Dr. Marianne-Land: An Eating Disorder Recovery Podcast

mariannemillerphd
  • 5.0 (28)
  • Mental Health
  • Updated Weekly

Welcome to this mental health and eating disorder podcast by Dr. Marianne Miller, who is an eating disorder therapist and binge eating and ARFID course creator. In this podcast, Dr. Marianne explores the ins and outs of eating disorder recovery. It’s a top podcast for people struggling with anorexia, bulimia, binge eating disorder, ARFID (avoidant restrictive food intake disorder), and any sort of distressed eating. We discuss topics like neurodiversity and eating disorders, self-compassion in eating disorder recovery, lived experience of eating disorders, LGBTQ+ and eating disorders, as well as anti-fat bias, weight-neutral fitness, muscularity-oriented issues, and body image. Dr. Marianne has been an eating disorder therapist for 13 years and has created a course on ARFID and selective eating, as well as a membership to help you recover from binge eating disorder and bulimia. Dr. Marianne has been in mental health for 28 years. Dr. Marianne is neurodivergent and works with a lot of neurodivergent folks. She has fully recovered from an eating disorder that lasted 25 years, and she wants to share her experience, knowledge, and recovery joy with you! Her interview episodes with top eating disorder professionals drop on Tuesdays. You can also tune in on Fridays when Dr. Marianne’s SOLO episodes that come out. You’ll hear personal stories, tips, and strategies to help you in your eating disorder recovery journey. If you’re struggling with food, eating, body image, and mental health, this podcast is for you!

  1. 1d ago

    Why Food Feels So Regulating: Autism, ADHD, Eating Disorders, & the Nervous System

    Why Food Feels So Regulating: Autism, ADHD, Eating Disorders, & the Nervous System Why can eating feel so calming, stimulating, or grounding? For many autistic people, ADHDers, and people with eating disorders, food does more than satisfy hunger. Eating can provide sensory input, emotional regulation, predictability, stimulation, and nervous system support. In this solo episode, Dr. Marianne explores food as self-regulation, co-regulation, and stimming, including why chewing, crunching, sipping, familiar foods, and repetitive eating experiences may help a neurodivergent nervous system feel more organized. She also discusses how these needs can intersect with autism, ADHD, anorexia, bulimia, binge eating disorder, and ARFID. What You'll Learn You'll learn why autistic and ADHD people may use food for sensory regulation, how eating can function as a form of stimming, and why "emotional eating" doesn't always capture what's actually happening. Dr. Marianne also explains why restriction can feel regulating for some people with anorexia, how food may help an overwhelmed or understimulated ADHD nervous system, why predictable safe foods can provide sensory security with ARFID, and how binge eating or bulimia can become intertwined with attempts to regulate distress. Rather than asking only, "How do I stop this eating behavior?" Dr. Marianne encourages a different question: "What is my nervous system getting from this?" Food, Stimming, & Neurodivergent Eating Food can provide powerful sensory experiences through taste, temperature, texture, chewing, swallowing, crunching, and repetition. For some neurodivergent people, these sensations can help increase stimulation, reduce overwhelm, support focus, or create predictability. Recovery doesn't have to mean eliminating food as a source of comfort or regulation. Instead, it can involve understanding what food provides and gradually expanding the ways your nervous system accesses safety, sensory input, connection, and support. Eating Disorder & Neurodivergent-Affirming Support If you're navigating ARFID, anorexia, bulimia, binge eating, autism, ADHD, sensory eating challenges, or neurodivergent eating disorder recovery, Dr. Marianne offers a neurodivergent-affirming, sensory-attuned, trauma-informed approach. Dr. Marianne provides eating disorder therapy in California and Washington, D.C., including telehealth and in-person services in San Diego, as well as coaching and consultation worldwide. Learn more about working with Dr. Marianne and find additional eating disorder and neurodivergence resources at drmariannemiller.com.

  2. 3d ago

    Anorexia in a Larger Body: How to Talk About Your Eating Disorder When Others Don't Understand

