Dr. Marianne-Land: An Eating Disorder Recovery Podcast

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.

What changes when an eating disorder has been part of someone’s life for 10, 20, 30, even 40+ years? In this conversation, I’m joined again by my friend and longtime collaborator Jaren Soloff, RD, IBCLC, the founder of Whole Women Nutrition. Together, we talk about why nutrition work looks different in long-term eating disorders, and why the starting point is almost always the same: safety. Jaren shares how decades of reinforcement can make symptoms look “functional” on the surface, while the eating disorder quietly shapes identity, routines, and self-worth. We explore the common pattern of minimizing, the fear that can spike when restriction loosens, and the tender reality that for many people, the eating disorder has served as protection, especially in the context of criticism, attachment wounds, body-based judgment, and the impossible standards placed on women across the lifespan. We also get practical. Jaren walks through what it can look like to make food feel safer through small, doable steps, including DBT-informed tools, sensory supports, and intentionally planned “after-meal” structure that helps the nervous system ride out discomfort without snapping back to restriction. If breakfast feels impossible, or discomfort after eating feels like a dealbreaker, this episode offers compassionate, concrete ways to build tolerance and trust, slowly and steadily. Finally, we talk about the midlife reality so many people face: body changes through perimenopause and menopause, and the way those changes can collide with long-standing eating disorder beliefs. Jaren explains why metabolism may shift with long-term restriction and aging, how loss of lean muscle mass can affect energy needs and health, and why increased fat storage in midlife can be an adaptive, protective process for bone health. We also name the risks of GLP-1 medications for people with eating disorders, including concerns about appetite suppression and the potential for additional lean muscle loss, especially for women in perimenopause and menopause. If you have felt “broken” because your body doesn’t respond the way it once did, or if you’ve carried an eating disorder for decades and wonder whether change is still possible, this conversation offers a grounded, compassionate path forward. You deserve care that moves at your pace, and support that treats safety as the foundation, not an afterthought. In this episode, we cover We discuss why long-term eating disorders require a different nutrition framework, how safety often sits at the center of recovery work, and why minimizing can keep patterns in place even when someone appears to be “functioning.” We talk about learning to tolerate discomfort after eating, building self-soothing skills, and using DBT-informed, sensory-based strategies to create new neural pathways. We explore perimenopause and menopause, including changes in estrogen, lean muscle mass, metabolism, and body fat distribution, and we name how ageism and sexism shape body fear in midlife. We also discuss GLP-1 medications and why they can be especially risky in the context of eating disorders. About Jaren Soloff, RD, IBCLC Jaren Soloff is a registered dietitian and international board-certified lactation consultant. She is the founder of Whole Women Nutrition, where she provides nutrition counseling and lactation support for adolescent girls and adult women, and supports families in raising competent, intuitive eaters. Jaren brings both professional experience and the wisdom of her own recovery journey to her work, with a steady emphasis on compassion, collaboration, and safety. Related Episodes 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. Pregnancy, Postpartum, and Eating Disorder Recovery With Jaren Soloff, RD on Apple and Spotify. Connect with Jaren Website: WholeWomenNutrition.com Instagram: @wholewomennutrition

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.

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.

