disorder therapy supports healing Related Episodes: 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 Me: If you're ready for support, I offer trauma-informed, neurodivergent-affirming eating disorder therapy in California, Texas, and Washington, D.C. Learn more and schedule a consultation at www.drmariannemiller.com. INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Follow me on Instagram @drmariannemiller Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Check out my blog. Want more information? Email me at hello@mariannemiller.com

For too long, eating disorders have been falsely framed as illnesses that only affect white, thin, affluent girls. This narrow stereotype erases countless people's experiences and blocks them from diagnosis and treatment. In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller dismantles this damaging myth and explores the liberation truth: eating disorders affect every race, gender, body size, religion, and ability. Yet bias in healthcare, anti-fat bias, racism, ableism, cissexism, and cultural stigma keep many people unseen and untreated. Content Caution: This episode includes discussion of eating disorders, misdiagnosis, systemic bias, and marginalized identities. Please take care while listening and pause if you need to. In This Episode, You'll Learn: How eating disorders impact BIPOC, LGBTQIA+, fat, neurodivergent, disabled, and faith-based communities Why biased diagnostic criteria exclude those who don't fit the stereotype How systemic oppression drives misdiagnosis and denial of care Why ARFID is often overlooked in neurodivergent adults, fat bodies, and marginalized identities What a liberation-focused, inclusive, and neurodivergent-affirming approach to care looks like If you have ever felt unseen in eating disorder spaces or dismissed because you didn't “look sick enough,” this episode validates your experience and calls for a more equitable path to recovery. Check Out Related Episodes: Why Thinness Still Equals “Goodness”: Exposing the Morality Behind Wellness, MAHA, & Christian Diet Culture on Apple & Spotify. The Hidden Risks of Non-Specialized Eating Disorder Treatment with Edie Stark, LCSW, @ediestarktherapy on Apple & Spotify. Breaking Free: Body Liberation After Binge Eating Disorder with Sophia Apostol @fatjoy.life on Apple & Spotify. Body Acceptance, Size Diversity, & Body Liberation on Apple & Spotify. ✨ Learn More About ARFID Support If ARFID is part of your story—or someone you love—I created a self-paced ARFID and Selective Eating Coursedesigned for adults with ARFID, parents, and professionals. It's neurodivergent-affirming, trauma-informed, and sensory-attuned. Check it out here: www.drmariannemiller.com/arfid INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND? Follow me on Instagram @drmariannemiller Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership. Check out my blog. Want more information? Email me at hello@mariannemiller.com

ARFID is not just a childhood diagnosis. In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, I am joined by registered dietitian Caroline (Callie) Holbrook, RD, to discuss what Avoidant/Restrictive Food Intake Disorder looks like in adults and how to navigate food and nutrition in ways that feel safe and supportive. Callie shares her expertise in working with adults with ARFID, highlighting how it often intersects with neurodivergence, sensory sensitivities, and the pressures of adult life such as relationships, work events, travel, and meal planning. We also talk about how shame develops around food, the impact of wellness culture, and why rigid nutritional rules can make ARFID even harder to manage. Content Caution: This episode includes discussions of eating disorders, food-related anxiety, shame, and nutrition planning. Please take care while listening and step away if needed. What We Cover in This Episode: How ARFID presents differently in adults compared to children The role of shame and social pressures in adult ARFID Strategies for building safe foods lists and reducing overwhelm Why processed foods can be a helpful and low-stress option Collaborative, neurodivergent-affirming approaches to nutrition Addressing sensory sensitivities, executive functioning challenges, and interoception Why progress may mean building energy intake and problem-solving around meals instead of immediately trying new foods This episode emphasizes flexibility, autonomy, and creating supportive environments for eating, including practical tips such as adjusting lighting, using sound regulation tools, and using distractions during meals. Why This Episode Matters: Adults with ARFID often feel misunderstood and pressured to eat in ways that do not align with their needs. This episode validates adult ARFID experiences and offers real-life strategies to navigate food safely and respectfully. About Caroline "Callie" Holbrook, RD: Callie is a Registered Dietitian based in San Diego, California. Originally from Alabama, she relocated across the country four years ago. Callie has extensive experience working in various levels of eating disorder treatment, including residential, partial hospitalization, intensive outpatient, and outpatient care. She has long been passionate about the field of eating disorders and has valued every step of her professional journey. Callie recently opened her own private practice in San Diego, specializing in eating disorders, ARFID/selective eating, and Intuitive Eating. She also provides nutrition counseling for individuals seeking a weight-neutral approach to diabetes care. Listen to Related Episodes: ARFID & Nutrition with Callie Holbrook, RD on Apple & Spotify. Living with Adult ARFID: Relationship Challenges No One Talks About on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat on Apple & Spotify. ARFID in Adults vs ARFID in Children on Apple & Spotify. Resources and Links: Connect with Caroline Holbrook, RD: www.holbrookrd.com Email Caroline: www.drmariannemiller.com Take the Next Step If you want in-depth tools for understanding and supporting ARFID in yourself or someone you love, check out my ARFID and Selective Eating Course. This self-paced course covers ARFID research, sensory sensitivities, neurodivergence, and practical strategies for everyday life.