    Anorexia in a Larger Body: How to Talk About Your Eating Disorder When Others Don't Understand Can you have anorexia in a larger body? Yes. Yet weight stigma and stereotypes about what an eating disorder "looks like" can make it difficult to feel believed, receive appropriate anorexia treatment, or talk about your experience with others. In this solo episode, Dr. Marianne discusses anorexia in larger bodies from both a clinical and lived-experience perspective. As an eating disorder therapist who has experienced anorexia and now lives in a larger body, she understands the complicated experience of having an eating disorder history that other people may not recognize. Anorexia, Atypical Anorexia, and Weight Stigma Anorexia and restrictive eating disorders occur across the weight spectrum. Body size cannot tell you how much someone restricts, how distressed they feel around food, or how much support they need. Dr. Marianne explores atypical anorexia, weight stigma, eating disorder recovery, and the painful experience of receiving compliments about weight loss when restriction is harming your health. How to Talk About Anorexia With Others What do you say when someone tells you that you "don't look anorexic"? Learn practical ways to talk about anorexia with family, friends, and healthcare providers, set boundaries around weight and body comments, advocate for weight-inclusive care, and respond when people don't understand your eating disorder. Work With Dr. Marianne If you're navigating anorexia, atypical anorexia, restrictive eating, or eating disorder recovery, Dr. Marianne offers neurodivergent-affirming, trauma-informed, weight-inclusive support. Learn more about eating disorder therapy, coaching, and consultation at drmariannemiller.com.

  3. 5d ago

    Harm Reduction & The Middle Place of Eating Disorder Recovery With "Slip" Author Mallary Tenore Tarpley, MFA

    How can harm reduction support eating disorder recovery when full recovery feels complicated, nonlinear, or far away? Dr. Marianne welcomes back journalist, professor, and author Mallary Tenore Tarpley, MFA, for a conversation about eating disorder harm reduction, anorexia recovery, long-term eating disorder recovery, and the pressure to achieve full recovery. Mallary is the author of Slip: Life in the Middle of Eating Disorder Recovery, a memoir that combines her lived experience with extensive research on how people actually experience eating disorder recovery. Eating Disorder Harm Reduction and Full Recovery Eating disorder recovery often gets framed in black-and-white terms: you are either sick or fully recovered. Mallary challenges that binary without dismissing the possibility of full recovery. For Slip, Mallary surveyed more than 700 people with lived experience of eating disorders and interviewed approximately 175 survey respondents, clinicians, and researchers. Of those surveyed, 85% identified with what she calls the “middle place,” the gray area between acute illness and full recovery. Dr. Marianne and Mallary discuss why rigid definitions of recovery can create shame for people navigating long-term anorexia recovery, lingering eating disorder thoughts, slips, relapse, and ongoing recovery work. What Does Eating Disorder Recovery Actually Mean? Recovery involves more than weight, food intake, or eliminating visible eating disorder behaviors. Mallary describes recovery through changes in identity, cognitive freedom, mental bandwidth, and physical well-being. She shares how her eating disorder once consumed her thoughts and identity. Now, eating disorder thoughts may still appear, but they no longer dictate her life in the same way. Dr. Marianne connects this with her own lived experience and discusses how reducing food and body preoccupation can create more capacity for relationships, work, interests, and life outside the eating disorder. Harm Reduction, Slips, and All-or-Nothing Recovery Mallary explains how harm reduction in eating disorder recovery can help someone move forward without demanding immediate perfection. Instead of treating an eating disorder thought or behavior as proof of failure, harm reduction creates room to notice what happened, reduce risk, and make another choice. Mallary shares a vulnerable example involving making grilled cheese for herself and her children. When a lingering eating disorder impulse influenced how she prepared her own sandwich, she noticed it, changed course, and moved forward without shaming herself. Dr. Marianne and Mallary also discuss neurodivergent eating disorder recovery, including how autism, ADHD, perfectionism, certainty-seeking, trauma, and nervous system needs can make rigid treatment expectations especially difficult. Slip: Life in the Middle of Eating Disorder Recovery Mallary’s book, Slip: Life in the Middle of Eating Disorder Recovery, combines memoir, journalism, and research to challenge simplistic narratives about eating disorders and recovery. Drawing from her own history with anorexia and changing eating disorder symptoms alongside the experiences of hundreds of others, Mallary asks what recovery can look like when it does not follow a clean before-and-after story. Mallary also shares what she is researching next, including optimization culture, the thin ideal, healthmaxxing, anti-aging pressures, body image, and cultural messages that encourage us to treat our bodies as endless projects requiring improvement. If you have ever wondered whether your eating disorder recovery “counts” because you still struggle, this conversation offers a more flexible way to understand healing, progress, and recovery. Follow Mallary on Instagram: @mallarytenoretarpley Go to her Substack: https://mallary.substack.com Related Episodes Check out "The Middle Place in Eating Disorder Recovery: How Slips Can Be Stepping Stones With Mallary Tenore Tarpley, MFA @mallarytenoretarpley" on Apple or Spotify: Listen to “'Slips'” in Eating Disorder Recovery in 2026: Why Setbacks Are Part of Progress, Not Failure (With Mallary Tenore Tarpley, MFA)" on Dr. Marianne-Land Podcast on Apple or Spotify. Work With Dr. Marianne Looking for eating disorder therapy, ARFID treatment, or neurodivergent-affirming eating disorder support? Dr. Marianne works with people navigating ARFID, anorexia, bulimia, binge eating, long-term eating disorders, autism, ADHD, and complex relationships with food and body image. Visit DrMarianneMiller.com to learn more about working with Dr. Marianne through therapy or coaching, explore her ARFID & Selective Eating Course for individuals, parents, and providers, and find additional eating disorder and neurodivergent-affirming resources. You can also listen to more episodes of Dr. Marianne-Land for conversations about eating disorder recovery, ARFID, autism, ADHD, body image, and creating a more sustainable relationship with food.

