Podcasts about arfid

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.

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 ever found yourself holding your breath at the dinner table? Watching what your child will (or won't) eat. Counting bites. Wondering if you're doing something wrong. Mealtimes can quietly become one of the most stressful parts of parenting, especially when selective or “picky” eating enters the picture. But what if it's not just about the food? When we zoom out, we see that eating is connected to emotional safety, nervous system regulation, sensory processing, modelling, and the overall parent–child relationship. Pressure, praise, rewards, and even our own food hang-ups can unintentionally make things harder. The good news? There are practical, compassionate ways to shift the dynamic. This is what we discuss in this episode. This episode is a little different as dietitian Atheana Brown is the one asking the questions and I am answering. Atheana and I chat about: Why labeling kids as “picky eaters” can reinforce the behaviour The powerful role of parental modelling and nervous system regulation at mealtimes How pressure, praise, rewards, and punishment can backfire The importance of prioritizing connection over control at the table When selective eating may signal something deeper (sensory challenges, tongue ties, gut health, nutritional deficiencies, ARFID, growth concerns) Red flags that may indicate it's time to seek professional support Practical ways to reduce stress around food and strengthen your relationship with your child If you're feeling stuck, stressed, or overwhelmed by your child's eating, this episode might just get you looking at it from a fresh perspective. You don't have to stay stuck and neither does your child. Episode Links: Come say hello to me on Instagram Read my books The Motherhood Reset, Nourished Mama and Mama Let It Go Grab my Picky Eating Guide Say hi to Atheana on Instagram Listen to Diet Culture Dropout podcast

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.

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

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.

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.

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

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...

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

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

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

In this episode, Child & Adolescent Psychiatrist Dr Josephine Neale - Clinical Director for Child and Adolescent Mental Health Services at the Priory and founder of Neale Health, the UK's first fully online child and adolescent psychiatry service - joins Ben to unpack ARFID (Avoidant Restrictive Food Intake Disorder), a condition many people have never heard of but is increasingly recognised in autistic and ADHD individuals.Josephine explains that ARFID isn't about weight or body image, but driven by four key subtypes: sensory discomfort, fear and anxiety (often around choking or vomiting), low appetite, or a combination of these.Drawing on her specialist work across autism, ADHD, and eating disorders, she breaks down why ND people experience food so differently, why ARFID is still often missed, and how eating difficulties can quietly build long before families know what's happening.This conversation offers clarity, compassion, and practical tools - whether you're navigating ARFID yourself, supporting a young person, or simply trying to better understand ND eating differences.If you would like to support us this Christmas please consider gifting from the below link to spread awareness and carry on the conversation:https://www.hidden20.org/christmas-grotto________Host: Ben BransonProduction Manager: Phoebe De LeiburnéVideo Editor: James ScrivenSocial Media Manager: Charlie YoungMusic: Jackson GreenbergHead of Marketing: Kristen Fuller00:00 Introduction00:48 Dr Josephine Neale: Her Background in Eating Disorders, Autism & ADHD7:20 Why Mind & Body Are Often Seen As Separate in Eating Disorders: & Why That Can Be Problematic 11:26 What Is ARFID? (Avoidant Restrictive Food Intake Disorder Explained)15:01 How Clinicians Assess ARFID 23:35 ARFID in Neurodivergent People: Autism, ADHD & Sensory Profiles25:29 The Four ARFID Subtypes: Fear, Sensory, Low Appetite & Combined29:40 What Causes ARFID? Understanding Roots, Triggers & Early Signs31:13 ARFID Fear Subtype: Anxiety, Choking Fears & Avoidance32:44 ARFID Low Appetite Subtype: Interoception & Reduced Hunger34:38 ARFID Sensory Subtype: Texture, Smell, Taste & Food Aversions48:23 Can ARFID Come and Go? Understanding Episodic Presentations50:30 Did ARFID Exist Historically? Why Modern Life May Be Increasing Cases55:36 Christmas & ARFID: How to Support People with Eating Difficulties1:01:08 ARFID at Someone Else's House: How Families Can Navigate Christmas Day1:05:59 Dr Josephine's Green Dot BadgeThe Hidden 20% is a charity founded by ADHD & autistic entrepreneur Ben Branson.Our mission is simple: To change how the world sees neurodivergence.No more stigma. No more shame. No more silence.1 in 5 people are neurodivergent. That's 1.6 billion of us - yet too many are still excluded, misunderstood, or left without support.To break the cycle, we amplify voices, challenge myths, and keep showing up. Spotlighting stories, stats and hard truths. Smashing stereotypes through honest voices, creative campaigns and research that can't be ignored.Every month, over 50,000 people turn to The Hidden 20% to feel safe, seen and to learn about brilliant brains.With your support, we can reach further, grow louder, and keep fighting for the 1 in 5 who deserve more.Join us at hidden20.org/donate.Become a monthly donor.Be part of our community where great minds think differently.Brought to you by charity The Hidden 20% #1203348______________Follow & subscribe…Website: www.hidden20.orgInstagram / TikTok / Youtube / X: @Hidden20charityBen Branson @seedlip_benDr Josephine Neale @drjosephineneale www.nealehealth.comIf you'd like to support The Hidden 20%, you can buy a "green dot" badge at https://www.hidden20.org/thegreendot/p/badge. All proceeds go to the charity. Hosted on Acast. See acast.com/privacy for more information.

