Podcasts about arfid

This episode is… very ADHD.We start with a quick revisit of ARFID after hearing from a listener who shared a powerful personal experience. Then we dive into your voicemails—covering everything from the heavy question of how to repair damage we worry we've done to our kids, to a very relatable struggle: emotional “doom piles.”And because no ADHD episode would be complete without a little delightful distraction, we wrap things up by watching some hilarious ADHD reels together.It's thoughtful, honest, a little chaotic, and full of those “wait… is this just me?” moments. If you've ever had a brain that jumps track mid-sentence, you'll feel right at home here.Watch this episode on YouTubeWant help with your ADHD? Join FOCUSED!Have questions for Kristen? Call 1.833.281.2343Hang out with Kristen on Instagram and TikTokSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Eating disorder recovery can feel frightening for reasons that go far deeper than food, weight, or body image. One of the most powerful drivers of eating disorder behaviors is fear of uncertainty. When recovery removes rigid rules and predictable routines, the nervous system can interpret that loss of certainty as danger. In this episode, Dr. Marianne explores how fear of uncertainty operates underneath many eating disorder behaviors and why letting go of control can feel destabilizing. She explains the psychology of intolerance of uncertainty and how eating disorders such as anorexia, bulimia, binge eating disorder, and ARFID can develop as attempts to create predictability in an overwhelming world. Intolerance of Uncertainty and Eating Disorders Many people with eating disorders experience what psychologists call intolerance of uncertainty. This means the brain interprets ambiguity and unpredictability as unsafe. Instead of thinking “I don't know what will happen but I can cope,” the nervous system may assume that something bad will happen if there is not a clear plan or outcome. Eating disorder behaviors can temporarily reduce this distress. Restrictive eating, binge eating, purging, body checking, and rigid food rules can create the illusion of certainty. These patterns often lower anxiety in the short term, which reinforces the cycle and makes recovery feel more intimidating. Dr. Marianne explains how this dynamic shows up in eating disorder recovery and why the loss of rigid control can trigger powerful anxiety responses. Why Uncertainty Feels Especially Hard for Neurodivergent People For many listeners, fear of uncertainty is intensified by neurodivergence, trauma history, or systemic stress. Changes in routine, fluctuating internal cues, sensory differences, and executive functioning challenges can all make unpredictability feel overwhelming. Dr. Marianne discusses how autism, ADHD, and other neurodivergent experiences can interact with eating disorders and recovery. She also highlights how weight stigma, ableism, racism, and other systemic pressures can make uncertainty in eating disorder recovery feel even riskier. Understanding these contexts helps shift the conversation from shame to compassion. Microdosing Uncertainty in Eating Disorder Recovery A key concept introduced in this episode is microdosing uncertainty. Instead of forcing dramatic change, recovery can involve practicing small, manageable exposures to unpredictability. Dr. Marianne explains how gradually introducing small shifts in eating patterns, routines, or body-related behaviors can help retrain the nervous system. These repeated experiences allow the brain to learn that uncertainty does not automatically lead to catastrophe. Microdosing uncertainty can help expand the window of tolerance and make eating disorder recovery feel more sustainable. Five Practical Skills for Managing Fear of Uncertainty This episode also explores five practical skills that can help people tolerate uncertainty in eating disorder recovery. Dr. Marianne discusses the importance of practicing small exposures to uncertainty, accurately naming nervous system reactions, creating compassionate structure that reduces overwhelm, regulating anxiety through body-based techniques, and cultivating contextual self-compassion. These skills help widen emotional capacity so recovery does not feel like stepping into chaos. Instead, listeners can gradually build confidence in their ability to navigate unpredictability. Related Episodes An Open Letter to the Body: Listening to the Part That Fears Getting Better on Apple and Spotify. Eating Disorders as Safety Systems: Why Letting Go Can Trigger Fear on Apple and Spotify. If Recovery Feels Unsafe Right Now: A Guided Moment for Eating Disorder Recovery Fear on Apple and Spotify. Expanding Freedom Beyond Eating Disorder Rules Eating disorders often promise certainty, but they narrow life in the process. Recovery may introduce unpredictability, yet it also expands possibilities for nourishment, flexibility, connection, and autonomy. Dr. Marianne emphasizes that recovery is not about eliminating uncertainty. The goal is to build the capacity to live meaningfully alongside it. Therapy and Self-Paced Eating Disorder Recovery Courses If this episode resonates with you and you are looking for additional support, you can visit Dr. Marianne's website to learn more about therapy and self-paced recovery courses. Dr. Marianne is a Licensed Marriage and Family Therapist specializing in eating disorders, including ARFID, binge eating disorder, anorexia, and bulimia. She offers therapy services in California, Texas, and Washington DC and provides virtual courses for people seeking flexible recovery resources. You can learn more about therapy and courses at drmariannemiller.com.

If eating disorder recovery has made your stomach feel worse instead of better, you are not alone. Many people experience bloating, constipation, reflux, stomach pain, and fullness during recovery. These symptoms can feel frightening and discouraging, especially when they show up after you start nourishing your body more consistently. In this solo episode, Dr. Marianne Miller, LMFT, explains why gastrointestinal symptoms are common during eating disorder recovery and why they do not mean recovery is failing. You will learn how restriction affects the digestive system, why symptoms sometimes intensify during early recovery, and what helps the gut heal over time. Dr. Miller also shares practical strategies for coping with GI discomfort while continuing recovery. This episode offers compassionate guidance for navigating one of the most misunderstood parts of eating disorder healing. Why GI Issues Are Common in Eating Disorder Recovery Many people are surprised when digestive symptoms worsen after they begin eating more consistently. Bloating, constipation, reflux, nausea, and stomach pain can make recovery feel confusing or even frightening. In this episode, Dr. Marianne Miller explains how restrictive eating, purging, inconsistent nourishment, and limited food variety affect the gastrointestinal system. When the body does not receive enough energy, digestion slows in order to conserve resources. Motility decreases, stomach emptying may become delayed, and the muscles of the digestive tract lose strength over time. When nourishment increases during recovery, the digestive system must relearn how to function. This recalibration process can temporarily intensify symptoms. While uncomfortable, these changes are often part of the gut rebuilding normal digestive rhythms. Common Digestive Symptoms During Eating Disorder Recovery People in eating disorder recovery frequently report symptoms such as bloating, constipation, reflux, abdominal discomfort, nausea, and early fullness. These symptoms may appear during early refeeding or after increasing meal consistency. Dr. Miller discusses how slowed gastrointestinal motility, microbiome changes, and nervous system activation contribute to these experiences. She also explains why bloating can feel especially distressing in a culture that places intense pressure on stomach appearance and body size. Understanding the physiology behind these symptoms can help reduce fear and prevent the eating disorder from using GI discomfort as justification for returning to restriction. The Gut Is Adaptable and Healing Is Possible One of the most important messages of this episode is that the digestive system is highly adaptable. With consistent nourishment, hydration, and medical support when needed, the gastrointestinal tract can recover significant function. Over time, stomach emptying can improve, bowel patterns can normalize, and abdominal discomfort can decrease. The gut lining regenerates, digestive enzymes adjust, and the microbiome can become more balanced. Recovery does not always follow a straight line, but healing is possible when the body receives consistent energy and care. Practical Ways to Cope With GI Symptoms in Recovery This episode also explores practical ways to cope with digestive discomfort while continuing eating disorder recovery. Dr. Miller discusses the role of mechanical eating in helping retrain digestive rhythms and why regular meals often support gastrointestinal healing. Sensory supports can also help regulate the nervous system, including wearing loose clothing, using a heating pad on the abdomen after meals, and creating calming eating environments. Hydration can support bowel function, and gentle abdominal massage may help stimulate motility. For some individuals, medical providers may recommend medications or short term treatments to reduce symptoms such as constipation, reflux, or delayed gastric emptying. Dr. Miller emphasizes that any movement during eating disorder recovery must be cleared by a medical provider first. If a physician has determined that movement is safe, gentle activities such as short walks or stretching may sometimes support digestion. Medical clearance is essential before incorporating movement into recovery. The Role of Medical Support in GI Healing Because digestive symptoms can overlap with other medical conditions, collaboration with an eating disorder informed medical provider is important. Physicians can help assess symptoms, rule out other causes, and recommend appropriate treatments when needed. Medications or medical supports may be helpful for constipation, reflux, nausea, or delayed gastric emptying. Seeking medical care for GI symptoms does not mean recovery is failing. It means symptoms are being treated compassionately and responsibly. Intersectionality and GI Symptoms Dr. Miller also highlights how systemic bias can affect how digestive symptoms are treated. People in larger bodies may have GI concerns dismissed as weight related rather than recognized as recovery related. People of color may experience undertreatment of pain. Neurodivergent individuals may experience sensory distress that is misunderstood or minimized. Acknowledging these realities helps contextualize why some people struggle to receive appropriate care and why compassionate, informed providers are so important. A Message of Hope for Eating Disorder Recovery GI distress during eating disorder recovery can feel discouraging, especially when symptoms appear after you begin nourishing your body more consistently. But digestive discomfort does not mean recovery is harming you. In many cases, it means the digestive system is relearning how to function. With time, consistent nourishment, appropriate medical support, and nervous system regulation, many people see meaningful improvement in digestive symptoms. Your body is not failing you. It is adjusting and healing. Work With Dr. Marianne Miller Dr. Marianne Miller, LMFT, is a fat eating disorder therapist who specializes in binge eating disorder, ARFID, and complex eating disorder recovery. She works with clients in California, Texas, Washington DC, and internationally through virtual therapy and coaching. If you are looking for eating disorder therapy that integrates physiology, neurodivergent affirming care, and liberation informed approaches, you can learn more about working with Dr. Miller at her website drmariannemiller.com. She also offers self-paced courses and resources designed to support sustainable eating disorder recovery.

Moving from understanding to healing in pediatric feeding care.Earn 0.10 ASHA CEUs for this episode with Speech Therapy PDWatch on YoutubeIn this episode of First Bite, Michelle Dawson, MS, CCC-SLP, CLC, BCS-S, is grateful to host Lauren Thompson, MEd, CCC-SLP, CLC, for a powerful conversation about trauma and Pediatric Feeding Disorder (PFD). Healing trauma takes time, compassion, and the willingness to move through fear in order to better understand what “trauma” is, especially as it relates to pediatric feeding. Together, Michelle and Lauren differentiate between “trauma-informed” and “trauma-sensitive” care, and Lauren offers thoughtful, practical strategies to help SLPs create trauma-sensitive feeding environments for those they are called to serve.This is part one of a two-part conversation. Part two will be released in April 2026.About the Guest(s): Lauren Thompson, M.Ed., CCC-SLP, CLC, is the owner of Well Fed Feeding & Swallowing Therapy in Londonderry, New Hampshire. Since 2012, she has supported infants and children with PFD, dysphagia, lactation challenges, ARFID, and feeding-related trauma across inpatient rehabilitation, hospital-based outpatient care, Level II and III NICUs, and public schools. Lauren blends trauma-sensitive care, connection-focused interventions, and play-based approaches to help families build safe, joyful, and pressure-free mealtime experiences.Show Notes:Contact Lauren: @laurenteetheslp on InstagramLauren's Private Practice: Well Fed Feeding TherapyLove Money Cause: Feeding MattersRelated Course: Allyship and Advocacy in Pediatric Feeding Disorder with Tracy Camille JohnsonMentioned in this episode:Register for the School-based Feeding and Swallowing Masterclass