  4. Aug 14

    How to Manage Weight Restoration When Your Autistic Child Has Anorexia, ARFID, & a PDA Profile

    How do you support weight restoration when your autistic child needs nutrition, but pressure around food makes eating even harder? For autistic children, teens, and adolescents with a PDA profile (Pathological Demand Avoidance or Pervasive Drive for Autonomy), weight restoration for ARFID, anorexia, and other restrictive eating disorders can become especially complicated. Parents may know that their child urgently needs more nutrition, yet direct demands, rigid meal expectations, sensory overwhelm, and medical procedures can increase distress and food refusal. In this solo episode, Dr. Marianne Miller discusses weight restoration in autistic children and teens with ARFID or anorexia, including how PDA, sensory processing differences, interoception, executive functioning, and nervous system overwhelm can affect eating disorder recovery. Autism, PDA, ARFID, and Anorexia During Weight Restoration Weight restoration involves more than getting enough calories into a child's body. Autistic children and adolescents may experience intense sensory sensitivities around food, difficulty identifying hunger and fullness cues, strong needs for predictability, executive functioning challenges, and distress when eating becomes a demand. Dr. Marianne explains why these differences need to become part of the treatment plan instead of being treated as behaviors that must be overcome. She also discusses an important distinction between ARFID and anorexia in autistic teens, including why some young people can experience features of both restrictive eating disorders. Why Pressure Around Food Can Backfire With a PDA Profile When an autistic child has a PDA profile, even necessary requests can activate a threat response. During eating disorder recovery, parents may find themselves repeatedly asking their child to eat another bite, finish a supplement, follow a meal plan, or complete a snack. The stakes are real. So is the child's nervous system response. You'll learn why reducing unnecessary demands does not mean abandoning weight restoration and how parents can protect medical safety without turning every meal into a power struggle. Medical Management of Eating Disorders in Autistic Children and Teens Medical stabilization can present additional challenges for autistic children and adolescents with ARFID or anorexia. Blood draws, vital signs, unfamiliar providers, hospital environments, bright lights, noise, disrupted routines, physical examinations, and unexpected procedures can create significant sensory and nervous system overload. Dr. Marianne discusses how autistic shutdowns, meltdowns, reduced communication, or refusal may reflect overwhelm rather than "noncompliance." She also explains why autism-informed and trauma-informed medical care matters when a young person requires medical monitoring or stabilization for a restrictive eating disorder. Supporting Eating Disorder Medical Management at Home Parents often become an important part of the medical management team during weight restoration. Under the guidance of a physician or eating disorder treatment team, some families may monitor aspects of their child's health at home between appointments. Dr. Marianne discusses practical ways parents can organize medical information, pay attention to changes in symptoms, create more predictable eating routines, reduce sensory demands, use preferred foods strategically, and communicate more effectively with medical providers. You'll also hear why home monitoring should complement, rather than replace, appropriate medical care and why concerning physical symptoms require prompt evaluation from your child's healthcare team. Neurodivergent-Affirming Tips for Weight Restoration This episode offers practical ideas for supporting an autistic child or teen through weight restoration, including creating predictable meal routines, prioritizing adequate nutrition before pushing food variety, making sensory accommodations, offering meaningful choices, reducing unnecessary conflict around food, and building a collaborative treatment team. For children with autism, PDA, ARFID, or anorexia, medical safety and autonomy do not have to exist on opposite sides of treatment. Neurodivergent-affirming eating disorder care can take malnutrition seriously and still respect sensory needs, communication differences, autonomy, trauma history, and nervous system regulation. Related Episodes PDA, ARFID, & Food Avoidance: Why “Just Eat” Doesn’t Work & What to Do Instead on Apple & Spotify. When PDA Drives ARFID: Understanding Food Refusal, Control, & Safety on Apple & Spotify. ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify. Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify. Eating Disorder Therapy in California and Parent Consultation Worldwide If your child, adolescent, or teen has ARFID, anorexia, autism, PDA, or another restrictive eating disorder, Dr. Marianne offers neurodivergent-affirming eating disorder therapy in California, including in-person services in San Diego and telehealth throughout California. For families outside California, Dr. Marianne also provides parent consultation worldwide for parents navigating ARFID, restrictive eating, autism, PDA, sensory challenges, weight restoration, and eating disorder recovery. Go to drmariannemiller.com and schedule a free, 15-minute phone or Zoom consultation. You can also learn more through Dr. Marianne's ARFID and Selective Eating Course, created for parents, providers, and others who want practical, neurodivergent-affirming strategies for understanding ARFID, autism, sensory processing, autonomy, trauma, and eating. If weight restoration has become a battle in your family, you do not have to choose between taking your child's medical needs seriously and respecting their neurodivergence. Support can account for both.