In this episode of Dr. Marianne-Land, I speak with fat activist, TEDx speaker, author, DEI expert, and podcast host Vinny Welsby (they/them) about anti-fat bias in healthcare, weight stigma in medicine, and the real-world harm fat patients experience when seeking medical care. Vinny, who shares extensively about fat liberation, weight-inclusive care, and dismantling diet culture on Instagram at @fierce.fatty, brings both lived experience and data into this conversation. This episode centers on Vinny’s survey of 270 fat people, in which 99.25% reported experiencing weight-based discrimination in healthcare. These findings expose how common medical weight stigma, anti-fatness, and provider bias truly are, and why so many fat people delay or avoid healthcare altogether. Weight Stigma in Healthcare: Survey Data and Lived Experience We break down what those survey results actually mean for patients. Vinny shares stories of medical dismissal, misdiagnosis, delayed treatment, and humiliation in healthcare settings, including being told to lose weight instead of receiving appropriate medical evaluation. We discuss how weight stigma shows up through provider assumptions, lack of size-inclusive equipment, routine weighing without consent, and dismissive or dehumanizing language. This section highlights how anti-fat bias in healthcare leads to worse physical health outcomes, increased medical trauma, and deep mistrust of medical systems. Medical Trauma, Nervous System Effects, and Avoiding Care We explore how repeated experiences of weight stigma activate the nervous system and create medical trauma. Even scheduling an appointment can trigger fear, shame, and exhaustion. Vinny and I talk about how this chronic stress contributes to people avoiding preventive care, delaying diagnosis, and experiencing worsening health conditions as a result. This conversation connects anti-fat bias, mental health, eating disorders, and healthcare avoidance, naming how the system often blames fat bodies for the very harm it causes. Intersectionality: Fatness, Gender, Queerness, and Neurodivergence A major focus of this episode is intersectionality. Vinny shares how anti-fatness intersected with being trans, nonbinary, queer, neurodivergent, and disabled, and how shame around body size limited access to identity exploration and self-expression. We talk about how weight stigma compounds oppression, especially for people with multiple marginalized identities. We also discuss how white privilege can reduce some harms while never eliminating weight-based discrimination, and why weight-inclusive healthcare must address racism, transphobia, ableism, and fatphobia together. What Weight-Inclusive Healthcare Actually Requires We challenge the idea that good intentions equal good care. This section explores what weight-inclusive healthcare truly requires, including provider education, consent-based weighing, size-inclusive furniture and equipment, respectful language, and accountability when harm occurs. We discuss why many providers believe they are weight-inclusive while continuing to practice weight-centered and stigmatizing care. Unlearning Anti-Fatness, Shame, and Diet Culture We close with guidance for beginning the process of unlearning anti-fatness. Vinny shares how shame thrives in isolation and how bringing it into the light reduces its power. We discuss diet culture, binary thinking, and how critical thinking helps people question harmful beliefs about weight, health, morality, and worth. This episode invites listeners to ask who benefits when people are taught to hate their bodies, and how compassion, curiosity, and community support healing. Who This Episode Is For This episode is for fat people, eating disorder survivors, clinicians, healthcare providers, and anyone who wants to understand how weight stigma in healthcare causes harm and what needs to change. About My Guest: Vinny Welsby (They/Them) Vinny Welsby is a fat activist, DEI leader, TEDx speaker, bestselling author of Fierce Fatty, and host of the Fierce Fatty Podcast. They work with individuals through Fierce Fatty and with organizations through Weight Inclusive Consulting, providing education and training on dismantling anti-fat bias in healthcare and beyond. You can find Vinny at fiercefatty.com and on Instagram at @fierce.fatty. Related Episodes When Doctors Harm: Medical Weight Stigma & Eating Disorders on Apple & Spotify. Having Anorexia in a Larger Body: Navigating Medical Anti-Fat Bias & Lack of Care with Sharon Maxwell @heysharonmaxwell on Apple & Spotify. Content Caution This episode includes discussion of medical trauma, weight stigma, eating disorders, healthcare discrimination, and systemic oppression. The harm described in this episode is real, widespread, and systemic.

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.

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.

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.

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.