Eating disorders are not just about food. They often begin as survival strategies...ways to manage overwhelming emotions, cope with trauma, or create a sense of control in a world that feels unpredictable. In this powerful episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, I sit down with Amy Ornelas, RD (@amyornelasrd), an eating disorder dietitian and somatic therapist, to explore what recovery really looks like beyond behaviors. We discuss how eating disorders often develop as protective mechanisms, why nervous system healing is essential for deeper emotional work, and how somatic therapy helps bridge the gap between body and mind. Amy shares her professional expertise, her personal journey of recovery, and how her own healing has deepened her ability to guide others. Content concerns: This episode discusses eating disorders, trauma, and recovery. This episode also dives into: How eating disorders can be rooted in trauma, sensitivity, or neurodivergence Why recovery happens in layers, not in a straight line The role of nervous system regulation and somatic therapy in healing The importance of safe therapeutic relationships in uncovering deeper wounds Why lasting recovery is about more than “just eating” Amy and I also discuss our own experiences with vulnerability, relationships, and how healing from eating disorders often involves re-learning safety, connection, and authenticity over time. If you've ever felt frustrated by the idea of a “quick fix” in recovery or wondered why healing feels so complex, this episode will validate your experience and help you see recovery as a layered, lifelong journey of coming home to yourself. ABOUT AMY ORNELAS, RD   Amy is an eating disorders specialist, yoga teacher, and intuitive practitioner. She is trained in somatic therapy. Amy works with individuals, families, and groups. She has been in the eating disorder field for 18 years.   Her own eating disorder recovery really sparked her desire to help others fully heal from diet culture and body image struggles.   She lives and practices in San Diego, California. She is able to work virtually with people in many states across the USA.   Contact Amy via Instagram @amyornelasrd Check out her website https://www.i-heart-nutrition.com/ Email Amy at amy@i-heart-nutrition.com   Check out past episodes when Amy was a guest! On Eating Disorders in Midlife & Our Personal Recovery Stories via Apple or Spotify. On Atypical Anorexia via Apple or Spotify On Eating Disorder Recovery, Higher Level of Care, & Renourishment via Apple or Spotify On Reconnecting With Your Body in Eating Disorder Recovery via Apple or Spotify On Trauma, Eating Disorders, & Levels of Care via Apple or 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 Learn about 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  