  5. Aug 12

    My Eating Disorder Recovery Story Continued: Internalized Weight Bias in the Age of Ozempic

    What happens to eating disorder recovery when the culture around you starts celebrating weight loss again? In this deeply personal solo episode, Dr. Marianne continues sharing her eating disorder recovery story and talks about something that has surprised her: the return of body insecurities during the Age of Ozempic. After recovering from a decades-long history of anorexia, binge eating disorder, orthorexia, and bulimia, she rarely spends much time thinking about her body size. But the rise of Ozempic and other GLP-1 medications like Zepbound and Wegovy has changed the cultural conversation around weight, thinness, and fat bodies. During the height of the body diversity movement, living in a larger body felt different. Plus-size clothing became more visible. Larger bodies appeared in advertising. Conversations about weight stigma, fatphobia, body neutrality, and fat liberation entered the mainstream. Now, many of those gains seem to be disappearing as celebrities become smaller, plus-size departments vanish from stores, and thinness once again becomes something we're expected to pursue. When Eating Disorder Recovery Meets the Age of Ozempic Dr. Marianne shares what it's like to encounter old eating disorder and body image thoughts after years of recovery. Sometimes those thoughts arrive unexpectedly: Look at that celebrity. They did it. Why can't I? Having that thought doesn't mean eating disorder recovery has failed. Recovery doesn't necessarily erase decades of conditioning around weight and body size. Instead, it can help us recognize internalized weight bias when it resurfaces and decide whether we want to listen to it. Dr. Marianne also discusses an important distinction: wanting a smaller body isn't necessarily the same thing as wanting relief from anti-fat bias. Sometimes the thought, Life would be easier if I were thinner, reflects a painful reality about how fat people are treated rather than a genuine desire to change one's body. The World Is Getting Smaller for Fat People Anti-fat bias doesn't exist only in our thoughts. It shows up in the physical world. Plus-size clothing departments have disappeared from many stores, forcing people in larger bodies to shop online. Airplane seats continue to create accessibility barriers for larger passengers. Cars, restaurant booths, waiting-room chairs, theaters, and other public spaces frequently fail to accommodate body diversity. The message can become impossible to ignore: if the world won't make more space for you, you're expected to make yourself smaller. Dr. Marianne explores the mental health toll of repeatedly navigating environments that weren't designed for your body. Constantly wondering whether a seat will fit, whether a store carries your size, or whether a healthcare provider will blame your symptoms on weight creates an enormous cognitive and emotional burden. Defending the Right to Be Fat Dr. Marianne shares a recent dream in which she found herself defending her fatness to another person. When she woke up, she realized how closely the dream reflected the experience of living in a larger body today. Fat people often have to defend their right to exist without pursuing intentional weight loss. They may have to advocate for appropriate healthcare, accessible seating, clothing, travel accommodations, and the basic right to occupy space without apology. That emotional labor takes energy. For neurodivergent people, the burden can become even greater. Autistic people and ADHDers may already expend significant energy navigating sensory needs, executive functioning, uncertainty, masking, and environments that weren't designed for neurodivergent nervous systems. When neurodivergence intersects with anti-fat bias and other forms of marginalization, the cumulative mental health toll can become significant. Internalized Weight Bias Doesn't Mean You've Failed at Recovery Eating disorder recovery happens in the real world, not in a protected bubble. You can appreciate your body and still feel hurt by weight stigma. You can reject diet culture and feel grief when plus-size clothing disappears. You can practice fat acceptance and still have moments when you wonder whether life would be easier in a smaller body. Those experiences don't erase recovery. Sometimes what looks like body dissatisfaction is actually grief, anger, exhaustion, or a desire to move through the world without constantly having to advocate for your right to belong. Dr. Marianne shares the question that helps her separate internalized weight bias from her own values: Do I actually want a different body, or do I want a different world? Related Episodes How a Part of Me Wanted to Take a Weight-Loss Drug on Apple & Spotify. My Eating Disorder Recovery Story on Apple & Spotify. Finding Liberation-Focused Eating Disorder Support If the Age of Ozempic has stirred up old body image struggles, eating disorder thoughts, or internalized weight bias, you don't have to navigate those experiences alone. Finding an eating disorder therapist or provider who understands weight stigma can make a profound difference. Liberation-focused, trauma-informed, neurodivergent-affirming eating disorder treatment can create space to examine these experiences without making weight loss the goal. If you'd like to work with Dr. Marianne, she provides eating disorder therapy in California for adolescents and adults navigating anorexia, bulimia, binge eating disorder, ARFID, body image concerns, and neurodivergence. If you live elsewhere, Dr. Marianne also offers consultations and coaching for individuals, families, and professionals. Learn more about working with Dr. Marianne at drmariannemiller.com.