What if the problem is not your motivation to recover, but a system that makes eating disorder treatment almost impossible to afford? In this conversation, I sit down again with Leslie Jordan Garcia @liberatiwellness. Leslie is a wellness strategist, certified eating disorder recovery coach, and Treatment Access Program Manager at Project HEAL. In this episode, we discuss real, concrete pathways to free and low-cost eating disorder care. We also talk about why you cannot separate eating disorder recovery from social justice, intersectionality, and body hierarchies. Leslie breaks down how Project HEAL removes financial and systemic barriers, how people from marginalized communities can apply, and how providers can join the Healer’s Circle to offer justice-focused, values-aligned care. In this episode, we talk about What Project HEAL is and how it works to remove financial and systemic barriers to eating disorder care in the United States The four major Project HEAL programs and how to apply for: Community Care groups for BIPOC folks Cash assistance that covers tertiary costs like rent, pet boarding, and transportation Outpatient treatment placement with sliding scale and pro bono providers Insurance navigation support and help with single case agreements Who qualifies for Project HEAL services, including people in all U.S. states and territories, and how they prioritize folks from communities that are historically and systemically marginalized How Leslie matches people with “unicorn providers” who are fat positive, HAES aligned, queer affirming, trauma aware, and non Christian based when needed The difference it makes when someone helps you navigate insurance, access care, and complete applications, especially when executive functioning is low or things feel overwhelming How economic precarity, layoffs, food insecurity, and shifting insurance policies are driving an uptick in applications for eating disorder treatment assistance Why intersectional, identity affirming care is not optional in eating disorder recovery, especially for BIPOC, queer, trans, disabled, and fat clients How Leslie’s social justice consulting work with universities, community colleges, and health organizations helps them: Reimagine intake forms and client facing processes Address promotion and salary inequities Create transformational circles where teams talk about harm, stereotypes, and systemic barriers How body hierarchies, food moralization, school fitness testing, and lunch shaming fuel eating disorders for kids and adults Why many people use eating disorders as a survival tool in the context of trauma, capitalism, surveillance, and unsafe systems What true equity and belonging could mean for decreasing the occurrence and severity of eating disorders About our guest: Leslie Jordan Garcia Leslie Jordan Garcia is a wellness strategist, certified eating disorder recovery coach, and social justice consultant dedicated to healing and liberation. She holds dual master’s degrees in business and public health and has more than a decade of experience across military, public health, and nonprofit sectors. Through her practice, Liberati Wellness, Leslie offers HAES aligned eating disorder recovery support, inclusive movement support, and equity and identity affirming care. Leslie also partners with organizations like Austin Health Commons and the Hogg Foundation to embed equity and justice into health systems and helping professions. She currently serves as the Treatment Access Program Manager at Project HEAL, where she manages cash assistance and treatment placement and works to match clients with values aligned, culturally responsive providers. You can find Leslie’s coaching and consulting work at Liberati Wellness and on Instagram at @liberatiwellness. Inside Project HEAL’s pathways to care In this episode, Leslie explains how Project HEAL supports people who are struggling with eating disorders and facing financial and systemic barriers to treatment. She walks us through the main programs: Informed ED (for professionals) A learning program for clinicians and dietitians who are newer to eating disorder treatment. It helps them build skills, reduce harm, and align their work with justice focused values so they can better support clients whose eating disorders are uncovered in general mental health or medical settings. Community Care A free, BIPOC only, 8 week support and process group focused on body liberation, community care, and healing from white supremacist body hierarchies. Cash Assistance Program A program that does not pay individuals directly, but instead covers tertiary costs that often block access to care. This can include rent, transportation, pet boarding, or other essential expenses so that people can actually attend the level of care their team recommends. Treatment Placement Leslie coordinates outpatient treatment placement, connecting people with dietitians, therapists, and other providers who offer sliding scale or pro bono care, especially when insurance does not cover enough dietitian sessions or mental health support. Insurance Navigation Project HEAL helps people understand their insurance benefits, locate in network providers, and pursue options like single case agreements when an appropriate provider is out of network. Leslie also mentions a time limited clinical assessment program for people who know they are struggling in their relationship with food and body but have never had a formal diagnosis. All of these services are free to applicants, and one application can cover multiple programs at once. Who can apply to Project HEAL Leslie shares that Project HEAL is U.S. based, and that includes all 50 states, Alaska, Hawaii, and U.S. territories such as Guam. Anyone in those locations can apply. Project HEAL prioritizes people from communities that have been historically and systemically marginalized, including: BIPOC communities Queer and trans communities People in larger bodies Disabled and chronically ill folks People navigating religious trauma and other layered identities Leslie’s role includes reading applications through an intersectional lens, tracking diversity demographics, and making sure that people who face the largest gaps in access are not overlooked. She also notes that if the application itself feels overwhelming, Project HEAL can connect applicants with someone who will help them complete it, which is especially important when executive functioning is low. Intersectionality, social justice, and eating disorder recovery Throughout the conversation, Leslie and I look at how eating disorders are never just about appearance. They are deeply tied to: Trauma and chronic stress How we perceive our bodies and how we believe others perceive our bodies Economic instability, job insecurity, and food insecurity Surveillance of bodies in workplaces, schools, and medical settings Racism, anti-fat bias, ableism, transmisia, and other forms of oppression Leslie talks about clients who restrict food so their children can eat when jobs cut hours, and how people in larger bodies often avoid eating at work because of constant surveillance and judgment, only to experience intense hunger and binge episodes later. We explore how body hierarchies, moralization of food, school fitness testing, and lunch policing create conditions where an eating disorder can become a primary coping strategy. Leslie describes how, over time, this can become deeply embedded, with the brain chemistry colluding with the eating disorder to create a sense of safety that the larger system fails to provide. For Leslie, social justice work is inseparable from eating disorder work. If people had secure access to food, safe housing, living wages, and genuine body equity, many would not need to rely on eating disorders to feel safer, visible, or invisible. Justice work inside systems Leslie also describes her justice work with institutions, including: Facilitating Transformational Circles where diverse team members connect as humans and then talk honestly about processes that exclude or harm people Supporting clinics that operate in queer neighborhoods yet do not see queer clients, and helping them examine what in their client facing processes is pushing people away Working with community colleges on salary and promotion inequities, examining reviews, ranking systems, and feedback processes that keep certain groups from advancing Helping organizations rework intake forms, policies, and internal culture so that equity, belonging, and justicebecome real practices rather than buzzwords She reminds us that what often gets labeled as “DEI” is actually about justice, accessibility, and belonging for everyone, including veterans, people who breastfeed, people who need ramps and accessible bathrooms, and more. How to connect with Project HEAL and Leslie To apply for Project HEAL’s Treatment Access programs Visit the Project HEAL website at projectheal.org and look for the section on Treatment Access. One application lets you indicate which services you want, including cash assistance, treatment placement, insurance navigation, and clinical assessment while that program is still active. Both individuals seeking care and providers who want to join the Healer’s Circle start on the same site. Providers can share their identities, specialties, body size, languages spoken, and communities they love to serve, which helps Leslie make strong intersectional matches. To work with Leslie as a coach or consultant You can learn more about Leslie’s equity and identity affirming eating disorder recovery coaching and social justice consulting at: Website: Liberati Wellness liberatiwellness.com Instagram: @liberatiwellness She currently has a reduced capacity for one to one clients but continues to support individuals and teams through coaching, collaboration with therapists and dietit