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

In this episode, I speak with Dr Anna Colton, a clinical psychologist who specialises in adolescence and eating disorders. We explore the rise of eating disorders, the impact of the pandemic, and how social media and diet culture shape young people's relationship with food and their bodies. The conversation offers practical, compassionate guidance for parents and caregivers on talking with children and teens about nutrition, body image, and healthy eating patterns. Anna is the author of How to Talk to Children About Food, and shares actionable strategies for conversations at home, signs to watch for, and when to seek professional help.   Key takeaways - Eating disorders are increasing, with the pandemic cited as a major contributing factor. Social and cultural pressures around weight have intensified with the introduction of weight-loss medications and pervasive diet messaging on social media. A large portion of nutrition guidance consumed by young people comes from platforms like Instagram and TikTok, where most content is not accurate. - Adolescence involves two key developmental tasks: separation from caregivers and individuation (forming a sense of self). COVID-era restrictions disrupted these processes, which, alongside heightened emotions and risk messaging, created an opportunity for disordered eating to flourish. - Language matters when talking about food. Be specific and neutral rather than labeling foods as “healthy” or “unhealthy.” Avoid fear-based or punitive messaging (e.g., “that will make you fat”). Emphasize balance, variety, and the overall pattern of the diet rather than single meals. - Create a healthy home food environment. Allow for a range of foods at home, avoid using food as a reward or punishment, and be cautious about restricting foods. This supports self-regulation and reduces the likelihood of binge-eating cycles driven by deprivation. - Focus on body function and acceptance, not appearance. There are billions of unique bodies, and variation is normal. Encourage body acceptance and appreciation for what the body does (movement, health, energy) rather than how it looks. It's realistic to acknowledge that not everyone feels positive about their body every day. - Support for puberty and body changes. Hormonal fluctuations and evolving bodies during adolescence can be unsettling. Discuss differences in energy needs, portions, and activity levels openly, and acknowledge that it's normal for bodies to change at different rates. - Handling trends with curiosity. Teens may be drawn to gym culture and protein supplements. It's useful to explore the evidence together, rather than dismissing interest. Encourage evidence-based choices and avoid pressuring or shaming. - Early signs of potential eating disorders. Watch for significant changes in eating patterns (skipping meals, cutting out whole food groups), increased anxiety around meals, extreme weight changes, and irregular periods in girls. If you notice these signs, approach with curiosity and seek help promptly. - Initial steps if you're concerned. Start with careful observation over a short period, then have a non-judgmental conversation. If concerns persist, consult a GP for baseline checks (weight, height, bloods) and consider seeing a psychologist or ED specialist. Early intervention is preferable to waiting for illness to become severe. - Treatment principles and parental roles. In anorexia, parents may need to support structured eating as part of recovery. In binge patterns, reducing restriction helps, since hunger drives cravings. Special situations like ARFID require expert assessment and tailored exposure-based strategies. The NHS and ED services are under-resourced, so timely engagement with healthcare providers is crucial. - When to seek specialist help. If concerns persist, especially with weight changes, food avoidance, or distress around eating, connect with a healthcare professional early. A qualified psychologist or dietitian with ED experience can offer targeted guidance and support.   Resources    Anna Colton's book How to Talk to Children About Food is a practical primer for parents.  You can follow her on https://www.instagram.com/drannacolton  search for The Food Psychologist on TikTok and her LinkedIn is https://www.linkedin.com/in/dr-anna-colton-79975521/  for evidence-based insights and ongoing discussions about eating, weight, and body image. If you enjoy the podcast please help us grow by sharing this episode, or writing a review. You can also find me at http://www.thetripleshift.org   connect with me at https://www.linkedin.com/in/emmacthomas/   follow along on Instagram at https://www.instagram.com/middlingalong_podcast/  or subscribe to my Substack at https://middlingalong.substack.com/   