  6. Aug 10

    Is Healthmaxxing Disordered Eating? Protein, Fitness Trackers, & Eating Disorder Recovery With Amy Ornelas, RD

    When does trying to be healthy cross the line into rigid or disordered eating? Healthmaxxing focuses on optimizing nutrition, protein, exercise, sleep, steps, and other health metrics. But for someone with an eating disorder or history of disordered eating, healthmaxxing can become another way to follow rigid rules, compulsively track behaviors, and disconnect from the body. In this episode of Dr. Marianne-Land, Dr. Marianne talks with registered dietitian and eating disorder specialist Amy Ornelas, RD, about healthmaxxing, diet culture, protein obsession, fitness trackers, compulsive exercise, and eating disorder recovery. Is Healthmaxxing the New Diet Culture? Healthmaxxing may look different from traditional dieting, but some of the messages sound familiar: eat the “right” foods, maximize protein, hit your steps, exercise consistently, track your metrics, and keep improving. Dr. Marianne and Amy discuss how healthmaxxing can become a socially acceptable form of rigid or disordered behavior. For someone recovering from an eating disorder, relying on an Apple Watch, Oura Ring, calorie tracker, or wellness influencer may also make it harder to rebuild trust in hunger, fullness, fatigue, and other body cues. Protein, Fitness Trackers, & Compulsive Exercise Protein has become one of the biggest trends in nutrition and wellness culture. Amy compares today's protein obsession to previous diet trends, including the fat-free craze of the 1980s and 1990s. Protein matters, but maximizing protein at every meal doesn't automatically make eating healthier. Dr. Marianne and Amy also unpack step counts, exercise goals, calorie tracking, and wearable fitness devices. Fitness data can provide useful information for some people, but it can also reinforce compulsive exercise, perfectionism, and eating disorder behaviors. Your body's needs change. Rest, relationships, sleep, pleasure, and spontaneity matter too. Eating Disorder Recovery & Rebuilding Body Trust Eating disorders can make hunger, fullness, fatigue, emotion, and physical sensations difficult to interpret. That uncertainty can make external rules and health metrics especially appealing. Amy explains how eating disorder nutrition therapy can provide appropriate structure as someone rebuilds nourishment and reconnects with their body. Unlike an algorithm or influencer, individualized nutrition support considers a person's history, eating disorder behaviors, physical needs, and recovery. Dr. Marianne and Amy also discuss what happens when fitness becomes part of your identity. Letting go of compulsive exercise or rigid health behaviors can raise a difficult question: Who am I if I'm no longer the person who always works out, eats a certain way, or prioritizes fitness? Recovery can create room to discover an identity beyond food, weight, exercise, and optimization. What You'll Learn You'll hear Dr. Marianne and Amy discuss healthmaxxing and disordered eating, diet culture and wellness culture, protein obsession and nutrition trends, fitness trackers and calorie tracking, compulsive exercise and step goals, fitness identity, hunger and fullness cues, body trust, and nutrition therapy in eating disorder recovery. They also ask a bigger question: What happens when trying to optimize your health starts taking away from your life? About Amy Ornelas, RD Amy Ornelas is a registered dietitian and eating disorder specialist with more than two decades of experience. She incorporates nutrition therapy, somatic therapy, yoga, and intuitive practices into her work with adolescents and adults. Her own eating disorder recovery helped shape her commitment to helping people move away from diet culture, rigid food rules, body image struggles, and disconnection from their bodies. Instagram: @amyornelasRD Website: i-heart-nutrition.com Related Episodes Have you ever had the experience of suddenly feeling huge in your body, even though nothing about your body has actually changed? That moment of intense body distress is incredibly common in eating disorder recovery. But what if that feeling is not really about body size at all? In this episode of Dr. Marianne-Land, Dr. Marianne Miller is joined by Amy Ornelas, RDN, an eating disorder dietitian, yoga teacher, and somatic therapy practitioner, to explore what body distress may actually be signaling underneath the surface. Together, they unpack how thoughts like “I feel huge” can often reflect emotional activation, overwhelm, grief, shame, anger, or stress rather than a literal change in body size. Amy explains how eating disorder behaviors such as restriction, binge eating, and purging can alter brain chemistry and disconnect people from their internal emotional world. When those behaviors begin to shift in recovery, many people suddenly find themselves face to face with emotions that may have been numbed or pushed aside for years. This can feel confusing, intense, and sometimes even frightening. Dr. Marianne and Amy