Have you ever had the experience of suddenly feeling huge in your body, even though nothing about your body has actually changed? That moment of intense body distress is incredibly common in eating disorder recovery. But what if that feeling is not really about body size at all? In this episode of Dr. Marianne-Land, Dr. Marianne Miller is joined by Amy Ornelas, RDN, an eating disorder dietitian, yoga teacher, and somatic therapy practitioner, to explore what body distress may actually be signaling underneath the surface. Together, they unpack how thoughts like “I feel huge” can often reflect emotional activation, overwhelm, grief, shame, anger, or stress rather than a literal change in body size. Amy explains how eating disorder behaviors such as restriction, binge eating, and purging can alter brain chemistry and disconnect people from their internal emotional world. When those behaviors begin to shift in recovery, many people suddenly find themselves face to face with emotions that may have been numbed or pushed aside for years. This can feel confusing, intense, and sometimes even frightening. Dr. Marianne and Amy talk about how eating disorders can function as powerful survival strategies that help people manage overwhelming emotional states. Rather than demonizing these behaviors, they explore how they often develop as adaptive coping mechanisms in environments where emotional expression was discouraged, dismissed, or unsafe. The conversation also highlights how family dynamics, culture, trauma, and neurodivergence can shape the way people learn to relate to their emotions. Many individuals grow up hearing messages that they are too sensitive, too emotional, or should simply get over what they feel. Over time, these messages can make emotional awareness feel dangerous or overwhelming. Amy introduces the role of somatic therapy in eating disorder recovery and explains how body-based approaches can help people reconnect with their internal sensations in a gradual and supportive way. Instead of forcing emotional processing, somatic work focuses on building safety in the nervous system and slowly increasing the capacity to notice and tolerate emotional states. Dr. Marianne and Amy also discuss how body image distress can function as a powerful distraction. It can feel easier to focus anger, fear, or grief on the body than to confront deeper sources of pain, such as relational conflict, social stress, or systemic injustice. Learning to translate body distress into emotional language can help people understand what their internal system is truly trying to communicate. This episode also addresses an important reality in eating disorder recovery: sometimes people appear more emotionally dysregulated as they begin healing. That increase in emotional expression can actually be a sign that someone is reconnecting with their inner world after years of emotional numbing. Amy shares several practical tools that can help people begin reconnecting with their emotions, including brief emotional check-ins throughout the day, asking simple questions about what feelings may be present when eating disorder urges arise, and using movement to help emotional energy move through the body. Dr. Marianne also brings in a neurodivergent-affirming lens, discussing how stimming, rocking, sensory soothing, and other nervous system supports can help people stay connected to themselves during emotionally intense moments. Together, they emphasize that emotions are not problems to eliminate. They are information from our internal systems that help guide us toward safety, boundaries, authenticity, and healing. In this episode, we discuss How eating disorder behaviors can numb or redirect difficult emotions. Why recovery often brings a surge of feelings to the surface, What somatic therapy is and how it can support eating disorder recovery. Why the thought “I feel huge” often reflects emotional distress rather than body change. How trauma, family systems, and culture shape emotional expression. Why body image distress can act as a distraction from deeper pain. The difference between compartmentalizing emotions and avoiding them. Why increased emotional intensity can be a sign of progress in recovery. Practical ways to begin noticing and naming emotions during recovery. How neurodivergent people may benefit from stimming and sensory supports. About the guest Amy Ornelas, RDN, is a registered dietitian nutritionist, eating disorder specialist, yoga teacher, and somatic therapy practitioner based in California. She works with individuals, families, and groups and integrates nutrition care with somatic and nervous system–informed approaches to eating disorder recovery. Connect with Amy Ornelas Instagram: @amyornelasRD Website: i-heart-nutrition.com Listen if you are Experiencing intense body image distress during eating disorder recovery. Trying to understand why recovery can bring more emotion, not less. Curious about somatic therapy and body-based approaches to healing. Looking for tools to help manage urges to restrict, binge, or purge. Interested in understanding the emotional layers beneath body distress. Related episodes On Eating Disorders as a Coping Strategy for Deeper Pain via Apple or Spotify. 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. Final note Body distress can feel incredibly convincing in the moment. But sometimes the feeling that your body is the problem is actually your emotional system trying to communicate something deeper. Learning to listen to those signals can be a powerful part of eating disorder recovery. Contact Dr. Marianne Check out Dr. Marianne's self-paced, virtual courses on ARFID and binge eating, as well as her therapy services in California, Texas, and Washington D.C., at her website drmariannemiller.com.

Your Questions Answered: Meal Plans, Bloating, Hunger, OCD, Movement & MoreRight then, let's get into it.I put a question box on Instagram and you all delivered. This episode is a juicy Q&A where I'm answering some of the most common — and some of the most vulnerable — questions that came in. From meal plans and bloating to OCD with binge eating, compulsive exercise trauma, self-care as avoidance, and ARFID being misdiagnosed in hospitals. We cover a lot of ground and I am not holding back.This episode is for you if:You're unsure whether to stick with your meal plan or eat intuitivelyYou're bloated, uncomfortable, and wondering when it will ever endYour hunger signals have disappeared and you don't know how to eat without themYou have OCD rituals around food and wonder if full recovery is even possible for youThe thought of exercise sends you into panic and freeze modeYou're doing all the self-care things but still feel like you're avoiding somethingYou or someone you love has ARFID and is being treated like they have anorexiaIn this episode, we cover:✨ Meal plans versus intuitive eating — the real questions you need to ask yourself first✨ How long bloating actually lasts in recovery and why it's a sign your body is healing✨ Why your digestive system needs time and what's really happening inside your body✨ How to eat when you have zero hunger — and why waiting for hunger is still restriction✨ Mechanical eating explained — what it is, why it works, and why it's worth it✨ OCD with binge eating disorder — yes, full recovery is absolutely possible✨ Why your OCD latches onto food specifically and what your nervous system is really asking for✨ Practical steps for OCD rituals around food — including tiny acts of rebellion✨ The freeze response around movement — why it's not a problem to fix, it's a body screaming for safety✨ Why you do not have a movement problem — you have a nervous system problem✨ Why forcing yourself back to exercise right now would be re-traumatising✨ What somatic healing practices actually look like when you're not ready for the gym✨ The difference between self-care as support versus self-care as avoidance✨ What true surrender actually looks like — and why it's uncomfortable on purpose✨ ARFID versus anorexia — why treating them the same way is harmful and what ARFID actually needsPowerful quotes from the episode:

Weight stigma affects far more than body size. It shapes healthcare, mental health treatment, and eating disorder recovery for people across all bodies. In this solo episode, eating disorder therapist Dr. Marianne Miller, LMFT, examines how anti-fat bias operates inside medical systems, mental health care, and everyday cultural messages about bodies. Weight stigma does not only harm people in larger bodies. It distorts how clinicians diagnose illness, how providers respond to symptoms, and how individuals relate to food, movement, and self-worth. People in larger bodies often face delayed diagnosis, dismissal of medical concerns, and barriers to eating disorder treatment. At the same time, people in smaller bodies frequently receive praise for behaviors that signal medical or psychological danger, which can hide eating disorders and delay care. In this episode, Dr. Marianne explores how weight stigma disrupts physical health, fuels disordered eating, and complicates recovery. Anti-fat bias increases stress, discourages people from seeking medical care, and encourages shame-based approaches to health. These pressures influence people across body sizes. They can lead individuals to distrust hunger cues, suppress bodily needs, and feel that their worth depends on body size. This conversation also explores how weight stigma interacts with other systems of oppression. Racism, ableism, gender bias, and class inequality can amplify weight-based discrimination in healthcare and mental health settings. When these systems overlap, people often experience greater barriers to accurate diagnosis, compassionate treatment, and sustainable eating disorder recovery. Dr. Marianne also discusses how a liberation-centered approach to treatment can support healing. Recovery becomes more possible when clinicians prioritize autonomy, body respect, and nervous system safety rather than weight control. Challenging anti-fat bias allows providers to offer more accurate care and helps clients rebuild trust with their bodies. If you have ever wondered why eating disorder recovery can feel harder in a culture obsessed with body size, this episode offers an important perspective. Addressing weight stigma creates space for more compassionate healthcare, more effective mental health treatment, and more accessible eating disorder recovery for people in every body.   Here are some related episodes: Anti-Fat Bias in Healthcare & Chronic Illness: Healing Body Image in a Marginalized Body With Ivy Felicia @iamivyfelicia on Apple and Spotify. Medical Weight Stigma & Eating Disorders on Apple & Spotify. Having Anorexia in a Larger Body: Navigating Medical Anti-Fat Bias & Lack of Care with Sharon Maxwell @heysharonmaxwell on Apple & Spotify.   Dr. Marianne Miller is a licensed marriage and family therapist specializing in eating disorder recovery, including ARFID, binge eating disorder, anorexia, and bulimia. Her work centers neurodivergent-affirming care, body liberation, sensory attunement, and trauma-informed treatment that supports long-term healing. You can learn more about therapy with Dr. Marianne Miller or explore her self-paced courses on eating disorder recovery via her website at drmariannemiller.com.

Many people believe restrictive eating is easy to recognize. They picture dramatic weight loss, visible food refusal, or a body that clearly signals medical danger. In reality, restrictive eating often develops quietly and exists on a wide spectrum that includes subtle undereating, ARFID, atypical anorexia, and chronic long-term restriction. In this solo episode, Dr. Marianne Miller explores the restrictive eating spectrum and explains why restriction does not always look the way people expect. Restrictive eating can appear in socially normalized patterns like skipping meals, chronic undereating, rigid food rules, sensory-based food avoidance, or medicalized dieting. Many people living with restriction never receive proper screening or support because their bodies or eating patterns do not match stereotypes about eating disorders. This episode also explores how neurodivergence, sensory sensitivities, trauma, and interoceptive differences can shape restrictive eating patterns, particularly in people with ARFID (Avoidant Restrictive Food Intake Disorder). Even when body image concerns are not present, the body can still experience significant restriction that affects mood, digestion, metabolism, and cognitive functioning. Dr. Marianne also examines so-called "atypical anorexia" and restrictive eating in higher-weight bodies, highlighting how weight stigma and anti-fat bias in healthcare can delay diagnosis and treatment. Many individuals experience serious medical complications from restriction while being told they are healthy or encouraged to continue dieting. The episode also addresses chronic restrictive eating, which can persist for years or decades and reshape hunger cues, nervous system regulation, and energy levels. Dr. Marianne explains how long-term restriction affects the body and why recovery requires more than simply “trying harder” to eat. Finally, this conversation explores what meaningful recovery looks like across the restrictive eating spectrum. Healing requires adequate nourishment, autonomy, compassionate support, and liberation from shame-based food culture. Recovery is not about perfection or rigid rules. It is about helping the body move toward safety, nourishment, and greater freedom over time. If you have ever wondered whether restrictive eating always fits inside a single diagnosis, or if your own relationship with food feels difficult to explain, this episode offers a broader and more compassionate framework for understanding what restriction can look like and how recovery can begin. Related Episodes Anorexia in Higher-Weight Bodies: Rethinking “Atypical Anorexia” & the Restrictive Eating Spectrum With Dr. Jennifer Gaudiani, MD @gaudianiclinic on Apple and Spotify. Anorexia & Night Eating Syndrome: Why Restriction Fuels Night Eating & What Helps on Apple and Spotify. The Quiet Places Where Anorexia Meets Identity & Expression on Apple and Spotify. Topics Discussed in This Episode Restrictive eating spectrum and why restriction is often invisible Subtle undereating and socially normalized food restriction ARFID and sensory-based restrictive eating patterns Being neurodivergent, experiencing interoception, and having eating issues. Atypical anorexia and restrictive eating in higher-weight bodies Weight stigma and diagnostic gaps in eating disorder care Chronic restrictive eating and long-term nervous system changes What real eating disorder recovery requires across the restrictive eating spectrum Resources Mentioned Dr. Marianne Miller's ARFID and Selective Eating Course teaches neurodivergent-affirming and sensory-attuned approaches to expanding nourishment safely and compassionately. The course provides structured guidance for individuals navigating ARFID, restrictive eating patterns, and complex relationships with food. You can learn more about the course and other recovery resources at drmariannemiller.com. Listen and Support the Podcast If this episode resonated with you, consider following the podcast, leaving a review, or sharing the episode with someone who may benefit from hearing it. These small actions help more people find compassionate, evidence-informed conversations about eating disorder recovery.