In this essential solo episode, Dr. Marianne challenges the narrow and harmful narrative that eating disorders primarily affect girls and women. She explores how toxic masculinity shapes, and often hides, disordered eating and body shame in boys and men. Backed by recent research, this episode unpacks how muscle dysmorphia, bingeing, and restriction are frequently dismissed as “normal” male behaviors, even when they reflect deep emotional pain. Dr. Marianne offers a liberation-focused framework for understanding the unique barriers boys and men face in getting help, and how we can dismantle the systems that reinforce silence, shame, and suffering. CONTENT CAUTION:This episode includes discussion of eating disorder behaviors, muscle dysmorphia, trauma, and toxic masculinity. Please take care while listening. WHAT YOU'LL LEARN IN THIS EPISODE: How toxic masculinity discourages emotional expression and reinforces disordered eating Why boys and men with eating disorders are often undiagnosed or misdiagnosed What muscle dysmorphia is and how it manifests in teen boys and adult men How social media trends like “looksmaxxing” fuel body obsession and psychological distress The role of trauma, emotional suppression, and performance culture in male ED experiences How clinicians, caregivers, and educators can support male-identified folks through a liberationist lens What affirming, emotionally honest healing can look like outside of gendered expectations LISTEN TO OTHER EPISODES ABOUT MEN, MUSCULARITY, & EATING DISORDERS: Men, Muscularity, Exercise, & Eating Disorder Stigmas with George Mycock, MSc @myo_minds on Apple & Spotify. Muscularity-Oriented Issues, Men, & Eating Disorders with MyoMinds' George Mycock, MSc on Apple & Spotify. Men, Eating Disorders, & Body Image with Jonny Landels, Certified Nutritionist & Personal Trainer on Apple & Spotify. RESOURCES & LINKS: Work with Dr. Marianne: www.drmariannemiller.com Follow on Instagram: @drmariannemiller RATE & REVIEW: If this episode spoke to you, please consider leaving a 5-star review and sharing it with your community. Your support helps amplify these critical conversations and brings liberation-based eating disorder care to more people. 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. Check out my blog. Want more information? Email me at hello@mariannemiller.com

What happens when someone is both neurodivergent and fat in a world that punishes difference? In this solo episode, Dr. Marianne unpacks how fatphobia and ableism intersect to create barriers in medical care, mental health treatment, and everyday life for people with ADHD, autism, PDA, and other forms of neurodivergence. She explores why fat liberation and neurodivergent rights must go hand-in-hand, and how body justice is essential—not optional—in eating disorder recovery, therapy, and community care. From sensory needs and executive functioning to the pressure to mask and shrink, this episode offers a powerful call to unlearn bias and build liberatory spaces where all bodies and minds are treated with dignity. Whether you're a fat neurodivergent person, a therapist, or someone committed to anti-oppressive care, this conversation is for you. CONTENT CAUTIONS: In this episode, Dr. Marianne discusses anti-fat bias, ableism, disordered eating, masking, and systemic oppression in medical and mental health settings. Please care for yourself as needed. WHAT YOU'LL LEARN IN THIS EPISODE: Why fat liberation is essential to neurodivergent-affirming care How anti-fat bias and ableism reinforce each other in ADHD and autism communities What executive dysfunction, sensory needs, and masking have to do with food and body shame Why fat neurodivergent people are underdiagnosed and often dismissed by providers What therapists and support people can do to stop reinforcing stigma How to practice body autonomy and community care outside of diet culture and compliance