This solo episode explores the quiet places where anorexia meets identity and expression. Dr. Marianne Miller speaks to the lived moments where someone learns to hide parts of themselves and how restriction becomes a language for survival. She examines how identity formation, self-expression, and body-based fear interact in ways that often remain hidden. The episode centers queer, trans, gender-expansive, and questioning listeners along with anyone who has felt pressure to quiet their identity in order to navigate the world. Dr. Marianne describes how anorexia rises when identity feels unsafe, unrecognized, or tightly controlled. She explains how restriction becomes a strategy to manage visibility, vulnerability, dysphoria, and the cultural pressure to stay small. The episode invites listeners to imagine recovery as a process of expanding expression, reclaiming autonomy, and restoring connection to their authentic self. Key Themes in This Episode Dr. Marianne examines the links between anorexia, identity, and self-expression. She describes how gender expectations and cultural norms shape the body story. She explains how queer and trans people often restrict to soften dysphoria or to quiet unwanted attention. She explores the way over-performance and people-pleasing silence authentic expression and strengthen restrictive behavior. She looks at the sensory landscape of anorexia and describes how neurodivergent experiences influence embodiment and identity. She also highlights the role of intersectionality. Race, culture, queerness, disability, and body size shape how someone expresses themself and how safe that expression feels. These intersections help explain why anorexia often becomes a predictable response to environments that restrict identity or punish authenticity. Why This Episode Matters Mainstream conversations about anorexia often focus on food without addressing identity, expression, and cultural pressure. Many listeners learn early that their identity takes up too much space. Many learn that desire, gender expression, and emotional truth need to stay hidden. This episode challenges the idea that anorexia develops inside a vacuum. Instead, it shows how anorexia forms inside relationships, systems, and environments that silence real expression. The episode offers validation for anyone who felt forced to shrink in order to stay safe. It expands the understanding of anorexia so listeners can see their experiences reflected with accuracy, compassion, and liberation. Who This Episode Supports This episode supports listeners who navigate anorexia while holding queer, trans, or gender-expansive identities. It supports people who experience identity suppression or dysphoria and who use restriction to manage that conflict. It supports neurodivergent listeners whose sensory experiences shape their relationship with their body and their identity. It also supports clinicians, loved ones, and community members who want a more accurate and compassionate understanding of anorexia. Resources Mentioned Liberation-based healing models Trauma-informed care Queer embodiment research Neurodivergent eating disorder literature Content Caution This episode discusses anorexia, restrictive eating, identity conflict, gender dysphoria, sexuality, sensory overwhelm, and the lived experience of shrinking to stay safe. Please listen with care and pause whenever your body needs space. Related Episodes Queer Mental Health & Eating Disorders: How Stress Shows Up in the Body & Brain With Winter Groeschl, NCC, LPC (@eatingdisorderrevealed): Apple & Spotify. LGBTQIA+, the Coming Out Process, & Eating Disorders: Apple & Spotify LGBTQIA+ & Eating Disorders: Apple & Spotify Learn More and Get Support Dr. Marianne Miller provides therapy and coaching for anorexia, ARFID, binge eating disorder, bulimia, trauma, and body-based fear. She supports clients across California, Texas, Washington D.C., and internationally. Explore additional episodes of the Dr. Marianne Land podcast for conversations about eating disorder recovery, neurodiversity, identity, embodiment, and body liberation. Check out her website at drmariannemiller.com. Follow her on Instagram @drmariannemiller.