In this episode, we welcome Naureen Hunani, a registered dietitian, educator, and the founder of Registered Dieticians or RDs for Neurodiversity, a group dedicated to changing how healthcare and mental health providers can support neurodivergent people with feeding and eating challenges. Her work focuses on the lived experiences of autistic and neurodivergent people and the intersection of feeding differences, feeding challenges, eating disorders, and Avoidant/Restrictive Food Intake Disorder or ARFID. By supporting disability and neurodiversity, Naureen challenges harmful, compliance-based feeding models and advocates for healthcare rooted in personal choice, access, and dignity. She is widely known for connecting clinical nutrition, disability rights, and social justice to help families, clinicians, and systems rethink what truly supportive, ethical feeding care looks like. https://adalive.org/episodes/episode-151/-Archive, Bios, Description, and Transcripts for Episode 151: When Eating Is a Disability Rights Issue

Why do some people with autism, ADHD, or AuDHD rely on the same safe foods every day, while certain textures or smells make eating feel impossible? In this episode, therapist and AuDHD advocate Patrick Casale shares how food sensory issues, texture aversion, and safe foods shape eating patterns for many neurodivergent adults. In this conversation, Dr. Marianne Miller speaks with Patrick about his experience of late-diagnosed autism and ADHD and how sensory sensitivities affect food choices, routines, and daily life. Patrick describes intense texture aversions, smell sensitivity, and the role safe foods play in creating nervous system stability. They also explore the internal tension many people with AuDHD experience between routine and novelty. Eating the same foods repeatedly can feel regulating and predictable, yet the ADHD side of the brain may crave variety and change. Patrick shares how this push and pull can make food decisions unexpectedly stressful. The discussion also touches on body dysmorphia in men, the pressure of toxic masculinity around appearance and strength, and why many men struggling with body image or eating concerns remain invisible in eating disorder conversations. Patrick also reflects on unmasking and self-advocacy, including honoring sensory needs, choosing comfortable clothing, and setting boundaries around overwhelming social expectations. About Patrick Casale Patrick Casale is an AuDHD TEDx speaker, therapist, podcaster, and consultant. He is the founder of All Things Private Practice and Resilient Mind Counseling. Patrick hosts the All Things Private Practice podcast and co-hosts Divergent Conversations with Dr. Megan Neff of Neurodivergent Insights. He also writes about late-discovered autism and ADHD on Substack in his newsletter The Grief Relief Paradox. Connect with Patrick on Instagram: @patrick.casale Related Episodes “Stuck” Isn't Lazy: Inertia in ADHD, Autism, & Eating Disorder Recovery With Stacie Fanelli, LCSW on Apple & Spotify. Autism & Eating Challenges: Understanding Sensory Needs, Routines, & Safety on Apple & Spotify. Work With Dr. Marianne Miller Dr. Marianne Miller is a licensed marriage and family therapist who specializes in eating disorders, ARFID, binge eating disorder, and neurodivergent experiences with food. Check out her website at drmariannemiller.com. To learn more about therapy with Dr. Marianne Miller or explore her self-paced virtual courses on eating disorder recovery, visit her website. Topics discussed: AuDHD, autism and ADHD, food sensory issues, texture aversion, safe foods, body dysmorphia in men, neurodivergent eating.

We are Virginia Sole-Smith and Corinne Fay and it's time for your February Indulgence Gospel!Today we are talking about influencers who show their expensive influencer grocery hauls, as well as people who spend A LOT OF MONEY on food delivery. (If you too had feelings about that ChrisLovesJulia reel...let's get into it!) We also talk about our own spending on groceries and food delivery....and our complicated feelings about both.

For years, Melissa MacMillan's opioid addiction brought chaos to her life - especially with her daughter Eden. Now, almost five years into recovery, Melissa and Eden share the tough conversations they're having as they try to rebuild their relationship.What does it take to be truly 'out of the woods,' getting through one big life hurdle, only to face a whole new set of challenges? That's what this episode of Now or Never is all about.A few weeks ago, Lisa de Lusignan wrote in to Now or Never to tell us about losing her husband to ALS, and the surprising thing helping her through her grief: pickleball. So of course we called her up, to find out how joy and sadness co-exist on the pickleball courts. “Nobody looked at me like, ‘Oh geez, I hope she's OK today.' Which is fine! And lovely for people to do that. But sometimes I just want to be a girl coming to play pickleball, not the sad wife."Since coming to Canada from Eritrea 23 years ago, Alazar Beyene has been giving new life to old shoes. But with the rise of fast fashion, business declined, so when his old patching machine broke down, Alazar was thinking about changing careers. Enter Marsha Shandur and her beloved winter boots. How Marsha turned to the power of the people for help to replace Alazar's machine. Mary Howley is on the hunt for a part-time job. She worked in the financial industry for nearly 30 years, but living as a single retiree in Ontario isn't as financially secure or care-free as she'd hoped.Tiffany Bird went 25 years without ever consuming a vegetable. She has ARFID, a fairly new and often misunderstood eating disorder that significantly restricts the volume and variety of foods people eat. For decades, the condition consumed her life and her health. Today, Tiffany is learning to accept that she may never be free of ARFID.

Mechanical eating refers to eating on a consistent schedule, usually every three to four hours, regardless of hunger cues. It is commonly introduced in early eating disorder treatment to stabilize nourishment and interrupt restriction or binge cycles. In this episode, Dr. Marianne explains how mechanical eating creates physiological rhythm in a body that has experienced disruption. Eating disorders affect digestion, blood sugar, hormones, and nervous system regulation. Mechanical eating restores predictability and reduces biological chaos. Lifelong recovery invites a deeper question. Is structure still serving you years into recovery, or has it become rigid? How Mechanical Eating Supports Your GI System, Blood Sugar, and Mood Mechanical eating is not just about timing. It directly supports digestive health, metabolic stability, and emotional regulation. Regular nourishment helps the gastrointestinal system relearn movement and tolerance after restriction. It can reduce bloating, reflux, constipation, nausea, and abdominal pain that often occur when eating patterns have been irregular. Mechanical eating also stabilizes blood sugar levels. Long gaps without food can lead to shakiness, irritability, brain fog, dizziness, and intense urgency to eat. Consistent intake smooths those fluctuations and supports steady energy throughout the day. Because the brain depends on adequate fuel, mechanical eating also improves mood regulation. Anxiety, irritability, and low mood often intensify when nourishment is inconsistent. Stabilizing blood sugar reduces these physiological stress responses and creates a more regulated emotional baseline. For many people, these benefits make mechanical eating a powerful and supportive tool. When Mechanical Eating May Stop Fitting Lifelong eating disorder recovery requires flexibility. A strategy that was essential in early recovery may need to evolve over time. Mechanical eating can become rigid if the clock replaces internal cues entirely. Some people experience anxiety if eating times shift. Others notice that hunger cues remain muted even after years of structure. For neurodivergent individuals, strict schedules may conflict with executive functioning variability, sensory sensitivities, or fluctuating energy. This episode explores how to recognize when mechanical eating is supportive and when it may need to be adapted. Recovery is not about perfect adherence. It is about building a sustainable, compassionate relationship with food and body over time. Who Mechanical Eating Helps Most in Long-Term Recovery Mechanical eating often benefits people who need predictable physiological regulation, reduced decision fatigue, and steady nourishment despite unreliable hunger signals. It can be especially helpful during stress, illness, life transitions, or periods of emotional overwhelm. Rather than seeing mechanical eating as a permanent rule, Dr. Marianne reframes it as a flexible tool that can be used when needed and modified when necessary. Lifelong recovery allows room for adaptation. ARFID, Selective Eating, and Mechanical Eating For individuals with ARFID or selective eating, mechanical eating alone is often not enough. Sensory sensitivity, fear of aversive consequences, and low appetite require neurodivergent-affirming and sensory-attuned approaches. Dr. Marianne's ARFID and Selective Eating Course provides structured, trauma-informed, and liberation-centered support for people who need more than traditional eating disorder recovery tools. In the course, she addresses nervous system regulation, sensory safety, and realistic long-term change. Learn more about the ARFID course and therapy options at drmariannemiller.com. Related Episodes Intuitive vs. Mechanical Eating: Can They Coexist? on Apple & Spotify. Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. The Truth About "High-Functioning" People With Lifelong Eating Disorders on Apple & Spotify. Understanding Harm Reduction: Why "Full Recovery" May Not Be the Goal for Lifelong Eating Disorders on Apple & Spotify. Key Topics Covered in This Episode Mechanical eating in lifelong eating disorder recovery Chronic eating disorders and long-term recovery GI system healing and digestive regulation Blood sugar stabilization and binge-restrict cycles Mood regulation and nervous system safety Neurodivergent-affirming eating disorder treatment ARFID and selective eating support If this episode resonated with you, consider sharing it with someone navigating long-term eating disorder recovery. And if you are looking for therapy or structured support grounded in liberation, sensory attunement, and autonomy, visit drmariannemiller.com to learn more about working with Dr. Marianne Miller. Take gentle care of yourself.

In this episode, we're diving into something I really wish I had known about sooner: ARFID — Avoidant/Restrictive Food Intake Disorder.ARFID is a serious eating disorder that has nothing to do with body image or weight loss. Instead, it's driven by things that are incredibly common for ADHD and autistic folks — sensory sensitivities, low appetite, lack of interest, anxiety, and fear of negative food experiences (like choking or vomiting).If you or someone you love:forgets to eat to eatlives off a small list of “safe foods”feels overwhelmed by textures, smells, or food prephas been called a “picky eater” your whole life…this episode might feel like a huge lightbulb moment.We're talking about:what ARFID actually is (and why it's not just picky eating)how sensory issues, anxiety, and interoception play a rolethe real physical and emotional impactswhy it shows up so often in neurodivergent peoplehow support and treatment actually workI'm also sharing personally — because learning about ARFID made me look at my own life and my kids in a completely new way.If this episode resonates, please share it with someone who needs to hear:https:///www.ihaveadhd.com/10thingsEquip HealthWatch this episode on YouTubeWant help with your ADHD? Join FOCUSED!Have questions for Kristen? Call 1.833.281.2343Hang out with Kristen on Instagram and TikTokSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

"By age 40, one in five women has dealt with an eating disorder—twice the rate we see by age 21." – Harvard UniversityWhile society often frames eating disorders as a struggle for teenagers, the reality is that women in midlife are increasingly vulnerable. In this episode, Dr. Rachel Pope addresses the "silent epidemic" affecting millions of women as they navigate the convergence of hormonal shifts, body image pressures, and life transitions.As we continue our New Year's series on weight management and GLP-1 medications, Dr. Pope is joined by internationally recognized expert Dr. Lucene Wisniewski. Together, they discuss the thin line between a healthy focus on nutrition and the onset of disordered eating. Why do perimenopause and menopause create a "biological window of risk"? How do we distinguish between "discipline" and "obsession"?Dr. Lucene Wisniewski, PhD, FAED, is a leader in eating disorder treatment and Dialectical Behavior Therapy (DBT) with nearly 30 years of experience. She provides a compassionate, evidence-based look at how women can protect their mental health while pursuing physical wellness.In this episode, we discuss: The Hormonal Connection: Why the menopause transition is a high-risk period for both relapses and "de novo" (new) eating disorders. Effective vs. Rigid Eating: Moving away from black-and-white "food rules" toward a flexible, social, and balanced relationship with fuel. Red Flags in Midlife: How to identify signs of preoccupation, body checking, and the moralization of food. The "Binge-Restrict" Cycle: Why "not eating" is often the biggest trigger for out-of-control eating. Tracking Apps & Tech: When tools like macro-trackers stop being helpful and start becoming a "life stance." ARFID in Adults: Understanding Avoidant Restrictive Food Intake Disorder and how it differs from traditional anorexia. Supporting Others: How to broach a conversation with a friend or family member without causing shame (and why you should never do it at the dinner table).National Resources for Help: NEDA Helpline: (800) 931-2237 Crisis Text Line: Text "HOME" to 741741 ANAD Helpline: (888) 375-7767About Our Guest:Dr. Lucene Wisniewski is the Founder and Chief Clinical Officer of the Center for Evidence-Based Treatment (CEBT). She is a Fellow of the Academy for Eating Disorders and an Adjunct Assistant Professor at Case Western Reserve University.Connect with Dr. Wisniewski: Website: cebtohio.comConnect with Dr. Rachel Pope: Website: ourwomanity.com Social Media: @drrachelpope