In this raw and emotionally charged solo episode, Dr. Marianne unpacks why thinness continues to be equated with goodness in mainstream culture. Drawing on the New York Times opinion piece The Unrepentant Return of Christian Diet Culture by Jessica Grose, Dr. Marianne explores how weight loss is still moralized through religious teachings, wellness trends, and political rhetoric. This episode critically examines the resurgence of Christian diet culture, the backlash against weight-loss medications like Ozempic, and the deeper implications of the Make America Healthy Again (MAHA) campaign led by Robert F. Kennedy Jr. Dr. Marianne reveals how these systems are not just about health, but about control, obedience, and purity. She discusses how thinness is still framed as a sign of self-discipline and spiritual worth, while fatness is treated as failure or sin. Using a liberationist lens, Dr. Marianne also highlights the historical roots of fatphobia in white supremacy, referencing Dr. Sabrina Strings' groundbreaking book Fearing the Black Body: The Racial Origins of Fat Phobia. This episode challenges listeners to question how religion, politics, and public health are deeply entangled in oppressive narratives about bodies and morality. For neurodivergent people, those raised in religiously rigid environments, and anyone recovering from body shame, this conversation offers both validation and a call to resistance. You may want to listen in short segments, especially if you're prone to sensory overload or religious trauma responses. CONTENT CAUTIONS: In this episode, Dr. Marianne discusses anti-fat bias, Christian purity and wellness culture, diet culture, disordered eating, white supremacy, and weight-loss medications. Please take care while listening and pause as needed. WHAT YOU'LL LEARN IN THIS EPISODE: How Christian diet culture can moralize thinness and spiritualizes weight loss Why Ozempic and similar medications are being rejected by some conservative groups The political motives and fatphobic messaging behind MAHA How alt-right Christian nationalism reinforces thinness as virtue The white supremacist roots of fatphobia, based on Dr. Sabrina Strings' research Why these systems disproportionately harm fat, neurodivergent, disabled, and BIPOC individuals What it means to reclaim body autonomy in a culture that demands control RELATED EPISODES: How Diet Culture & Purity Culture Fuel Eating Disorders: Unpacking the Trauma Behind the Rules with Cassie Krajewski, LCSW @inneratlastherapy on Apple & Spotify. When Faith Hurts: Religious Trauma & Eating Disorders in Neurodivergent Communities with Victoria Leon, LCSW, on Apple & Spotify. Breaking Up With Diet Culture with Dr. Lisa Folden, @healthyphit on Apple & Spotify. WORK WITH DR. MARIANNE: Dr. Marianne offers therapy to individuals in California, Texas, and Washington, D.C., specializing in eating disorders, ARFID, body image healing, religious trauma, and fat liberation. She is neurodivergent-affirming and is LGBTQIAA+ affirming. Learn more or inquire about working together at drmariannemiller.com. 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. Check out my blog. Want more information? Email me at hello@mariannemiller.com

Diet culture thrives in isolation. It tells us we must heal alone, control ourselves into wellness, and avoid burdening others with our food struggles. But what if true recovery depends not on control, but on connection? In this solo episode, Dr. Marianne explores how co-regulation—the experience of nervous system safety in relationship—can be a radical force for healing. She explains how eating disorders often develop in the absence of relational safety and why diet culture reinforces disconnection and shame. Through the lens of nervous system science, trauma-informed care, and body liberation, this episode centers the power of healing in community. Dr. Marianne also shares why co-regulation can look different for neurodivergent people, especially those with PDA (Pervasive Drive for Autonomy). You'll learn how autonomy and co-regulation are not opposites, and how spacious, consent-based connection can be life-changing in recovery. Whether you are navigating ARFID, anorexia, bulimia, binge eating, or a complex relationship with food and body, this episode offers a compassionate, liberation-oriented approach to healing that honors your boundaries, your needs, and your nervous system. WHAT YOU'LL LEARN IN THIS EPISODE: Why diet culture depends on disconnection and control How eating disorders often emerge from a lack of safe, attuned relationships What co-regulation is and why it supports sustainable recovery How co-regulation can be tailored for neurodivergent folks, including those with PDA Why autonomy and connection are both essential for healing Ways to build nervous system safety in recovery without pressure or compliance How community-based healing challenges shame, perfectionism, and diet culture LISTEN TO RELATED EPISODES: Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat on Apple & Spotify. PDA & Eating Disorders: Why the Pervasive Drive for Autonomy Matters in Recovery on Apple & Spotify. Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) with Stacie Fanelli, LCSW @edadhd_therapist on Apple & Spotify. Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 2) with Stacie Fanelli, LCSW @edadhd_therapist on Apple & Spotify. MENTIONED IN THIS EPISODE: Looking for therapy with Dr. Marianne? She offers trauma-informed eating disorder therapy in California, Texas, and Washington, D.C. Learn more or reach out at drmariannemiller.com Supporting someone with ARFID or navigating it yourself? Explore the self-paced ARFID and Selective Eating course, grounded in sensory-attuned, neurodivergent-affirming care: drmariannemiller.com/arfid CONTENT CAUTIONS: This episode includes discussion of eating disorders, food trauma, PDA, and sensory distress. Please listen with care and pause if needed. Subscribe to Dr. Marianne-Land wherever you get your podcasts. If today's episode resonated with you, consider rating and reviewing the show. Sharing it with others helps bring these conversations to more people who need them. 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