In this episode, Dr. Marianne Miller explores the reality that many people with lifelong eating disorders do not resonate with the traditional idea of full recovery. She explains why harm reduction can offer a compassionate and sustainable path for individuals who have lived with chronic anorexia, long term bulimia, binge eating disorder, ARFID, and other long standing eating disorders. This conversation centers trauma history, neurodivergence, sensory needs, oppression, and the intersectional barriers that prevent many people from reaching what treatment programs often define as full recovery. If you have lived with an eating disorder for decades, if you have experienced trauma or misdiagnosis, if you are neurodivergent, or if you live in a marginalized body that has faced medical discrimination, you may find this episode deeply validating. Harm reduction gives you realistic recovery goals that respect your lived experience, your nervous system, and your access needs. What You Will Learn in This Episode Dr. Marianne explains how harm reduction works in eating disorder recovery and how it differs from traditional recovery models. She shows how harm reduction supports safety, stabilization, and dignity for people who have navigated chronic eating disorders for most of their lives. You will learn why the nervous system sometimes cannot tolerate pressure toward full recovery and why a flexible, collaborative approach can feel more aligned for many people. You will hear how sensory issues, interoception challenges, executive functioning differences, autistic burnout, and ADHD related overwhelm shape eating patterns for neurodivergent individuals. You will learn how trauma history, attachment ruptures, racialized stress, gender based discrimination, medical fatphobia, and identity marginalization influence both the development of eating disorders and the recovery process. Key Topics Covered This episode covers a wide range of topics that matter deeply for people with chronic eating disorders. These topics include how harm reduction supports stabilization when the long term eating disorder has become intertwined with survival. You will hear why the phrase full recovery can feel unrealistic or even harmful for people who have lived with their eating disorder for decades. Dr. Marianne explains how harm reduction creates safety, reduces shame, increases autonomy, and supports people who need a gentler and more individualized approach. The episode explores the role of neurodiversity in eating disorder recovery. This includes how sensory sensitivities shape food choices, how interoception differences impact hunger awareness, how executive functioning challenges influence meal consistency, and why many autistic and ADHD individuals need accessible, predictable, and customized strategies. You will also learn how intersectional oppression shapes health outcomes for people of color, queer and trans individuals, disabled individuals, fat individuals, and anyone living across multiple marginalized identities. Dr. Marianne describes what harm reduction can look like in daily life, from maintaining safe foods to creating sensory friendly meals to reducing medical instability in small, sustainable steps. She shares how this approach honors personal history and current capacity and how it helps many people live with more stability and less suffering. Who This Episode Is For This episode is for anyone living with a lifelong eating disorder who has felt pressure to pursue full recovery even when that expectation does not align with their reality. It is for people with chronic anorexia, chronic bulimia, long term binge eating disorder, ARFID shaped by sensory needs, and individuals with complex trauma who feel overwhelmed by traditional treatment expectations. This episode is also for neurodivergent individuals who live with autistic sensory profiles, ADHD impulsivity, interoception challenges, and executive functioning struggles that interfere with eating. It is for people living in marginalized bodies who have experienced medical discrimination or misdiagnosis. It is for professionals who want to learn how to apply harm reduction to eating disorder treatment in inclusive, neurodivergent affirming, and identity informed ways. Why This Episode Matters Many people with chronic or lifelong eating disorders feel invisible in mainstream recovery culture. They hear messages that full recovery is the only worthy goal and feel ashamed when their body or nervous system cannot meet those expectations. This episode names that truth with compassion. Harm reduction is a valid and ethical approach that honors lived experience and brings relief to people who need safety more than perfection. This episode matters because it acknowledges the role of trauma, neurodivergence, sensory needs, and intersectionality in long term eating disorders. It challenges the idea that recovery must look the same for everyone. It shows that you deserve care even if your healing does not follow a traditional blueprint. Your life still holds value and possibility. Related Episodes 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. Resources and Support If you want more resources on lifelong eating disorders, harm reduction, ARFID, sensory based eating, and neurodivergent affirming care, visit drmariannemiller.com where you will find blog posts, guides, and links to specialized support. You can also explore my ARFID course and binge eating recovery membership options if you want deeper help with binge eating disorder, bulimia, ARFID, or long term eating disorder recovery. My work supports clients in California, Texas, Washington DC, and internationally through coaching. Join the Conversation If this episode resonated with your experience of a lifelong eating disorder or if you are curious about harm reduction as a recovery model, I would love to hear your thoughts. You can connect with me on Instagram at @drmariannemiller and share what stood out to you. For More Dr. Marianne-Land Podcast Episodes To explore more episodes on eating disorders, neurodiversity, trauma, and body liberation, listen to the full archive on your favorite podcast platform.