Confidence is not about loving how you look. It is about resilience, safety, and agency in eating disorder recovery. In this thoughtful and grounded conversation, Dr. Marianne Miller sits down with therapist, educator, and podcast host Rachelle Heinemann, LMHC, LPC @raquelleheinemann, to explore the deeper emotional and relational layers beneath body image distress and disordered eating. Rather than focusing only on surface-level body image strategies, this episode examines how confidence develops through resilience, meaningful connection, personal agency, and small intentional steps taken over time. Together, they discuss why traditional approaches to body image may feel incomplete, how unsafe environments can intensify negative body thoughts, and what it truly means to cultivate confidence in the context of eating disorder recovery. This conversation offers compassionate, clinically informed insight for anyone navigating body image struggles, low self-esteem, chronic disordered eating patterns, or the long path of healing. What We Explore in This Episode The relationship between body image, confidence, and disordered eating. Why confidence is better understood as resilience rather than appearance or personality. How safety, stress, and environmental context influence body image distress. The role of agency, assertiveness, and small achievable steps in recovery. Why meaningful, supportive relationships are foundational to confidence building. How deeper emotional needs often drive body image pain more than physical appearance. Practical ways to begin cultivating resilience in eating disorder recovery. A Different Way to Understand Confidence Many conversations about confidence center on visibility, charisma, or loving one's body at all times. In this episode, Raquelle offers a more compassionate and realistic framework: confidence as an internal, flexible resilience that can grow even when fear, uncertainty, or body image distress are still present. Through clinical stories and lived therapeutic insight, this discussion reframes confidence as something that develops through curiosity, connection, and repeated small acts of courage, rather than perfection or performance. About Rachelle Heinemann, LMHC, LPC Rachelle Heinemann is a licensed mental health counselor in New York and a licensed professional counselor in New Jersey. She specializes in working with individuals experiencing disordered eating, eating disorders, anxiety, depression, and relationship challenges. She teaches courses on eating disorders and body image, provides continuing education for clinicians, and hosts the podcast Understanding Disordered Eating. Raquelle also contributes leadership within the International Association of Eating Disorder Professionals New York. Her confidence and resilience workbook, discussed in this episode, guides readers through curiosity, connection, and small actionable steps toward meaningful and sustainable change. Resources and Links Rachelle's Confidence & Resilience Workbook: (Use code PODCAST to download for free.) Understanding Disordered Eating Podcast Bergen Mental Health Group Follow Rachelle on Instagram: @rachelleheinemann Related Episodes DIVING DEEP to Help Folks Recover From Eating Disorders, With Rachelle Heinemann, LMHC, CEDS, @rachelleheinemann on Apple and Spotify. When Exercise Becomes Punishment: Body Image, Shame, & Disordered Eating With Dr. Lisa Folden @healthyphit on Apple and Spotify. Work With Dr. Marianne Miller Dr. Marianne Miller is a licensed marriage and family therapist specializing in: Eating disorder recovery ARFID and selective eating Binge eating disorder Neurodivergent-affirming care Body liberation and weight-inclusive healing Therapy and coaching are available in California, Texas, Washington, DC, and worldwide. You can also explore: The ARFID & Selective Eating Course The Binge Eating Recovery Membership More episodes of the Dr. Marianne-Land Podcast on body image, neurodivergence, and long-term recovery Listen, Follow, and Share If this episode resonated with you, consider following the podcast, leaving a review, or sharing it with someone who may need compassionate, evidence-informed support for body image and eating disorder recovery. Your support helps more people find liberation-oriented, neurodivergent-affirming care.

This goes along with the interview about Embodied Exercise. For many people, the other side of that coin is eating. And rates of disordered eating are higher among Autistics, ADHDers (especially women), and trans and gender non-conforming folks.The episode only briefly touches on ARFID, an eating disorder more likely to affect autistic people for multiple reasons. If you know someone who could be an expert interview on ARFID, please send them my way.Oh another fun fact I didn't mention... it's possible that the "obesity epidemic" (unscientific nonsense) was literally caused by dieting. Yes, that's correlation, but damn it makes a compelling chart. (from Anti-Diet, book below)Mentioned in episode:Book Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating by Christy Harrison MPH RD*ep. 129 Embodied Exercise with Martha MunroeAuDHD Flourishing resources:Transcript Doc (often a few weeks behind, but we do catch up!)Mattia's NewsletterLike Your Brain community space (Patreon/Discord)*affiliate link Hosted on Acast. See acast.com/privacy for more information.

NEED HELP FOR AN EATING DISORDER? Call: 888-364-5977 or head to: https://emilyprogram.com/begin-recovery/ Host Lindsey Elizabeth Cortes interviews Dr. Jillian Lampert (Vice President of Strategy and Public Affairs at The Emily Program), who explains eating disorders as mental health diagnoses that disrupt a person's relationship with food and negatively impact life, and outlines diagnoses including anorexia nervosa (including that it can occur without visible underweight), bulimia nervosa, binge eating disorder, ARFID, and OSFED; she notes orthorexia is not currently a DSM diagnosis. They discuss why athletes are at higher risk (temperament traits like persistence, rule-focus, and high standards combined with sport pressures), warning signs such as secrecy, defensiveness, and constant preoccupation with food, and serious health consequences including RED-S impacts, cardiac risk (especially with purging and electrolyte disruption), GI issues, bone and endocrine effects, and dental damage. Dr. Lampert describes The Emily Program's full continuum of care (inpatient through outpatient, including virtual options), emphasizes individualized treatment for athletes (including decisions about training/competition), and shares Jessie Diggins' public story of treatment, recovery, relapse, and ongoing support; the episode closes with encouragement to seek help by calling or requesting contact through emilyprogram.com. Dr. Jillian Lampert, PhD, MPH, RD, LD, FAED, is the Vice President of Strategy and Public Affairs for The Emily Program, a national eating disorder treatment company. She completed her doctorate degree in Nutrition and Epidemiology and Master of Public Health degree in Public Health Nutrition at the University of Minnesota. She earned a Master of Science degree in Nutrition at the University of Vermont and completed her dietetic internship at the University of Minnesota Hospital and Clinics. She has an expansive range of policy, clinical, research, education, teaching, and program development experience in the area of eating disorders. Episode Highlights: 01:22 Sponsor Break: WaveBye for Period Pain & Cycle Support 03:00 Eating Disorder Help Resources (NEDA + Emily Program) 04:00 Meet Dr. Jillian Lampert + Why Awareness Week Matters 06:26 Eating Disorders 101: What They Are (and Aren't) 08:31 Types of Eating Disorders: Anorexia, Bulimia, Binge Eating, ARFID, OSFED 12:21 Where Orthorexia Fits + When “Healthy Eating” Becomes Harmful 15:25 Why Athletes Are Higher Risk: Temperament, Perfectionism & Pressure 17:25 Crossing the Line: Red Flags Like Secrecy, Defensiveness & Isolation 21:21 The “Iceberg” of ED Thoughts + How Much You Think About Food 25:02 Sponsor Break: RED-S Quiz + Recovery Membership & Coaching 27:34 Physical Consequences: RED-S, Heart Risk, Electrolytes & GI Damage 34:43 Why you should still talk to a doctor (even if they're not ED-trained) 35:24 From consequences to recovery: the real goal is feeling good again 36:02 Inside The Emily Program: levels of care from inpatient to outpatient 37:59 What makes The Emily Program different: all levels, nationwide, long-term support 40:32 Athletes & recovery goals: using your drive without expecting a quick fix 41:54 Jessie Diggins' story: treatment, relapse, and staying on the team 43:00 Can you keep training in treatment? How athlete care is individualized now 51:45 Recovery is possible: skills that last, hope after relapse, and being your best self 55:28 How to get help today: website, phone call, and don't wait 59:03 Final takeaway + where to find resources and support Resources and Links: For more information about the show, head to work with Lindsey on improving your nutrition, head to: http://www.lindseycortes.com/ Join REDS Recovery Membership: http://www.lindseycortes.com/reds WaveBye Supplements – Menstrual cycle support code LindseyCortes for 15% off: http://wavebye.co Previnex Supplements – Joint Health Plus, Muscle Health Plus, plant-based protein, probiotics, and more; code CORTES15 for 15% off: previnex.com Female Athlete Nutrition Podcast Archive & Search Tool – Search by sport, condition, or topic: lindseycortes.com/podcast Female Athlete Nutrition Community – YouTube, Instagram @‌femaleathletenutrition, and private Facebook group Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Why Food Anxiety Is Not Always About Dieting: Understanding ARFID and Intuitive Eating - An interview with Robyn L. Goldberg, RDN, CEDS-C Diet culture often dominates conversations about eating disorders, but not all struggles with food are driven by weight, body image, or dieting. In this episode, Curt Widhalm and Katie Vernoy talk with registered dietitian nutritionist and certified eating disorder specialist Robyn L. Goldberg about Avoidant Restrictive Food Intake Disorder (ARFID), intuitive eating, and how therapists can recognize when food anxiety requires a different clinical approach. Robyn explains how ARFID differs from more familiar eating disorders, why it is often mislabeled as “picky eating,” and when intuitive eating principles need to be adapted or set aside. This conversation offers therapists practical guidance for assessment, referral, and collaboration with eating-disorder-informed dietitians. Key Takeaways ARFID is not driven by weight or body image concerns and is often rooted in sensory sensitivities, trauma, or fear of aversive consequences Intuitive eating is not a one-size-fits-all model and may require significant structure for some clients Rigid food rules and avoidance can be protective for clients but may also limit functioning and quality of life Exposure-based approaches are often central to ARFID treatment and require specialized training Therapists should refer to eating-disorder-informed dietitians when food restriction significantly impacts health or daily life Guest Bio Robyn L. Goldberg, RDN, CEDS-C, is a registered dietitian nutritionist and certified eating disorder dietitian and consultant with over twenty-eight years of experience. She is the author of The Eating Disorder Trap, host of The Eating Disorder Trap Podcast, and a nationally recognized expert featured in major media outlets. Full Show NotesRead the full show notes and resources at: https://www.mtsgpodcast.com Community and SupportJoin our Facebook group: https://www.facebook.com/groups/therapyreimaginedSupport the podcast on Patreon: https://www.patreon.com/c/mtsgpodcast Modern Therapist's Survival Guide Creative Credits Voiceover by DW McCannhttps://www.facebook.com/McCannDW/ Music by Crystal Grooms Manganohttps://groomsymusic.com/

Have you heard of ARFID (Avoidant/Restrictive Food Intake Disorder)? It describes extreme “picky eating” and can hijack families. But as with most disorders that seem to move quickly into parenting awareness, information, treatment, and internet discussions are all over the place. In this episode, Lynn brings back her colleague Mindy Szelap for a dose of solid information, myth-busting, and practical steps to take. What's normal developmentally? What are the do's and don'ts of mealtime? And does a parent's anxiety make it worse? Yup. Find Mindy at: https://www.bayareaspacetreatment.com/ WE'VE MADE PLAYLISTS OF OUR EPISODES TO HELP YOU FIND RESOURCES ON SPECIFIC TOPICS. Here is our first: For those brand new to the podcast, we suggest starting with this playlist featuring Lynn Lyons and the 7-part anxiety disruptor series as well as a 3-part series on the skills most helpful in managing anxious kids: flexibility, problem solving, and autonomy. Consult our Spotify profile for the most up-to-date selection.   We will select two listeners who complete our listener survey. We hope it is you!   FOLLOW US Join the Facebook group to get news on the upcoming courses for parents, teens, and kids. Follow Flusterclux on Facebook and Instagram. Follow Lynn Lyons on Twitter and Youtube. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Why does eating still feel impossible for neurodivergent people with long-term eating disorders, even after insight, treatment, and real effort? In this episode, Dr. Marianne Miller explores the hidden sensory, executive functioning, and nervous system friction that causes eating to keep breaking down in daily life. This conversation moves beyond motivation, fear foods, and traditional recovery advice to name the invisible moments when hunger arrives too late, meals require overwhelming cognitive energy, sensory overload interrupts eating, masking replaces body awareness, or a nervous system crash follows nourishment. You'll learn why neurodivergent eating disorder recovery often stalls inside standard treatment models, how chronic eating disorders can reflect adaptation rather than failure, and what actually supports sustainable nourishment for people living with ARFID, anorexia, bulimia, binge eating disorder, and long-term restrictive or chaotic eating patterns. This episode offers a neurodivergent-affirming, trauma-informed, and weight-inclusive framework for understanding why eating still feels so hard—and how recovery can begin by reducing friction instead of increasing pressure. If you're searching for realistic eating disorder recovery, support for ARFID in adults, or compassionate care that centers sensory needs and autonomy, this conversation is for you. You can also check out my self-paced, virtual ARFID course or other resources on my website, drmariannemiller.com. Related Episodes Unmasking, Embodiment, & Trust: A Neurodivergent Approach to Eating Disorder Recovery With Dr. Emma Offord @divergentlives via Apple & Spotify. Unmasking in Eating Disorder Recovery: What Neurodivergent People Need to Know About Safety & Healing via Apple & Spotify. Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe via Apple & Spotify. Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify.