talk about how eating disorders can function as powerful survival strategies that help people manage overwhelming emotional states. Rather than demonizing these behaviors, they explore how they often develop as adaptive coping mechanisms in environments where emotional expression was discouraged, dismissed, or unsafe. The conversation also highlights how family dynamics, culture, trauma, and neurodivergence can shape the way people learn to relate to their emotions. Many individuals grow up hearing messages that they are too sensitive, too emotional, or should simply get over what they feel. Over time, these messages can make emotional awareness feel dangerous or overwhelming. Amy introduces the role of somatic therapy in eating disorder recovery and explains how body-based approaches can help people reconnect with their internal sensations in a gradual and supportive way. Instead of forcing emotional processing, somatic work focuses on building safety in the nervous system and slowly increasing the capacity to notice and tolerate emotional states. Dr. Marianne and Amy also discuss how body image distress can function as a powerful distraction. It can feel easier to focus anger, fear, or grief on the body than to confront deeper sources of pain, such as relational conflict, social stress, or systemic injustice. Learning to translate body distress into emotional language can help people understand what their internal system is truly trying to communicate. This episode also addresses an important reality in eating disorder recovery: sometimes people appear more emotionally dysregulated as they begin healing. That increase in emotional expression can actually be a sign that someone is reconnecting with their inner world after years of emotional numbing. Amy shares several practical tools that can help people begin reconnecting with their emotions, including brief emotional check-ins throughout the day, asking simple questions about what feelings may be present when eating disorder urges arise, and using movement to help emotional energy move through the body. Dr. Marianne also brings in a neurodivergent-affirming lens, discussing how stimming, rocking, sensory soothing, and other nervous system supports can help people stay connected to themselves during emotionally intense moments. Together, they emphasize that emotions are not problems to eliminate. They are information from our internal systems that help guide us toward safety, boundaries, authenticity, and healing. In this episode, we discuss How eating disorder behaviors can numb or redirect difficult emotions. Why recovery often brings a surge of feelings to the surface, What somatic therapy is and how it can support eating disorder recovery. Why the thought “I feel huge” often reflects emotional distress rather than body change. How trauma, family systems, and culture shape emotional expression. Why body image distress can act as a distraction from deeper pain. The difference between compartmentalizing emotions and avoiding them. Why increased emotional intensity can be a sign of progress in recovery. Practical ways to begin noticing and naming emotions during recovery. How neurodivergent people may benefit from stimming and sensory supports. About the guest Amy Ornelas, RDN, is a registered dietitian nutritionist, eating disorder specialist, yoga teacher, and somatic therapy practitioner based in California. She works with individuals, families, and groups and integrates nutrition care with somatic and nervous system–informed approaches to eating disorder recovery. Connect with Amy Ornelas Instagram: @amyornelasRD Website: i-heart-nutrition.com Listen if you are Experiencing intense body image distress during eating disorder recovery. Trying to understand why recovery can bring more emotion, not less. Curious about somatic therapy and body-based approaches to healing. Looking for tools to help manage urges to restrict, binge, or purge. Interested in understanding the emotional layers beneath body distress. Related episodes On "I Feel Huge" Versus "What I'm Actually Feeling": Translating Body Distress Into Emotions" via Apple or Spotify. On Eating Disorders as a Coping Strategy for Deeper Pain via Apple or Spotify. On Eating Disorders in Midlife & Our Personal Recovery Stories via Apple or Spotify. On Atypical Anorexia via Apple or Spotify On Eating Disorder Recovery, Higher Level of Care, & Renourishment via Apple or Spotify On Reconnecting With Your Body in Eating Disorder Recovery via Apple or Spotify On Trauma, Eating Disorders, & Levels of Care via Apple or Spotify. Work With Dr. Marianne If healthmaxxing, compulsive exercise, rigid food rules, body image concerns, or anxiety around eating have become tangled up with your eating disorder, Dr. Marianne offers a neurodivergent-affirming, trauma-informed approach to eating disorder recovery. Dr. Marianne specializes in ARFID, binge eating, anorexia

  7. Aug 7

    Why Lived Experience Matters in Anorexia & Bulimia Recovery for Neurodivergent People: 5 Things I've Learned as Both a Therapist & Someone in Recovery