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

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

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 

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

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.

In this episode of First Bite, Michelle Dawson, MS, CCC-SLP, CLC, BCS-S, is joined by Dr. Amy Talbot, Director and Clinical Psychologist of the Talbot Centre in Australia, to unpack the well-established overlap between Pediatric Feeding Disorder (PFD) and Avoidant Restrictive Food Intake Disorder (ARFID). For SLPs new to this area of practice, the lines between roles and responsibilities, particularly with respect to each diagnosis, can be blurry, and Dr. Talbot is here to clean it all up!If you are curious as to what the differences are between PFD and ARFID and want to learn more about how a psychologist can contribute to the care of clients with feeding-related concerns (PFD/ARFID) as part of a multidisciplinary team, then be sure to join this conversation.By the end of the hour, Amy plans to equip guests with strategies for building relationships with suitably trained or qualified psychologists as part of their referral network, aiming to grow a robust interprofessional practice team.Show Notes: Feeding Matters: https://www.feedingmatters.orgTalbot Centre: https://thetalbotcentre.com.auButterfly Foundation: https://butterfly.org.auAbout the Guest(s): Dr Amy Talbot (she/her) is a multi-award-winning clinical psychologist and director of The Talbot Centre, a multidisciplinary service in Sydney. Her work focuses on eating, feeding, and body image concerns, with an emphasis on neurodiversity-affirming, family-centred care. Amy is a sought-after presenter, supervisor, and researcher, known for advancing interdisciplinary approaches to complex case formulation and integrating lived experience perspectives to improve outcomes for individuals with ARFID and related feeding disorders.Follow First Bite: https://linktr.ee/FirstBitePodcastSpotify: https://open.spotify.com/show/36kfA1xbU156vHPilALVoJ?si=086bed1210af45d5Apple Podcasts: https://podcasts.apple.com/us/podcast/first-bite/id1399630680

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.

In this episode, I'm joined by clinical psychologist and Equip co-founder Dr. Erin Parks for a clear, compassionate guide to eating disorders. We sort through ARFID vs. picky eating, anorexia, bulimia, and binge eating; early signs to watch for (and what's normal); how to talk about food and bodies at home; and when to step in and get help—so you know what to worry about, what to let go, and exactly where to start.Visit equip.health/goodhumans to learn more about Equip's virtual, evidence-based eating disorder treatmentI WROTE MY FIRST BOOK! Order your copy of The Five Principles of Parenting: Your Essential Guide to Raising Good Humans Here: https://bit.ly/3rMLMsLSubscribe to my free newsletter for parenting tips delivered straight to your inbox: draliza.substack.com Follow me on Instagram for more:@raisinggoodhumanspodcast Sponsors:Wayfair: Head to Wayfair.com right now to shop all things homeZip Recruiter: Go to ZipRecruiter.com/HUMANS right now, you can try it FOR FREENature's Sunshine: Nature's Sunshine is offering 20% off your first order plus free shipping. Go to naturessunshine.comAvocado Mattress: Get an extra $25 off their current sale at AvocadoGreenMattress.com with the code humansQuince: Go to Quince.com/humans for free shipping on your order and 365-day returnsPlease note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.