Night eating can feel confusing, distressing, and isolating for people living with anorexia, especially when restriction shapes daytime eating. Many adults limit food during the day and then experience intense hunger, urgency to eat, or automatic eating at night. This pattern often creates shame and the belief that recovery is failing. In this episode, Dr. Marianne Miller explains why anorexia and night eating syndrome frequently overlap and how daytime restriction drives nighttime eating through biological survival responses and nervous system stress. She reframes night eating as adaptation rather than loss of control and challenges treatment messages that rely on shame or rigid control. This conversation centers trauma-informed, neurodivergent-affirming eating disorder recovery and introduces non-punitive tools that support regulation, safety, and sustainable change. Why Anorexia and Night Eating Syndrome Often Occur Together Many clinical frameworks treat anorexia and night eating syndrome as separate or opposing diagnoses. In practice, restriction, energy deficit, and nervous system activation during the day often lead the body to seek nourishment at night when threat levels feel lower. Night eating in anorexia does not reflect a failure of discipline. It reflects a biological and neurological survival response to deprivation, chronic stress, and unmet energy needs. Understanding this connection reduces shame and opens the door to more effective, compassionate eating disorder treatment. How Daytime Restriction Fuels Nighttime Eating Restriction includes more than eating small amounts of food. It can involve delaying meals, limiting food variety, suppressing hunger signals, or following rigid food rules that keep the body in a constant state of vigilance. When restriction continues across the day, the body tracks energy debt, stress hormones rise, and hunger intensifies. Nighttime may become the first moment when eating feels possible or safe. This cycle explains why night eating in anorexia can persist even when someone feels committed to recovery. Why Shame and Control Do Not Resolve Night Eating Common advice such as eating more during the day often overlooks nervous system safety, trauma history, and neurodivergent sensory needs. Increasing pressure or tightening rules usually strengthens the restriction and night eating cycle rather than resolving it. Reducing shame and supporting regulation creates conditions where change can occur without punishment or fear. Supportive Approaches That Address Root Causes Recovery-supportive care focuses on safety, predictability, and nervous system regulation rather than control. Daytime nourishment becomes more sustainable when eating feels safe enough and emotionally tolerable. Removing moral judgment from night eating reduces the restriction-shame cycle that keeps symptoms active. Gentle structure can support regulation without imposing rigid rules, and trauma-informed, neurodivergent-affirming treatment allows the body to receive nourishment without overwhelming threat. When these conditions develop, night eating often softens naturally over time. Who This Episode Is For This episode speaks to adults living with anorexia and night eating syndrome, people who restrict during the day and eat at night, and individuals navigating chronic eating disorders or recovery that feels stalled despite effort. It also supports neurodivergent adults managing sensory needs around food and anyone seeking weight-inclusive, trauma-informed eating disorder therapy that honors autonomy and lived experience. Related Episodes Night Eating Syndrome on Apple & Spotify (my 2nd most popular podcast episode of all time!) Understanding Night Eating Syndrome: Executive-Function Tools for Real Recovery on Apple & Spotify. Why Am I Eating at Night? Understanding Night Eating Syndrome in Your 30s, 40s, & 50s on Apple & Spotify. Work With Dr. Marianne Miller If you are looking for eating disorder therapy in California or support for anorexia, night eating syndrome, ARFID, or binge eating disorder, Dr. Marianne Miller offers neurodivergent-affirming, liberation-centered care for adults. You can learn more about therapy services, recovery resources, and ways to work together by visiting her website, drmariannemiller.com. You deserve support that works with your body, respects your nervous system, and honors your autonomy in recovery.

In this episode of Full of Beans, Han is joined by Jo Read, a mum to two daughters, ARFID advocate and 1/3 of 3 Mums 1 Mission ARFID. Jo's youngest daughter, Ethel, is diagnosed with ARFID and is awaiting an autism assessment. Since supporting Ethel through her sensory-based eating difficulties, Jo has poured her energy into raising awareness, because when you're living it, ARFID can feel unbelievably isolating.If you're a parent or carer navigating food fears, sensory sensitivities, “helpful” comments that aren't helpful, and the constant planning that comes with ARFID, this one is for you. You're not doing it wrong. You're responding to a very real, very complex need.Key Takeaways:The reality of ARFID as a genuine fear that can override hungerSensory sensitivities (texture, smell, predictability) are at the core of ARFIDWhy consistency and familiarity make certain foods feel saferThe limits of BMI as a marker of health in children with arfidHow sensory overload at mealtimes can increase food avoidanceThe impact of ARFID on family life, routines, siblings and social plansWhy “just stop feeding them” advice doesn't work for ARFIDThe value of community, advocacy and finding people who understandHow progress in ARID can look small but still be meaningfulTimestamps:00:00 Jo's story and Ethel's ARFID diagnosis02:20 Early Signs of ARFID 05:30 BMI and Nutrition10:50 Safe foods, Predictability and Super Senses 14:10 The Sensory Overload of Eating 17:00 Family Impact: Days Out, Siblilngs, Friends20:20 Social Judgement and Support29:00 Looking Ahead and Slow ProgressResources & LinksFollow @eff_and_arfid on InstagramListen to the 3Mums1Mission ARFID PodcastConnect with Us:Subscribe to the Full of Beans PodcastFollow Full of Beans on InstagramCheck out our websiteListen on YouTube⚠️ Trigger Warning: Mentions of eating disorders, ARFID. Please take care when listening.If you enjoyed this episode, don't forget to subscribe, rate, and share the podcast to help us spread awareness.Sending positive beans your way, Han

What if anorexia is being missed simply because of body size? In this powerful and deeply validating conversation, I sit down with eating disorder physician Dr. Jennifer Gaudiani, MD @gaudianiclinic to explore why the term “atypical anorexia” can obscure real medical risk, delay diagnosis, and reinforce weight stigma across healthcare systems. We discuss what has changed since the first edition of Sick Enough, why weight stigma remains foundational to eating disorder harm, and how current research is reshaping clinical understanding of restrictive eating, ARFID in adults, digestive illness, neurodivergence, chronic medical conditions, and long-term eating disorder recovery. At the center of this episode is an urgent truth for 2026: severe eating disorder suffering does not require being underweight. What We Discuss in This Episode Throughout this conversation, we examine why most people with anorexia are not underweight and how weight stigma continues to shape who gets believed, diagnosed, and treated. Dr. Gaudiani shares what is new and expanded in the second edition of Sick Enough, including updated medical research on binge eating disorder, ARFID across the lifespan, atypical anorexia, and the broader restrictive eating spectrum. We also explore the critical role of gastrointestinal pain, mast cell activation syndrome (MCAS), postural orthostatic tachycardia syndrome (POTS), and complex chronic illness in both driving and worsening restrictive eating patterns. This discussion highlights why many adults with ARFID remain misdiagnosed for years, how neurodivergence such as autism and ADHD intersects with eating disorders, and why neurodivergent-affirming, weight-inclusive, trauma-informed care is essential for meaningful recovery. Key Themes for Eating Disorder Recovery in 2026 We further discuss harm reduction, autonomy, and realistic pathways for people living with long-term or chronic eating disorders, including how rebuilding trust after medical trauma can reopen the possibility of healing. Rather than framing recovery as “full recovery or nothing,” this episode explores how supporting quality of life, medical stability, and patient-directed goals can actually improve outcomes. These themes reflect major shifts happening in eating disorder treatment in 2026, including movement toward weight-inclusive medicine, trauma-informed care, recognition of ARFID in adults, support for chronic eating disorders, and clinical models that affirm neurodivergent lived experience. About the Guest Dr. Jennifer Gaudiani, MD @gaudianiclinic is a board-certified internal medicine physician and one of the leading medical experts in eating disorder care. She is the founder and medical director of the Gaudiani Clinic, a weight-inclusive outpatient medical practice providing specialized treatment for eating disorders, undernourishment related to complex medical conditions, and trauma-informed primary care across the United States via telemedicine. Dr. Gaudiani previously served as medical director at the ACUTE Center for Eating Disorders and is the author of Sick Enough: A Guide to the Medical Complications of Eating Disorders, a widely respected clinical and patient resource now released in a fully updated second edition. Her work centers compassion, autonomy, and dignity for people in all body sizes seeking eating disorder recovery. Resources Mentioned Resources referenced in this episode include Sick Enough: A Guide to the Medical Complications of Eating Disorders (Second Edition) and the Gaudiani Clinic, which offers weight-inclusive outpatient medical care for eating disorders throughout the United States. Content Caution This episode includes discussion of eating disorders, restrictive eating, ARFID, medical complications, gastrointestinal illness, weight stigma, and medical trauma. Please listen in the way that feels most supportive for you and take pauses as needed. Work With Dr. Marianne If this conversation resonated, you are not alone. I provide neurodivergent-affirming, trauma-informed, weight-inclusive eating disorder therapy for adults in California, Texas, and Washington, D.C., along with worldwide coaching support. You can learn more or schedule a consultation at drmariannemiller.com. Listen Next If you found this episode meaningful, you may also connect with conversations on ARFID in adults, medical trauma in eating disorder care, chronic eating disorders and harm reduction, neurodivergence and restrictive eating, and complex medical complications such as low heart rate, gastrointestinal illness, MCAS, and recovery in higher-weight bodies. Here are some episodes to listen next: Atypical Anorexia Explained: Why Restriction Happens at Every Body Size on Apple or Spotify. Atypical Anorexia: Mental & Physical Health Risks, Plus How the Term is Controversial on Apple or Spotify. Chronic Eating Disorders in 2026: What Hope Can Actually Look Like on Apple and Spotify. Why Some Eating Disorders Don't Resolve: Understanding Chronic Patterns & What Actually Supports Change on Apple and Spotify. When PDA Drives ARFID: Understanding Food Refusal, Control, & Safety on Apple & Spotify. ARFID Explained: What It Feels Like, Why It's Misunderstood, & What Helps on Apple & Spotify.