    Does it matter whether your eating disorder therapist has personally recovered from anorexia or bulimia? In this solo episode of Dr. Marianne-Land, I explore that question from two perspectives: as an eating disorder therapist and as someone who spent about 25 years navigating anorexia, binge eating, orthorexia, bulimia, compulsive exercise, and the long road to recovery. Lived experience does not replace professional training, and professional training does not require lived experience. Both forms of knowledge have value. In this episode, I share how my personal recovery has shaped my clinical work and why that perspective can be especially meaningful for autistic people, ADHDers, AuDHDers, and other neurodivergent adults recovering from anorexia and bulimia. What You'll Learn You'll hear five lessons that have transformed the way I understand eating disorder recovery. We discuss why what appears to be resistance is often nervous system overwhelm, how to tell the difference between neurodivergent traits and eating disorder symptoms, why shame rarely creates lasting recovery, how safety supports sustainable healing, and why recovery ultimately becomes about building a meaningful life instead of simply eliminating symptoms. Why Neurodivergent People Often Need a Different Recovery Conversation Traditional eating disorder treatment does not always account for sensory processing differences, executive functioning challenges, autistic burnout, ADHD, interoceptive differences, or the ways trauma and neurodivergence can intersect with anorexia and bulimia. In this episode, I explain why understanding your nervous system can make recovery feel more compassionate, more realistic, and more sustainable. Rather than forcing yourself to fit a rigid recovery model, you can begin building an approach that respects both your neurodivergence and your recovery goals. Who This Episode Is For This episode is for adults recovering from anorexia nervosa, atypical anorexia, bulimia nervosa, chronic eating disorders, or long-term restrictive eating. It's also for autistic adults, ADHDers, AuDHD adults, highly sensitive people, therapists, dietitians, parents, caregivers, and anyone who wants a deeper understanding of neurodivergent-affirming eating disorder treatment. Mentioned in This Episode If you want to learn more about sensory processing, autonomy, nervous system regulation, and neurodivergent-affirming approaches to eating, check out my ARFID and Selective Eating Course. Although the course focuses on ARFID, many of the concepts also apply to neurodivergent people recovering from anorexia, bulimia, and other eating disorders. Related Episodes Harm Reduction for Eating Disorders: How Lived Experience Shapes Recovery, Support, & Long-Term Healing on Apple & Spotify. Lived Experience of ARFID in Autistics & ADHDers: Sensory Survival & Misunderstandings With Dr. Panicha McGuire, LMFT, RPT on Apple & Spotify. Unmasking in Eating Disorder Recovery: What Neurodivergent People Need to Know About Safety & Healing via Apple & Spotify. Connect With Dr. Marianne Miller If you're looking for eating disorder therapy in California or Washington, D.C., or eating disorder coaching from anywhere in the world, I'd love to help. I specialize in anorexia, bulimia, ARFID, binge eating disorder, autism, ADHD, AuDHD, and neurodivergent-affirming eating disorder treatment. Visit www.drmariannemiller.com to learn more about working with me, explore my ARFID course, and listen to more episodes of Dr. Marianne-Land. If you found this episode helpful, please follow the podcast, leave a rating or review on Apple Podcasts or on Spotify, and share it with someone who could benefit from hearing that recovery does not have to look the same for everyone.