TikTok claims to have banned “SkinnyTok,” but disordered eating content continues to thrive under rebranded hashtags, edited images, and wellness culture language. In this eye-opening episode of Dr. Marianne-Land, Dr. Marianne Miller is joined by eating disorder prevention advocate and educator Jen Tomei (@askjenup) to unpack the rise of SkinnyTok and its harmful influence on teens and adults alike. Jen, founder of the Jenup Community in the UK, shares firsthand experiences of discovering disturbing content on TikTok—even after reporting and flagging videos, the algorithm continued pushing them. Together, she and Dr. Marianne draw chilling parallels to the pro-ana forums of the early 2000s, and explore how new forms of tech—including AI-edited bodies—are further distorting body image online. They also examine how neurodivergent teens, who are often more vulnerable to extreme thinking and sensory overload, may be especially impacted by these trends. Plus, they critique the rise of weight loss drugs like Ozempic and their potential to normalize restriction—even in pediatric settings. WHAT YOU'LL LEARN IN THIS EPISODE: Why SkinnyTok still exists despite being technically banned How TikTok's algorithm can push disordered content—even without user interaction What “pro-ana” and “thinspo” culture looks like in 2025 The physiological damage caused by overexercise and undereating How social media is shaping disordered eating culture in schools globally The link between ADHD, cortisol, and disordered eating behaviors How weight loss drugs like Ozempic may impact teens' mental and physical health Why media literacy and early intervention in schools are urgently needed CONTENT CAUTIONS: This episode includes discussion of disordered eating, anorexia, pro-eating disorder content, social media harm, and weight loss medications including Ozempic and Zepbound. MEET OUR GUEST: Jen Tomei is the founder of Jenup.com, a UK-based organization providing school workshops on eating disorder prevention, body image, and self-esteem. A survivor of an eating disorder and a late-diagnosed ADHD adult, Jen brings both lived experience and professional insight into the complex intersection of neurodivergence, mental health, and diet culture.

In this solo episode, Dr. Marianne Miller, LMFT, breaks down the reality of atypical anorexia and challenges the damaging myth that only thin people struggle with restrictive eating. Despite the name, atypical anorexia is far from rare—and for many people in mid-sized and fat bodies, it goes undetected, misdiagnosed, or even encouraged by medical providers because of weight stigma. Dr. Marianne explores why restriction is deeply harmful regardless of body size, and shares research showing that at least 50% of people who meet anorexia criteria are not in bodies typically identified as anorexic. She also explains how neurodivergence—including autism, ADHD, and OCD traits—can interact with restriction, and why sensory-attuned, neurodivergent-affirming, and trauma-informed care is essential. If you've ever felt like you weren't “sick enough” to deserve support, this episode is here to offer clarity, validation, and the reminder that you are already worthy of care. WHAT YOU'LL LEARN IN THIS EPISODE: What atypical anorexia actually means and why the name is misleading The percentage of people with anorexia who are not underweight The effects of weight stigma in delaying eating disorder diagnosis and treatment How restriction harms people in every body size The connection between neurodivergence and restrictive eating Why restriction “counts” even if you haven't lost weight How healing begins with naming the disorder and receiving affirming care CONTENT CAUTIONS: This episode includes discussion of restrictive eating, weight stigma, medical complications, and BMI. Please listen with care and take breaks if needed. CHECK OUT OTHER PODCAST EPISODES ON ATYPICAL ANOREXIA: 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. WORK WITH DR. MARIANNE: If you're struggling with restriction, food obsession, or atypical anorexia and are seeking affirming, experienced support, Dr. Marianne offers therapy in California, Texas, and Washington, D.C. Her approach is weight-inclusive, neurodivergent-affirming, and trauma-informed. Get started here:

Still feeling stuck in recovery, even after therapy, nutrition work, or intuitive eating? You are not alone. In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores a common but often overlooked reason why recovery can feel incomplete: the possibility of living with more than one eating disorder at the same time. Through a trauma-informed and neurodivergent-affirming lens, Dr. Marianne unpacks how symptoms from anorexia, ARFID, bulimia, binge eating disorder, and orthorexia can overlap. She explains why traditional treatment models often miss the full picture and offers insights for those whose food struggles are complex, ongoing, and still misunderstood. This episode offers clarity, encouragement, and real solutions for those who have been feeling unseen in recovery. CONTENT CAUTIONS: This episode includes discussion of the following topics: Eating disorder behaviors including restriction, bingeing, purging, and food avoidance Co-occurring and misdiagnosed eating disorders Sensory aversions and food-related trauma Weight stigma and systemic bias in diagnosis Neurodivergent experiences related to eating Please care for yourself while listening. Take breaks as needed and return when you feel ready. WHAT YOU'LL LEARN IN THIS EPISODE: Why multiple eating disorders can exist at the same time How eating disorder symptoms often overlap or shift over time Examples of combinations like ARFID with anorexia, or binge eating with orthorexia The ways neurodivergence, trauma, and marginalization impact eating behavior Why traditional recovery approaches may not work for everyone What it means to build a recovery model that supports your full lived experience Encouragement for those who feel like their recovery has stalled or isn't working How to seek care that addresses the full picture rather than one diagnosis MENTIONED IN THIS EPISODE:

In this soul-nourishing and deeply insightful episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller sits down with fat liberationist author and activist Amanda Martinez Beck to unpack what it really means to live with diabetes in a fat body—especially in a medical system steeped in anti-fat bias. Amanda shares her personal journey of being diagnosed with type 2 diabetes while navigating eating disorder recovery, medical gaslighting, and societal pressure around weight loss drugs like Ozempic. She reflects on how reclaiming the word “fat,” grounding her activism in faith and philosophy, and building fat community have supported her in choosing self-trust over shame. You'll hear about her healing journey, her shift from size dignity to fat liberation, and her vision of a world designed with fat people in mind. In this episode, we explore: Why diabetes stigma in fat bodies is so dangerous—and so common The liberating power of community with other fat people How Amanda's beliefs as a Christian and a philosopher shape her body politics Her experience with Ozempic, including what led her to stop taking it The emotional toll of medical fatphobia—and how she found a weight-inclusive doctor The birth of her substack series Nozempic Mondays, a haven for people resisting GLP-1 pressure If you've ever felt dismissed by providers, pressured to shrink your body for “health,” or like your needs in a fat body are invisible—this episode is for you. You are not alone. You deserve care that honors your whole self. CONTENT CAUTIONS: Discussion of weight loss, eating disorders, diabetes, Ozempic, and medical trauma. GUEST BIO: 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 WORK WITH DR. MARIANNE: Dr. Marianne Miller is a licensed eating disorder therapist offering therapy in California, Texas, and Washington, D.C., and ARFID consulting worldwide. She specializes in helping neurodivergent and humans of all shapes and sizes heal their relationship with food, bodies, and eating. Learn more at www.drmariannemiller.com OTHER EPISODES ON BODY LIBERATION THAT YOU MIGHT LIKE: Body Liberation, Intersectionality, & Soul Work with @liberatiwellness Leslie Jordan Garcia, MPH, PT on Apple & Spotify. Body Acceptance, Size Diversity, & Body Liberation on Apple & Spotify. Breaking Free: Body Liberation After Binge Eating Disorder with Sophia Apostol @fatjoy.life 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

Struggling to tell the difference between OCD and ARFID—or wondering if you or your client might be dealing with both? You're not alone. In this episode of Dr. Marianne-Land, Dr. Marianne explores the nuanced relationship between Obsessive-Compulsive Disorder (OCD) and Avoidant/Restrictive Food Intake Disorder (ARFID)—two conditions that often overlap and require very different support. Learn how to differentiate between OCD rituals and ARFID food avoidance, what misdiagnosis of OCD in ARFID can look like (especially in neurodivergent individuals), and how these conditions show up differently in children versus adults. You'll also hear how nervous system regulation and sensory attunement play a central role in supporting sustainable recovery. Whether you're a therapist, caregiver, or neurodivergent person navigating food fears, this episode offers a validating, trauma-informed, and practical perspective on complex eating presentations.