Imagine being afraid of a pickle. Or a banana. Or a nub of bread. That’s daily life for people with ARFID (Avoidant/Restrictive Food Intake Disorder). It's an eating disorder not driven by weight or body image, but by fear, sensory overwhelm, or low appetite. People with this condition experience real terror and powerful aversions to certain foods - far beyond picky eating. Clinical psychologist Dr. Evelyna Kambanis explains ARFID, who it affects, and how treatment helps people reclaim their lives. Andrew Luber (aka “ARFID Andrew”) shares his funny, blunt, and vulnerable attempts at food exposures online. And Danielle Meinert tells the story of carrying ARFID since toddlerhood, and the startling change she says came after a high-dose psilocybin experience. Resources: National Eating Disorders Association - ARFIDAssociation of Anorexia Nervosa and Associated DisordersFamilies Empowered and Supporting Treatment of Eating Disorders Suggested episodes: The hidden hunger of Pica: Stories from people who eat objects Anorexia is complex. Two people talk frankly about their decades-long journeys GUESTS: Dr. Evelyna Kambanis: Licensed clinical psychologist in the Eating Disorders Clinical & Research Program at Massachusetts General Hospital and a faculty member at Harvard Medical School. She is involved in clinical care and research on ARFID Andrew Luber, aka ARFID Andrew: Los Angeles filmmaker and social media creator who documents food exposures with humor under the tagline, “Conquering my fear of food one laugh at a time” Danielle Meinert: Lived with ARFID for 27 years after a major shift in her relationship with food following ear surgery as a toddler. After years of trying traditional approaches, she described experiencing a dramatic change after a session using psilocybin Support the show: https://www.wnpr.org/donateSee omnystudio.com/listener for privacy information.

When self-criticism ramps up during eating disorder recovery, it can feel confusing or discouraging, especially when behaviors are beginning to change. This episode explores why that intensification is often part of the healing process rather than a sign that recovery is going wrong. In this solo episode, Dr. Marianne Miller explains why the inner critical voice often gets louder as eating disorder behaviors decrease and familiar control systems loosen. Instead of framing self-criticism as simply negative self-talk, this episode examines it as a regulatory strategy shaped by nervous system threat, social pressure, and internalized ableism. Internalized Ableism in Eating Disorder Recovery Recovery often collides with a world that expects bodies and minds to function efficiently, consistently, and quietly. In this section, Dr. Marianne names how those expectations become internalized as harsh self-judgment, especially for neurodivergent people, people with chronic illness, and those navigating long-term eating disorders. You'll hear how internalized ableism fuels self-criticism when recovery requires pacing, support, repetition, or accommodation, and why needing these supports does not mean recovery is failing. The Inner Critic and Nervous System Threat Many people try to argue with or silence self-critical thoughts in recovery. This episode explains why that approach often backfires and intensifies the inner voice instead. Dr. Marianne explores how the inner critic functions as a response to perceived threat and why understanding its role is more effective than trying to eliminate it. Responding to Self-Criticism Without Shame This episode offers compassionate, neurodivergent-affirming ways to respond to self-criticism without turning recovery into another performance. The focus is on reducing threat, supporting regulation, and loosening the critic's authority rather than suppressing it. A brief clinical vignette illustrates how self-criticism rooted in internalized ableism can show up even when healing is actively underway. Nonlinear Eating Disorder Recovery For people with long-term or chronic eating disorders, progress often looks different than expected. This section reframes recovery as a process that prioritizes safety, accommodation, and sustainability over efficiency or perfection. Loud self-criticism does not mean failure. It often signals that a system is reorganizing in response to change. A Gentle Reminder Recovery is not about proving you can function the way the world demands. It is about building a life that supports your nervous system, your needs, and your humanity. Related Episodes This Is Body Grief: How Ableism, Intersectionality, & Eating Disorders Shape Our Body Experiences With Jayne Mattingly 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. Work With Me and Learn More If this episode resonated and you want structured, neurodivergent-affirming support, you can learn more about my self-paced ARFID course. The course is designed for teens and adults navigating avoidant and restrictive eating patterns and focuses on sensory needs, nervous system safety, and realistic, sustainable change without shame or pressure.

Eating disorder recovery in midlife often looks very different than recovery earlier in life. For many adults over 40, anorexia and bulimia are not new struggles but long standing patterns shaped by decades of survival, responsibility, and adaptation. This episode explores why recovery after 40 requires a different lens and why difficulty healing is not a personal failure. In this solo episode, Dr. Marianne Miller examines how anorexia and bulimia persist into midlife and what actually supports healing at this stage of life. Rather than focusing on willpower or symptom control, this conversation centers nervous system safety, autonomy, grief, and the cumulative impact of stress and systemic harm. You will hear how hormonal changes, aging bodies, chronic stress, caregiving roles, and identity related oppression all shape midlife eating disorder recovery. This episode also addresses why traditional treatment models often fall short for adults over 40 and how neurodivergent affirming, weight inclusive, and harm reduction oriented care can offer a more sustainable path forward. Recovery after 40 is not about catching up or starting over. It is about choosing care that fits the life you are living now. In this episode, we cover: Anorexia and bulimia in midlife and why recovery changes after 40. Why long standing eating disorder patterns often reflect adaptation, not resistance. How the body communicates differently in midlife through hunger, fatigue, pain, and stress. The role of grief, fear, and ambivalence in midlife eating disorder recovery Intersectionality in recovery, including the effects of weight stigma, racism, ableism, and anti-queer and anti-trans bias. Neurodivergence, sensory sensitivity, and why many adults were never supported earlier in life. Why harm reduction and pacing often support recovery better than urgency. What weight inclusive, autonomy centered therapy can look like for adults over 40. Who this episode is for: Adults over 40 navigating anorexia or bulimia. People with long term or recurring eating disorder patterns. Neurodivergent adults and those with sensory sensitivities. Fat people and others harmed by weight stigma in healthcare. Anyone who has felt left behind by traditional eating disorder treatment. Related episodes: The Hidden Pain of Midlife Anorexia: Why Coping Breaks Down & What Heals on Apple & Spotify. Why Is Anorexia Showing Up Again in Midlife? You're Not Imagining It 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. About working with Dr. Marianne Miller Dr. Marianne Miller is a licensed marriage and family therapist specializing in eating disorder therapy for adults, including anorexia, bulimia, binge eating disorder, and ARFID. Her work centers neurodivergent affirming, weight inclusive, and harm reduction approaches that honor safety, agency, and lived context. Dr. Marianne works with adults in California, Texas, and Washington DC. Therapy is grounded in an understanding of how trauma, systemic oppression, and nervous system overwhelm shape eating struggles across the lifespan. Learn more about working with Dr. Marianne and current therapy availability by visiting her website drmariannemiller.com. Content note This episode discusses eating disorders, recovery, and midlife body changes. Listener discretion is advised.

When you live with a chronic illness, food restriction is often framed as “medical,” “necessary,” or “just being responsible.” But for many people, especially those with eating disorder histories, that kind of guidance doesn't support health. It fuels fear, shame, isolation, and disordered eating patterns that are hard to unwind. In this episode, Dr. Marianne is joined by Vanessa Connolly, a registered dietitian nutritionist and board-certified kidney nutrition specialist, for a grounded, compassionate conversation about what happens when restriction is prescribed rather than chosen and why that matters so deeply for eating disorder recovery. Together, they unpack how diet culture shows up in chronic illness care, how weight stigma and medical bias shape food advice, and why many people are quietly harmed by guidance that prioritizes control over nourishment. In This Conversation, We Explore This episode looks at how chronic illness care can unintentionally recreate the same dynamics that drive eating disorders, especially for people who have already spent years being told their bodies are the problem. We talk about how fear-based food rules around labs, numbers, and diagnoses often strip people of cultural foods, social connection, and bodily trust. You'll hear why blanket dietary restrictions are rarely neutral, how they can worsen food fear and disordered eating, and what a more supportive, humane approach to nutrition can look like. Vanessa also explains why focusing on what can be added rather than taken away, including fiber, balance, and satisfaction, supports both physical health and psychological safety. This episode names the emotional cost of food policing, family surveillance, and medical dismissal, especially for people in larger bodies and those navigating multiple marginalized identities. Topics Covered We discuss eating disorder recovery alongside chronic illness, including chronic kidney disease, diabetes, and high blood pressure, without defaulting to diet culture or weight-centric care. This conversation includes medical gaslighting and delayed diagnoses, how lab values like GFR are often misunderstood or minimized, and why many patients are never fully informed about what's happening in their own bodies. We also explore anti-fat bias in healthcare, intersectionality, cultural food loss, and how shame and restriction can isolate people from their communities at the very moment they need support the most. Why This Episode Matters If you've ever felt afraid to eat after a diagnosis, confused by conflicting medical advice, or worried that “doing everything right” is actually making things worse, this episode is for you. This is not a conversation about willpower, compliance, or perfect eating. It's about restoring agency, reducing harm, and finding ways to care for your body that don't require sacrificing your relationship with food. About the Guest Vanessa Connolly is a registered dietitian nutritionist and board-certified kidney nutrition specialist with over 20 years of experience supporting people with chronic kidney disease. Her work centers on helping clients preserve kidney function without unnecessary restriction, food fear, or shame. She is deeply committed to accessible, weight-inclusive, and judgment-free care. You can find Vanessa on Instagram and TikTok @grainandgreen.kidneys, where she shares practical, anti-diet education about kidney health and chronic illness. Related Episodes The Real Talk on Kidney-Friendly Diets & Disordered Eating With Vanessa Connelly, RD @grainandgreen.kidneys on Apple and Spotify. Chronic Illness, Wellness Culture, & Eating Disorder Recovery: Taking an Anti-Diet Approach With Abbie Attwood, MS, @abbieattwoodwellness on Apple and Spotify. Anti-Fat Bias in Healthcare & Chronic Illness: Healing Body Image in a Marginalized Body With Ivy Felicia @iamivyfelicia on Apple and Spotify. Support Beyond This Episode If eating feels complicated, unsafe, or overwhelming after years of restriction, diagnosis-driven food rules, or medical trauma, you don't have to navigate that alone. Dr. Marianne offers eating disorder therapy and support for people navigating binge eating disorder, ARFID, anorexia, bulimia, and long-term eating struggles, including when chronic illness or medical advice is part of the picture. Services are available in California, Texas, Washington, D.C., and worldwide. Go to drmariannemiller.com for more information.

In this episode of Full of Beans, Hannah is joined by Sarah Woodruff, mum to Grace and 1/3 of the podcast 3Mums1MissionARFID. Sarah co-created the podcast after feeling deeply isolated navigating her daughter's eating difficulties, wanting to create a space where parents could hear stories that reflected their own and feel less alone. In this conversation, Sarah shares Grace's journey in more depth, including the years of uncertainty, dismissal, escalation, and the ongoing reality of supporting a child with ARFID and autism.This episode is for parents, carers, and SEN professionals who are feeling unheard or wondering whether they're “overreacting.” It offers reassurance that you're not imagining it, permission to trust your instincts, and comfort in knowing that others have walked a similar path. Above all, it's a reminder that ARFID is complex, individual, and never a result of bad parenting.Key takeaways:What ARFID can look like beyond early childhoodWhy the term “late-onset ARFID” deserves questioning.How autism, sensory overwhelm and anxiety can affect eatingWhy emetophobia (fear of vomiting) can make eating feel genuinely unsafeHow school stress and transitions can exacerbate ARFID in childrenHow ARFID differs from “fussy eating” How food avoidance can lead to weight loss, distress, or social isolationHow lowering pressure around food can support ARFID recoveryThe power of parental intuition, even when professionals dismiss concernsTimestamps:02:50 Grace's early eating and when things began to change07:40 Anxiety, school stress, and the escalation of food restriction10:10 ARFID, emetophobia, and reaching crisis point13:30 Hospital care, NG tube feeding, and diagnosis22:50 Autism, masking, and questioning “late-onset” ARFID29:00 What helped: reducing pressure and rebuilding safety36:20 A message for parents who are questioning themselvesResources & LinksListen to the 3Mums1Mission ARFID PodcastConnect with Us:Subscribe to the Full of Beans PodcastFollow Full of Beans on InstagramCheck out our websiteListen on YouTube⚠️ Trigger Warning: Mentions of eating disorders, ARFID, NG tube feeding. Please take care when listening.If you enjoyed this episode, don't forget to subscribe, rate, and share the podcast to help us spread awareness.Sending positive beans your way, Han