What happens when chronic illness meets wellness culture, diet culture, and the desperate search for answers in a system that continues to fail so many people? In this episode, I talk with Abbie Attwood, MS, @abbieattwoodwellness, an anti diet, weight inclusive nutrition therapist and host of the Full Plate Podcast. Abbie and I explore how chronic illness, medical gaslighting, and the pressure to find a cure can intersect with disordered eating. We talk about the ways wellness messaging pushes restrictive food rules, how OCD and anxiety deepen vulnerability to this messaging, and how food fear can feel like control when life feels unpredictable. We also discuss athlete identity, compulsive exercise, thin privilege, masking, neurodivergence, and the grief that comes when illness or injury forces people to rethink who they are. This conversation opens space for nuance, compassion, and the reality that healing happens inside context, not perfection. Content Caution We talk about chronic illness, disordered eating, exercise compulsion, and food restriction. Please take care of yourself as you listen. Key Topics We Cover 1. How wellness culture preys on vulnerability Abbie discusses how chronic illness created a perfect storm for disordered eating, especially when wellness messaging promised control, cures, and answers that science did not support. 2. Chronic illness and the search for control We talk about how desperation, medical dismissal, and misinformation make people more likely to turn to restrictive food rules and elimination diets. 3. OCD, anxiety, and increased vulnerability to wellness culture Abbie shares how her undiagnosed OCD and lifelong anxiety made the rigid, all or nothing tone of wellness culture feel reassuring, while actually deepening harm. 4. Athlete identity, loss, and compulsive movement We explore how losing movement due to chronic illness or injury can destabilize identity, trigger grief, and reignite disordered behaviors around exercise. 5. Masking, neurodivergence, and the pressure to perform wellness We discuss how neurodivergent masking can hide exhaustion and overwhelm, and how the pressure to perform health or discipline can push people deeper into food and exercise rigidity. 6. Chronic illness culture, shame, and blame We look at how chronic illness culture and wellness culture both place responsibility on the individual, leading to shame and self blame when bodies do not behave as expected. 7. What real nourishment looks like when illness limits capacity Abbie talks about the need for compassion, ease, adding rather than restricting, and honoring energy limitations instead of forcing strict food rules. Who This Episode Is For People navigating chronic illness and food anxiety Listeners recovering from eating disorders Neurodivergent folks who feel pressured to mask or follow rigid health rules Athletes or former athletes grieving changes in movement Anyone tangled in wellness culture messaging Clinicians who want a deeper understanding of how chronic illness intersects with disordered eating People who struggle with shame when illness reduces their capacity About Today’s Guest Abbie Attwood, MS, is an anti diet, weight inclusive nutrition therapist, writer, and host of the Full Plate Podcast. She provides virtual nutrition therapy and body image support through Abbie Attwood Wellness and writes a widely loved Substack newsletter on healing our relationships with food and body. You can find her at @abbieattwoodwellness and abbieattwoodwellness.com. Links Mentioned Abbie Attwood Wellness Substack: abbieattwoodwellness.substack.com Abbie’s website: abbieattwoodwellness.com Instagram: @abbieattwoodwellness Full Plate Podcast Related Episodes Breaking Up With Diet Culture with Dr. Lisa Folden, @healthyphit on Apple & Spotify. How Eating Disorder Recovery Heals Life Overall via Apple or Spotify. Overexercising, ADHD, & Eating Disorders with @askjenup Jenny Tomei on Apple & Spotify. How Diet Culture & Purity Culture Fuel Eating Disorders: Unpacking the Trauma Behind the Rules with Cassie Krajewski, LCSW @inneratlastherapy on Apple & Spotify. Work With Me If you want support for binge eating disorder, ARFID, chronic eating struggles, or complex eating disorder patterns shaped by trauma, neurodivergence, or chronic illness, you can connect with me at drmariannemiller.com for therapy in California, Texas, or Washington D.C. I also offer global coaching and specialized courses.