Struggling with bulimia in your 30s, 40s, 50s, or beyond? You're not alone. In this solo episode, Dr. Marianne Miller explores what bulimia can look like in midlife, why the internal chaos may actually intensify with age, and how to approach healing without shame. We dig into the unique emotional and physiological challenges of recovering from bulimia later in life, including how hormonal shifts, grief, caregiving roles, and long-term masking can impact eating behaviors. Dr. Marianne also unpacks how neurodivergence—especially autism, ADHD, and PDA—can intersect with bulimia symptoms, intensifying binge-purge cycles and making traditional recovery models inaccessible or even harmful. You'll learn why your body's responses make sense, how to regulate your nervous system with neurodivergent-affirming strategies, and what it actually takes to move toward healing—on your terms. WHAT WE COVER IN THIS EPISODE Why bulimia often resurfaces or intensifies in midlife How midlife stress, identity shifts, and cultural stigma contribute to internal chaos The link between bulimia, sensory overwhelm, and emotional regulation How neurodivergent traits like executive dysfunction, masking, and interoceptive challenges affect eating behaviors Why shame-based approaches don't work—and what actually helps Practical, compassionate tools for managing binge urges, purging, and nervous system dysregulation Why recovery in midlife is not only possible—but deeply liberating THIS EPISODE IS FOR YOU IF... You feel stuck in a binge-purge cycle despite years of effort You're neurodivergent and traditional ED treatment hasn't helped You've been quietly struggling with bulimia in midlife and feel alone in it You want recovery tools that are sensory-attuned, autonomy-affirming, and realistic

In this powerful conversation, Dr. Marianne welcomes back body image coach and anti-diet educator Debbie Saroufim for a candid discussion about what happens when weight loss triggers eating disorder thoughts—even in solid recovery. Debbie opens up about how recent stress and anxiety have impacted her appetite and body, and how unsolicited weight-related comments from others can be both activating and isolating. Together, we unpack why even “positive” feedback about weight loss can be harmful, how body changes can feel destabilizing, and what it means to hold complex emotions without slipping back into disordered behaviors. We also talk about: The problem with equating weight loss with wellness How eating disorder thoughts can show up years into recovery The myth of a “correct” body image or recovery experience Perimenopause, changing bodies, and the grief that can follow Why body neutrality may offer more freedom than forced body positivity Mindfulness, fart metaphors (yay!), and how to let thoughts pass without bottling them up Whether you're in recovery, supporting someone who is, or navigating your own relationship with body changes, this episode offers honesty, compassion, and tools to help you stay grounded.

In this solo episode, Dr. Marianne Miller explores the powerful and often overlooked connection between masking neurodivergence and eating disorders. If you've ever felt like you're performing just to get through the day—suppressing your sensory needs, camouflaging your communication style, or overriding your body's cues to fit societal expectations—this episode will resonate deeply. Dr. Marianne breaks down what masking looks like in autistic and neurodivergent individuals, including social, sensory, emotional, and cognitive masking, and how these patterns can lead to or exacerbate disordered eating behaviors like restriction, bingeing, and compulsive exercise. She also explains the systemic pressures—including ableism, fatphobia, and white supremacy—that reinforce masking, and how this contributes to burnout, identity confusion, and food-related distress. Most important, Dr. Marianne offers a compassionate look at what it means to unmask as part of eating disorder recovery. You'll learn how reclaiming your sensory needs, autonomy, and embodied preferences can help you heal—not by becoming someone else, but by honoring exactly who you are.

Autistic individuals are significantly more likely to experience eating disorders—but the signs often go unrecognized, and traditional treatment models frequently fall short. In this solo episode, Dr. Marianne explains the unique ways eating disorders show up in autistic people, why those struggles are often misunderstood, and what kind of support actually helps. You'll learn about the sensory, emotional, and social dimensions of disordered eating in autistic individuals, the high rates of ARFID and anorexia in this population, and why interoception, masking, and shutdowns often complicate recovery. Most importantly, this episode explores the power of neurodivergent-affirming, trauma-informed care—care that adapts to the client rather than forcing the client to adapt to the system. Whether you're autistic, suspect you might be, or support someone who is, this episode offers validation, clarity, and a path forward that doesn't rely on shame or compliance.