Avoidant Restrictive Food Intake Disorder does not end in childhood. Many adults live for years, even decades, with ARFID that goes unnamed, misunderstood, or incorrectly treated. In this solo episode, Dr. Marianne Miller explores why ARFID in adults is so often missed, how misdiagnosis shapes harmful care pathways, and what adult-appropriate support actually requires. This conversation centers adults who never felt seen in eating disorder spaces, who were told their struggles were anxiety, habits, or personality traits, and who learned to adapt quietly rather than receive care that fit. Why ARFID in Adults Is Frequently Missed ARFID still gets framed as a childhood diagnosis in many clinical settings. When adults present with long-standing food avoidance, fear of adverse consequences, or limited food variety, providers often overlook ARFID entirely. This section explores how outdated training and pediatric-focused models contribute to delayed recognition and missed diagnosis. Common Misdiagnoses That Delay ARFID Treatment Adults with ARFID are frequently misdiagnosed with anorexia, generalized anxiety disorders, gastrointestinal conditions, or trauma responses. Dr. Miller explains how weight-centered assumptions and surface-level assessments obscure the nervous system and sensory drivers of ARFID, leading to treatment that does not address the real issue. Why So Many Adults Go Untreated for Years Many adults with ARFID become highly skilled at adapting. They plan their lives around food access, avoid social eating, and manage significant cognitive and emotional labor behind the scenes. Because this adaptation often looks like functioning, providers underestimate the depth of distress and delay appropriate intervention. Neurodivergence, Trauma, and Medical History in Adult ARFID ARFID in adults frequently overlaps with neurodivergence, chronic illness, trauma, and complex medical experiences. This episode discusses how sensory processing differences, interoceptive challenges, and past food-related or medical harm shape adult eating patterns and must be addressed in care. What Adult-Appropriate ARFID Care Actually Looks Like Effective ARFID treatment for adults requires flexibility, collaboration, and respect for autonomy. Dr. Miller outlines why rigid eating disorder models often fail adults with ARFID and what support looks like when it centers nervous system safety, lived experience, and real-world practicality. Late Diagnosis Does Not Mean Failure If you received an ARFID diagnosis later in life, or are only now recognizing yourself in this conversation, this section offers validation. Delayed diagnosis reflects systemic gaps, not personal shortcomings. There is no expiration date on care, understanding, or support. Related Episodes When PDA Drives ARFID: Understanding Food Refusal, Control, & Safety on Apple & Spotify. ARFID Explained: What It Feels Like, Why It's Misunderstood, & What Helps on Apple & Spotify. Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Support and Resources Dr. Marianne shares information about her virtual, self-paced, ARFID and Selective Eating course, designed for adults seeking neurodivergent-affirming, trauma-aware support that does not rely on pressure, shame, or one-size-fits-all approaches.  You can find information about ARFID therapy on her website at drmariannemiller.com. Also check out her blog on ARFID topics. If this episode resonated, consider sharing it with someone who has struggled to find language or care for long-standing eating challenges. ARFID in adults deserves recognition, respect, and treatment that fits.

Living with a chronic eating disorder often means wanting recovery and fearing it at the same time. Many people feel torn between change and safety, hope and grief, relief and loss. This solo episode explores why that ambivalence is not a failure, but a meaningful part of chronic eating disorder recovery. In this episode, Dr. Marianne Miller explains how dialectical thinking from DBT supports people with long-term eating disorders by allowing two truths to exist at once. Rather than forcing either-or recovery narratives, dialectics centers the AND. It helps people work with fear, attachment, and survival strategies without shame. This episode focuses on the internal experience of recovery, not just behavior change. It is not a safety systems episode or a harm reduction overview. It is about how people live inside ambivalence and how radical acceptance creates space for movement without forcing certainty. Dialectical Thinking and the AND in Eating Disorder Recovery Dialectical thinking recognizes that two things can be true at the same time. In eating disorder recovery, this might look like wanting relief while still relying on eating disorder behaviors to feel regulated. These experiences are not contradictions to fix. They reflect adaptation, nervous system learning, and lived reality. Rigid recovery binaries often increase shame and disengagement, especially for people with chronic or long-standing eating disorders. Living in the AND supports flexibility, honesty, and continued engagement in care. Why Ambivalence Is Not Resistance Ambivalence is often misinterpreted as resistance in eating disorder treatment. This episode challenges that belief directly. Ambivalence is information from a nervous system that learned how to survive. For many people who are fat, disabled, neurodivergent, BIPOC, LGBTQIA+, chronically ill, or medically harmed, recovery fear is shaped by real systems. Weight stigma, medical trauma, racism, ableism, and lack of access to affirming care all matter. Fear does not mean failure. Radical Acceptance Without Giving Up Radical acceptance does not mean liking what is happening or giving up on recovery. It means naming reality so shame stops driving the process. When people stop fighting themselves for being ambivalent, curiosity, flexibility, and choice become more possible. This episode reframes radical acceptance as a tool for supporting sustainable change in chronic eating disorder recovery. Redefining Success in Chronic Eating Disorders Recovery does not have to mean certainty or symptom elimination. It can mean increased tolerance for uncertainty, moments of choice, and the ability to say, “I am struggling and still worthy of care.” Dialectical thinking offers a compassionate, realistic framework for long-term eating disorder recovery. Related Episodes Chronic Eating Disorders in 2026: What Hope Can Actually Look Like on Apple and Spotify. Why Some Eating Disorders Don't Resolve: Understanding Chronic Patterns & What Actually Supports Change on Apple and Spotify. When an Eating Disorder Becomes Chronic: Recovery Tools for Persistent Anorexia & Bulimia on Apple and Spotify. Support and Resources Dr. Marianne Miller offers a self-paced, virtual ARFID and Selective Eating course grounded in neurodivergent-affirming, trauma-informed care. The course focuses on safety, flexibility, and realistic change over time for people with restrictive, avoidant, or long-standing eating struggles. Links and details are available in the show notes. Work with Dr. Marianne in therapy if you live in California, Texas, or Washington D.C. Go to drmariannemiller.com to schedule a free, 15-minute consultation call. You do not have to choose one truth. You can want recovery and fear letting go. You can live in the AND.

In this week's episode, Han is joined by Michelle Jacques. Michelle is a devoted mum of two who has lived with ARFID since her son started weaning. Through her own experience of supporting her son with ARFID, she has become a passionate advocate, working tirelessly to raise awareness and support others navigating life with this complex food intake disorder. She is the founder of @arfid_life_uk, where she raises awareness of ARFID by sharing her family's experience.This episode holds space for the grief, the guilt, the fight, and also the hope, including the unexpected shift Michelle has seen as her son's body becomes nourished again.This week, we discuss:What ARFID can look like and how it can go beyond “picky eating.”How sensory differences, autistic eating, and ARFID can overlapHow illness can trigger choking fears and a trauma response that reinforces food avoidanceWhat it's like when a child's intake drops to just a couple of “safe” itemsWhat a PEG (gastrostomy tube) is and how PEG feeding can support ARFIDThe emotional impact of PEG decisions for parents, including grief andguiltWhy nutrition can change anxiety, rigidity, and capacityThe role of advocacy in ARFID awarenessHow to document ARFID symptoms to report to a doctorTimestamps:03:10 Sensory differences, autism, and how ARFID developed over time07:40 Illness, choking fears, and how trauma can collapse food intake09:15 Hospitalisation: constipation and appendix surgery18:30 What a PEG is (and what people often misunderstand about it)29:40 How PEG feeding can support ARFID41:30 Guilt, grief, and learning to let the feelings exist45:10 ARFID Advocacy workResources & LinksFollow @arfid_life_uk on InstagramListen to the 3Mums1Mission ARFID PodcastConnect with Us:Subscribe to the Full of Beans PodcastFollow Full of Beans on InstagramCheck out our websiteListen on YouTube⚠️ Trigger Warning: Mentions of eating disorders, ARFID, NG tube feeding. Please take care when listening.If you enjoyed this episode, don't forget to subscribe, rate, and share the podcast to help us spread awareness.Sending positive beans your way, Han

When picky eating is extreme, it's rarely just about the food. Pediatric dietitian Katharine Jeffcoat explains how anxiety and sensory challenges impact eating, what helps beyond nutrition, and how to reduce pressure at the table—plus a simple "food science" approach to support progress.

Not all eating disorder behaviors feel distressing. For many neurodivergent people, certain eating patterns can feel calming, organizing, or regulating rather than intrusive or unwanted. This solo episode explores the often misunderstood difference between egosyntonic and egodystonic eating disorder behaviors, with a specific focus on neurodivergent experiences. Dr. Marianne Miller breaks down why distress is not a reliable indicator of risk, how soothing routines can still create long-term concerns, and how clinicians and individuals can assess eating behaviors without pathologizing neurodivergence. This conversation centers nuance, consent, and nervous system safety rather than urgency or moral judgment. What Does Egosyntonic vs Egodystonic Mean in Eating Disorders? Egodystonic eating disorder behaviors feel unwanted and distressing. They often clash with a person's values or sense of self and can feel out of control. Egosyntonic behaviors, on the other hand, feel aligned with the self. They may feel logical, helpful, or necessary, even when others express concern. This episode explains why egosyntonic does not mean harmless and why egodystonic does not automatically mean more severe. These terms describe internal experience, not medical or nutritional risk. Neurodivergence, Regulation, and Eating Disorder Behaviors Neurodivergent nervous systems often rely on structure, predictability, and repetition for regulation. Food routines, sameness, timing, or tracking can reduce sensory overload and cognitive demand. What feels regulating internally may look concerning externally. Dr. Marianne explores how clinicians and loved ones often misread neurodivergent regulation as pathology, or dismiss concern when distress is absent. This section highlights why both reactions miss the full picture. Why Distress Is Not a Reliable Marker of Risk Many eating disorder assessments rely too heavily on visible distress. This episode explains why distress can fluctuate and why the absence of distress does not equal safety. Neurodivergent people may feel calm and regulated even as food variety narrows, rigidity increases, or nourishment decreases. The episode emphasizes the importance of looking beyond how a behavior feels in the moment and instead examining how it shapes health, flexibility, and daily life over time. Where Is the Line Between Regulation and Harm? This episode directly addresses the question many people ask but rarely get answered clearly. The line is not about whether a behavior feels soothing. It is not about motivation or readiness for change. It is about what the behavior requires and what it takes away over time. Dr. Marianne outlines how to evaluate eating behaviors through function, sustainability, and long-term consequences without shaming, coercion, or urgency. A Neurodivergent-Affirming Approach to Care This conversation is not about taking away coping strategies or forcing change. Removing regulation without replacement can destabilize neurodivergent people and increase risk. Instead, this episode discusses how to preserve safety while reducing long-term harm through added supports, sensory accommodations, and gradual expansion. The focus stays on consent, autonomy, and respect for identity. Who This Episode Is For This episode is for neurodivergent teens and adults who feel confused when eating behaviors feel helpful but raise concern from others. It is also for clinicians who want to assess eating disorders without relying solely on distress or external appearance. If you have ever thought, this does not feel like a problem to me, but other people seem worried, this episode speaks directly to that experience. Related Episodes Unmasking, Embodiment, & Trust: A Neurodivergent Approach to Eating Disorder Recovery With Dr. Emma Offord @divergentlives via Apple & Spotify. Unmasking in Eating Disorder Recovery: What Neurodivergent People Need to Know About Safety & Healing via Apple & Spotify. Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe via Apple & Spotify. Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify. Work With Dr. Marianne Miller Dr. Marianne Miller is a licensed marriage and family therapist specializing in eating disorder recovery with a neurodivergent-affirming, trauma-informed approach. She works with teens and adults navigating ARFID, binge eating disorder, and long-term eating disorder patterns. Go to her website at drmariannemiller.com for information on therapy and online, self-paced courses.