What happens when an eating disorder has been part of your life for years or even decades. In this solo episode, Dr. Marianne Miller explores what recovery can look like when anorexia or bulimia becomes chronic, persistent, or long-term. Drawing from her experience as a therapist specializing in eating disorders, Dr. Marianne offers trauma-informed, neurodivergent-affirming, and body-liberation tools that help people reconnect with their bodies, support their nervous systems, and rebuild trust when recovery feels unreachable. This episode provides compassionate guidance for anyone who has lived with an eating disorder for a long time and wonders if healing is still possible. It also supports clinicians, loved ones, and helpers who want to understand the realities of severe and enduring eating disorders with more depth, nuance, and humanity. Why This Episode Matters People with chronic anorexia or bulimia often feel overlooked by treatment models that expect rapid transformation or complete symptom remission. Many have cycled through recovery attempts and relapse, often carrying shame for not recovering quickly enough. Dr. Marianne reframes chronic eating disorders as endurance rather than failure. She introduces recovery approaches that honor the nervous system, acknowledge survival strategies, and center autonomy, safety, and dignity. Key Topics Covered This episode explores why chronic anorexia and bulimia develop and why they persist over time. It highlights how survival strategies become deeply wired into the nervous system and how shame, trauma, sensory overload, and systemic oppression shape long-term eating disorders. Listeners learn how to use persistence instead of perfection, how to rebuild interoceptive awareness, how to support sensory needs, and how to regulate the nervous system in ways that feel gentle and sustainable. The episode also introduces self-compassion as a powerful tool that helps soften shame and create the conditions for real healing. Dr. Marianne explains how relational safety, autonomy, and body trust become essential for long-term recovery. Listeners also hear how intersectionality influences chronicity and why marginalized people often face more barriers to care. Who This Episode Is For This episode supports people living with chronic anorexia or bulimia, people who feel exhausted by long-term recovery efforts, and people who wonder if healing is still possible after many years of struggle. It also supports therapists, dietitians, physicians, and loved ones who want to understand chronic eating disorders through a neurodivergent-affirming, sensory-attuned, and trauma-informed lens. Content Caution This episode discusses chronic anorexia and bulimia, including references to restriction, purging, and trauma. Please listen with care and take breaks if you need to ground or regulate. Your comfort and safety matter. Related Episodes on Lifelong Eating Disorders 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 and Get Support If this episode resonates with you, visit drmariannemiller.com to learn more about therapy, coaching, and resources for eating disorder recovery, including chronic anorexia and chronic bulimia. Dr. Marianne offers care that emphasizes autonomy, collaboration, and nervous system safety. You do not have to heal alone. You can also listen to more episodes of Dr. Marianne-Land on all major podcast platforms.