  8. Aug 5

    Is It OCD, Perfectionism, or Both? Why It Matters in Eating Disorder Recovery

    Many people with eating disorders get labeled as perfectionists. Sometimes that's accurate. Sometimes it's only part of the story. In this episode of the Dr. Marianne-Land Podcast, I explore the overlap between OCD and eating disorders, perfectionism, anxiety, autism, ADHD, and the cognitive effects of malnutrition. I explain why similar behaviors can have very different underlying causes and why understanding those differences can change the course of eating disorder treatment and recovery. If you've ever found yourself stuck in food rules, body checking, repetitive thoughts, calorie calculations, reassurance-seeking, or endless self-doubt, this episode offers a more nuanced way to understand what's happening beneath the surface. Rather than focusing only on what behaviors look like, I discuss why identifying their function leads to more effective and compassionate care. What You'll Learn In this episode, you'll learn how perfectionism differs from OCD in eating disorder recovery and why the distinction matters. I discuss why intrusive thoughts, compulsive checking, and reassurance-seeking are often mistaken for perfectionism, how anorexia nervosa and other restrictive eating disorders can increase obsessive thinking, and why starvation affects cognitive flexibility and mental rigidity. I also explain how autism, ADHD, sensory needs, and routine dependence can sometimes resemble OCD while reflecting very different underlying experiences. Finally, I share why understanding the function of eating disorder behaviors helps clinicians, individuals, and families choose more effective treatment approaches. OCD, Perfectionism, and Eating Disorders Perfectionism has long been associated with anorexia nervosa, bulimia nervosa, and other eating disorders. At the same time, many people who believe they're simply perfectionists may also experience OCD, significant anxiety, or both. Looking only at outward behaviors can miss what is actually maintaining the cycle of restriction, compulsions, fear, and distress. In this episode, I discuss why food-related rituals, repeated checking, body checking, calorie counting, and reassurance-seeking may look similar across different conditions while serving very different purposes. Understanding those differences helps people receive more individualized, neurodivergent-affirming care instead of one-size-fits-all treatment. Why Neurodivergence Makes the Picture More Complex Autism, ADHD, ARFID, sensory processing differences, and nervous system regulation can all influence eating behaviors, routines, and food preferences. Predictability and consistency often help neurodivergent people reduce overwhelm and make eating feel safer. Those experiences are not automatically signs of OCD or perfectionism. I explain why clinicians need to understand the role of sensory processing, cognitive load, executive functioning, and nervous system regulation before drawing conclusions about repetitive eating behaviors. This perspective supports more accurate assessment and more compassionate eating disorder treatment. Why This Matters for Recovery Recovery looks different depending on what's driving the behavior. Someone whose eating disorder is fueled primarily by perfectionism may need different interventions than someone struggling with OCD, autism, or multiple overlapping conditions. When treatment targets the underlying process instead of the surface behavior alone, recovery often becomes more individualized, effective, and sustainable. Understanding the "why" behind eating disorder behaviors creates opportunities for greater self-compassion and more meaningful healing. This Episode Is For You If... This episode is for anyone recovering from anorexia, bulimia, ARFID, binge eating disorder, or another eating disorder who has wondered whether perfectionism tells the whole story. It's also for autistic, ADHD, and AuDHD individuals, parents, caregivers, therapists, dietitians, physicians, and other professionals who want a more nuanced understanding of OCD, perfectionism, neurodivergence, and eating disorder recovery. Related Episodes OCD & Eating Disorders: Why Food Rules, Rituals, & “Not Feeling Right” Take Over on Apple & Spotify. When Eating Disorders Meet Anxiety, OCD, or Depression: Co-Occurring Challenges & Recovery Strategies on Apple & Spotify. Obsessions, Compulsions, and Control: How OCD Intertwines With Eating Disorders on Apple & Spotify. Food, Fear, & Fixation: How OCD Shapes Eating Disorders on Apple & Spotify. Work With Dr. Marianne Miller If you're looking for a neurodivergent-affirming eating disorder therapist, I provide therapy for adults and adolescents throughout California and Washington, D.C. I also offer parent consultation and eating disorder coaching worldwide. My practice specializes in ARFID therapy, anorexia treatment, bulimia treatment, binge eating disorder therapy, autism and ADHD, and neurodivergent-affirming eating disorder care. I use a sensory-attuned, trauma-informed, autonomy-supportive approach that honors each person's unique nervous system and lived experience. Learn more about therapy, consultation, my ARFID & Selective Eating Course, and additional resources at www.drmariannemiller.com. If you enjoyed this episode, please follow the Dr. Marianne-Land Podcast, leave a rating or review on Apple Podcasts or on Spotify, and share this episode with someone who may benefit from a more compassionate understanding of OCD, perfectionism, and eating disorder recovery.

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About

Welcome to this mental health and eating disorder podcast by Dr. Marianne Miller, who is an eating disorder therapist and binge eating and ARFID course creator. In this podcast, Dr. Marianne explores the ins and outs of eating disorder recovery. It’s a top podcast for people struggling with anorexia, bulimia, binge eating disorder, ARFID (avoidant restrictive food intake disorder), and any sort of distressed eating. We discuss topics like neurodiversity and eating disorders, self-compassion in eating disorder recovery, lived experience of eating disorders, LGBTQ+ and eating disorders, as well as anti-fat bias, weight-neutral fitness, muscularity-oriented issues, and body image. Dr. Marianne has been an eating disorder therapist for 13 years and has created a course on ARFID and selective eating, as well as a membership to help you recover from binge eating disorder and bulimia. Dr. Marianne has been in mental health for 28 years. Dr. Marianne is neurodivergent and works with a lot of neurodivergent folks. She has fully recovered from an eating disorder that lasted 25 years, and she wants to share her experience, knowledge, and recovery joy with you! Her interview episodes with top eating disorder professionals drop on Tuesdays. You can also tune in on Fridays when Dr. Marianne’s SOLO episodes that come out. You’ll hear personal stories, tips, and strategies to help you in your eating disorder recovery journey. If you’re struggling with food, eating, body image, and mental health, this podcast is for you!

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