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

In this week's episode, Han is joined by Michelle Jacques, Sarah Woodruff and Jo Read. Together, they are the hosts of 3Mums1MissionARFID, which is on a mission to raise awareness regarding ARFID as a result of their experience of navigating their own experience of supporting their children with ARFID. This week, we discuss:What ARFID is and how it differs from “fussy eating”How sensory sensitivity, gag reflexes, and nervous system overload affect eatingHow fear of choking and emetophobia (fear of vomiting) can drive food avoidanceHow illness and medical trauma can cause sudden drops in food intakeWhat it feels like to parent a child with ARFID, including guilt, grief, and constant vigilanceHow dismissal and judgment from professionals and others impact familiesWhat an ARFID diagnosis can offer, and where support often still falls shortHow NG and PEG feeding can become part of ARFID care and the complex emotions that come with itHow school stress, anxiety, and social pressures can contribute to late-onset ARFIDWhy peer connection and lived-experience support are so powerful for parentsTimestamps:04:20 Why they started Three Mums One Mission: ARFID11:00 Jo: sensory sensitivity, gag reflex, and “typical” feeding advice that didn't fit20:50 Michelle: illness triggers, supplements, and PEG feeding32:00 Sarah: late-onset ARFID, school anxiety, crisis point + hospital experienceResources & LinksFollow @3Mums1MissionARFID on Instagram Connect with Us:Subscribe to the Full of Beans PodcastFollow Full of Beans on InstagramCheck out our websiteListen on YouTube⚠️ Trigger Warning: Mentions of eating disorders, ARFID, NG tube feeding. Please take care when listening.If you enjoyed this episode, don't forget to subscribe, rate, and share the podcast to help us spread awareness.Sending positive beans your way, Han

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

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

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

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

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

Avoidant restrictive food intake disorder (ARFID) is an eating disorder where people severely restrict food due to fear, sensory sensitivities, or low interest — not body image concerns — causing significant health and social problems Unlike normal picky eating, ARFID involves intense distress, extremely narrow food choices, nutritional deficiencies, weight loss, and serious disruption to daily life and social activities Prevalence ranges from 0.35% to 6.4% depending on region, primarily affecting children and teens, with average diagnosis at age 11 and higher male representation than other disorders Treatment approaches include parental control strategies, cognitive behavioral therapy, family-based treatment, food therapy, and sequential oral sensory methods to gradually reduce food-related fear and anxiety A specialized protocol combining psychology, hypnosis, and neuro-linguistic programming shows 90% success for adults and 65% for children, often achieved in single session

Have a message for Karena? She'd love to hear from you and share your comment or question on air!Leave Karena a voicemail: https://www.speakpipe.com/KarenaDawnWhat if grief isn't just about what you've lost, but also about honoring who you were and how far you've come?In this raw and heartfelt episode of The Big Silence, Karena sits down with entrepreneur, artist, and mental health advocate Tallulah Willis. The youngest daughter of Bruce Willis and Demi Moore shares what it was like navigating life in one of Hollywood's most iconic families. We talk about confronting eating disorders, ADHD, autism, and her father's dementia journey, Tallulah opens up about the many forms grief can take. She shares how she's learned to embrace "good grief," build unshakeable self-trust, and find healing through creativity and vulnerability. Whether you're processing your own loss, struggling with identity, or searching for permission to feel it all, Tallulah's wisdom will reassure you that you're exactly where you need to be.How do you learn to trust yourself when life keeps throwing you into the unknown, and honor all the versions of yourself that got you here?True strength comes from acknowledging your feelings, giving yourself the dignity of your process, and knowing you can handle whatever comes your way.(00:00) Redefining Grief & The Power of "Yes, And"The concept of "Good Grief" and making space for celebration within the painHow DBT (dialectical behavior therapy) helps navigate the "yes, and" of complex emotions(3:30) High School: ADHD, Autism & Feeling InvisibleHer recent autism diagnosis and lifelong ADHD Believing she was unintelligent Feeling "mid" and overlooked by adults who should have seen her(06:02) Growing Up in the Spotlight: Life as Bruce and Demi's DaughterWhat it was like being raised by "the last era movie stars"Fielding paparazzi from a young age How early experiences shaped her adaptability(8:39) Eating Disorders, ARFID & Using Control to CopeHow her eating disorder became a catch-all for unprocessed emotionsLiving with ARFID (avoidant restrictive food intake disorder) her whole lifeThe journey to recovery and learning to nourish herself (20:57) Surrounding Yourself with People Who See YouGrieving relationships with people who didn't see herBeing surrounded by people whose reflection of her she lovesHer fiancé's recognition of her ability to adapt and roll with new situationsLearning what it means to be truly seen and valued(24:08) Her Father's Dementia, Love & Finding JoyNavigating Bruce Willis's FTD diagnosis and the family's decision to go publicWhy she initially avoided learning the clinical details Handling invasive questions with graceHow transparency opens doors for others to get checked and seek help(31:06) Self-Trust, Pausing & Acknowledging Your FeelingsThe power of naming what's realFocusing on her art practice: drawing, interior design, and creative expressionWhy she's leaning into discomfort and pushing herself into new spacesThe magic of curiosityReconnect with yourself and your community: We start the New Year, New TI-YOU Challenge January 5th in the Tone It Up App. Just download the Tone It Up App at...

Avoidant restrictive food intake disorder (ARFID) is an eating disorder where people severely restrict food due to fear, sensory sensitivities, or low interest — not body image concerns — causing significant health and social problems Unlike normal picky eating, ARFID involves intense distress, extremely narrow food choices, nutritional deficiencies, weight loss, and serious disruption to daily life and social activities Prevalence ranges from 0.35% to 6.4% depending on region, primarily affecting children and teens, with average diagnosis at age 11 and higher male representation than other disorders Treatment approaches include parental control strategies, cognitive behavioral therapy, family-based treatment, food therapy, and sequential oral sensory methods to gradually reduce food-related fear and anxiety A specialized protocol combining psychology, hypnosis, and neuro-linguistic programming shows 90% success for adults and 65% for children, often achieved in single session

Dr. Tony Ebel sits down with Shandy Watters, integrative speech-language pathologist and functional nutrition practitioner, to unpack the root causes of complex picky eating in kids with neurodevelopmental challenges. Moving beyond typical feeding advice, Shandy shares her five-domain framework and explains how nervous system regulation plays a central role in feeding struggles.Parents will learn practical, real-life strategies to reduce mealtime stress, including environmental setup, co-regulation, movement before meals, and supportive positioning. Shandy also highlights hidden food triggers and shares powerful success stories that offer both clarity and hope for families navigating complex picky eating.-----Links & Resources:Learn more about Shandy's work and access free resources to support your child at speakingofhealthandwellness.comGrab Shandy's free guide The Dos and Don'ts for Parents of Complex Picky Eaters: https://www.speakingofhealthandwellness.com/freebiesFollow Shandy on Instagram: @speakingofhealthandwellness-----Key Timestamps:(00:00) What Is Complex Picky Eating? Typical vs. complex feeding challenges(09:00) The Nervous System Connection Why regulation matters for feeding(16:00) The Five-Domain Paradigm Shandy's framework for complex picky eating(28:00) Beyond Gluten and Dairy Hidden inflammatory food triggers(37:00) Mealtime Setup What actually supports success(43:00) The 90-90-90 Rule Proper positioning for feeding and digestion(47:00) Beyond Obedience Redefining the goal of feeding support(52:00) ARFID and Missed Diagnoses Overlooked PANS and PANDAS connections(55:00) Autism and Feeding Challenges Rethinking the root cause(58:00) Success Story From Goldfish to Salmon(01:05) Resources How to work with Shandy-- Follow us on Socials: Instagram: @pxdocs Facebook: Dr. Tony Ebel & The PX Docs Network Youtube: The PX Docs For more information, visit PXDocs.com to read informative articles about the power of Neurologically-Focused Chiropractic Care. Find a PX Doc Office near me: PX DOCS DirectoryTo watch Dr. Tony's 30 min Perfect Storm Webinar: Click Here

For most of her life, science teacher and meteorologist Crystal Weidman was labeled a "picky eater." While friends and family fixated on her unique food rules, they completely missed the clues that something more serious was to blame.  In this episode Crystal shares her story of navigating ARFID (Avoidant/Restrictive Food Intake Disorder) along with OCD (Obsessive Compulsive Disorder).  This conversation sheds light on what ARFID really is (and isn't), why recovery is rarely linear, and how community and self-compassion can transform a life.  Whether you're familiar with ARFID or hearing about it for the first time, Crystal's story offers connection, clarity, and hope. Links Mental Note Podcast www.mentalnotepodcast.com  Other episodes about ARFID: What is ARFID Anyway? Avoidant Restrictive Food Intake Disorder with Dr. Michelle Jones - Click here for episode. Is It Picky Eating or Avoidant Restrictive Food Intake Disorder (ARFID)? - Click here for episode.  Overview of ARFID (Overview, Resources, Quiz, FAQ, and more): www.eatingrecoverycenter.com/conditions/arfid  Pathlight Mood & Anxiety Center: www.pathlightbh.com     Eating Recovery Center: www.eatingrecoverycenter.com Free Group Support: www.pathlightbh.com/support-groups    Free Evaluation with a Trained Therapist:  (877) 850-7199 

Guest: Rachel Conrad, MA, CCC-SLPEarn 0.10 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/courses/embracing-lived-experiencesIn the first episode of 2025, Michelle is joined by Jaclyn Pederson, MHI, CEO of Feeding Matters, and William Sharp, PhD, Director of Children's Multidisciplinary Feeding Program (Atlanta, GA) and Professor at Emory University School of Medicine, to lay the foundation for a year of combining passion, advocacy, and learning. These guests share their expertise and highlights from a recent journal publication on how the diagnoses of “Pediatric Feeding Disorder” and “Avoidant Restrictive Feeding Intake Disorder” are individualistic while simultaneously overlapping to capture the unique needs of the little ones on our caseloads. Additionally, they share practical insight into the roles and responsibilities of various team members, such as the SLP and the psychologist, in evaluating and treating these little ones as part of an interprofessional practice team.About the Guest: Rachel Conrad, MA, CCC-SLP, is the owner of Bite and Bloom Therapy, LLC, under The Mindful Collective, where she specializes in pediatric feeding and swallowing, ARFID, AAC, and sensory-based therapy. She serves as the Chair of the Feeding Matters Research Consortium, a patient- and family-centered research initiative partially funded by the Patient-Centered Outcomes Research Institute (PCORI). Rachel brings a unique perspective to her work, combining her professional expertise with her lived experience of pediatric feeding differences and ARFID. She collaborates with The Village, a perinatal and eating disorder provider group, and participates in national advocacy and education initiatives to improve early intervention and interdisciplinary care for children with feeding differences. Rachel has delivered presentations and talks on best practices for evaluating and treating medically complex children with feeding and swallowing disorders. She is passionate about creating spaces where patients and families feel truly heard, seen, and valued in discussions about feeding differences. She is a member of the American Speech-Language-Hearing Association (ASHA) and the Kansas Speech-Language-Hearing Association (KSHA) and is committed to advancing awareness, research, and best practices in pediatric feeding and swallowing. Rachel bridges the gap between research, clinical practice, and lived experience to support children and families navigating feeding differences.Show Notes:Bite & Bloom Therapy: https://www.mindfulcollectivegroup.com/rachel-conradFeeding Matters: https://www.feedingmatters.orgFind Assistance: https://www.findhelp.org

Kevin hears Danielle Meinert's “The Day I Met ARFID” story from The Story Collider for the first time and gives you his hot takes. You can also watch this episode on YouTube! This is part of our RISK! Reacts series, where we listen to a story told on another show and give our first reactions. Here's the Spotify Playlist mentioned in the episode. And here is an article about the playlist from hopkinsmedicine.org.

Is it picky eating or something deeper? In this episode, RD Kristen Nyampong breaks down Avoidant Restrictive Food Intake Disorder (ARFID) — what it looks like, how it's often missed, and why it can show up differently in BIPOC communities. We talk about helping clients expand food variety without pressure or shame, navigating family dynamics, and how dietitians can work through a trauma-informed and weight-inclusive lens.If you're living with diabetes or prediabetes and want personalized support from a Registered Dietitian Nutritionist covered by insurance, visit diabetesdigital.co to connect with our culturally aware and weight-inclusive team. And if you love the show, don't forget to rate and review us on iTunes or Spotify—it makes a huge difference! For additional resources and show notes, head to diabetesdigital.co/podcast.