Eating disorder recovery often requires developing a relationship with food, hunger, movement, and body size that differs sharply from what society considers “normal.” In this conversation, Dr. Marianne welcomes back psychotherapist Shira Collings, LPC, to discuss a powerful question: Can eating disorder recovery become its own form of neurodivergence? Shira describes neurodivergence as a way of thinking, processing information, or living that diverges from dominant social expectations. From this perspective, rejecting diet culture, anti-fat bias, intentional weight loss, and rigid rules about “healthy eating” can place someone outside the cultural norm. Recovery may change how a person understands nourishment, pleasure, rest, exercise, body acceptance, and the right to eat without trying to control their body size. Eating Disorder Recovery in the Ozempic and GLP-1 Era Dr. Marianne and Shira discuss why eating disorder recovery can feel especially isolating in the Ozempic and GLP-1 era. As weight loss becomes culturally celebrated again, people in recovery may experience grief, loneliness, body-image distress, or renewed pressure to shrink themselves. They also examine the growing tendency to call hunger, cravings, and thoughts about food “food noise.” For many people recovering from anorexia, bulimia, binge eating, chronic dieting, or other eating disorders, noticing hunger and responding to food cravings represent meaningful signs of healing. Treating these experiences as problems that should disappear can undermine body trust and reinforce disordered eating beliefs. Hunger Cues, Neurodivergence, and Body Trust Hunger does not feel the same for everyone. Autistic people, ADHDers, highly sensitive people, and others with neurodivergent eating experiences may not notice traditional hunger cues such as a growling stomach. Hunger might appear as lightheadedness, difficulty concentrating, irritability, thoughts about food, emotional changes, or a desire for sensory regulation through eating. Dr. Marianne shares how ADHD hyperfocus can interfere with recognizing when she needs food and why mechanical eating helps her nourish herself consistently. Shira explains that eating without experiencing a specific type of physical hunger does not mean someone is eating incorrectly. Rebuilding body trust can include recognizing your individual hunger signals and releasing the fear of eating “too much.” Diet Culture, Anti-Fat Bias, and the Fear of Eating Too Much The conversation also addresses how anti-fat bias, purity culture, healthmaxxing, and moral judgments about food teach people to distrust hunger and reject pleasure. Larger-bodied people often face added pressure to become the “good fatty” by pursuing weight loss, exercising frequently, or proving that they eat according to society’s definition of health. Sustainable eating disorder recovery may mean letting go of the belief that you must control your weight to deserve nourishment, rest, pleasure, care, or belonging. Dr. Marianne and Shira acknowledge how difficult this work can feel when friends, family members, healthcare providers, therapists, treatment programs, and social media continue to reinforce diet culture. About Shira Collings, LPC Shira Collings is a feminist, neurodiversity-affirming, LGBTQIA+-affirming, fat-affirming, and disability justice-aligned psychotherapist. Their specialties include eating disorders, body image, reproductive mental health, trauma, grief, and loss. Shira supports clients in healing from external and internalized oppression and creating lives aligned with their values. Learn more about Shira at threadandthreshold.com or follow them on Instagram at @threadandthreshold.therapy. In This Eating Disorder Recovery Episode Dr. Marianne and Shira discuss eating disorder recovery as neurodivergence, hunger cues in autism and ADHD, mechanical eating, body trust, food noise, Ozempic and GLP-1 medications, anti-fat bias, diet culture, body acceptance, fear of eating too much, weight-neutral recovery, and the loneliness of rejecting cultural expectations around food and body size. Related Episodes What If You're Not Broken? Neurodivergence, Sanism, Eating Disorders, & Radical Acceptance With Shira Collings, LPC on Apple & Spotify. About Dr. Marianne Miller Dr. Marianne Miller is an eating disorder therapist with nearly 30 years of mental health experience. She specializes in ARFID, binge eating, anorexia, and bulimia through a neurodivergent-affirming, sensory-attuned, trauma-informed, and weight-neutral approach. Dr. Marianne provides therapy in California and Washington, D.C., as well as coaching for clients worldwide. Learn more about working with her, her self-paced ARFID course, and her Binge Eating Recovery Membership at drmariannemiller.com.