Most providers still don’t recognize ARFID when it’s right in front of them. In this episode, Dr. Marianne Miller unpacks why Avoidant/Restrictive Food Intake Disorder remains so misunderstood—and how that misunderstanding harms children and adults who live with it. Dr. Marianne explains what ARFID really is, how it shows up across neurotypes, and why messages like “just try harder” damage safety, trust, and nervous system regulation. Through a neurodivergent-affirming lens, she explores how bias, pressure, and diet-culture thinking keep ARFID invisible and why it’s time for providers to see the reality of this eating disorder. Why This Episode Matters For too long, ARFID has been dismissed as “picky eating.” This episode reframes ARFID as a real, body-based eating disorder rooted in sensory processing, fear, or trauma—not defiance or willpower. Dr. Marianne highlights the emotional and physiological impact of being told to “try harder,” and how that phrase erodes autonomy, increases shame, and dysregulates the body. When we understand ARFID as a nervous-system and safety-based challenge, our entire approach to care changes. Listening replaces forcing. Collaboration replaces control. Compassion replaces shame. Key Topics Covered What ARFID Really Is: Understanding sensory-based, fear-based, and low-interest eating patterns that have nothing to do with dieting or body image. Why Professionals Miss It: How traditional training and diet-culture frameworks erase ARFID from diagnosis and treatment. The Harm of “Try Harder” Messages: Exploring what happens when people are shamed or pressured to eat against their nervous system’s limits. The Neurodivergent Lens: How autism, ADHD, and other forms of neurodivergence intersect with eating, safety, and sensory regulation. The Role of Bias: Why marginalized identities—fat, BIPOC, neurodivergent, or gender-diverse people—are more likely to be misunderstood or dismissed. What Support Looks Like: How neurodivergent-affirming, sensory-attuned, and autonomy-based care creates safety and possibility. Who This Episode Is For Therapists, dietitians, and physicians who want to understand ARFID beyond stereotypes. Parents who feel blamed or overwhelmed by their child’s restricted eating. Adults who have lived with food fear or sensory eating struggles and never had language for it. Neurodivergent people who want their experiences around food to be seen, validated, and supported. Content Caution This episode includes discussion of eating behaviors, sensory distress, and medical dismissal related to ARFID. Please take care of yourself and listen in a way that feels safe for your body and nervous system. Related Episodes 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. Learn More and Get Support If you want to understand ARFID more deeply or build sensory-attuned support skills, check out Dr. Marianne’s self-paced ARFID & Selective Eating Course. This training explores sensory processing, collaborative care, and trauma-informed strategies for clinicians, parents, and community members. Visit drmariannemiller.com/arfid to learn more.

What happens when you live with a severe eating disorder in a larger body yet the medical system refuses to see it? In this powerful conversation, Sharon Maxwell (she/they) shares her story of surviving anorexia in a fat body, advocating for herself inside medical systems that consistently denied her care, and reclaiming joy, autonomy, and embodiment after years of harm. Sharon is an educator, speaker, and fat activist who dedicates her work to dismantling anti fat bias and eradicating weight stigma in healthcare and society. Their story and activism have been featured in the New York Times Magazine, The Tamron Hall Show, The Wall Street Journal, NPR, 60 Minutes, and more. Together, we explore the realities of receiving medical care while fat, why compassionate providers save lives, how weight stigma shaped Sharon’s early life and nearly cost her her life, and why reclaiming joy becomes an act of resistance. This episode holds so much wisdom, solidarity, and truth telling for anyone in eating disorder recovery, anyone harmed by medical weight stigma, and anyone committed to building a safer world for people in larger bodies. What We Cover in This Episode Sharon’s Early Story and Reclaiming Joy Sharon shares a surprising fun fact about being a lifelong pianist and how taking jazz lessons helped them reclaim creativity after growing up in a restrictive religious cult that controlled every aspect of music, expression, and embodied joy. They describe how jazz has become part of their healing and identity reconstruction. Growing Up Fat, Undiagnosed, and Unseen Sharon lived in a fat body their entire life and struggled with anorexia for nineteen years. They went undiagnosed because medical providers only saw their body size. When Sharon arrived with obvious symptoms of an eating disorder, providers dismissed the symptoms and blamed their body. They describe how weight stigma prevented treatment and reinforced eating disorder patterns. The Doctor Who Changed Everything Sharon describes the first doctor who recognized the eating disorder and offered real compassion. That moment shifted the trajectory of their life. We discuss how rare this experience is and why truly compassionate medical care can be lifesaving for people living in larger bodies. Medical Trauma and the Cost of Weight Stigma Sharon shares painful stories about: Being denied necessary medical procedures because of body size. Experiencing trauma at gynecological appointments. Nearly dying from untreated tonsillitis because providers assumed weight was the cause rather than treating the actual condition. The emotional and financial toll of weight stigma across childhood and adulthood. We discuss how the healthcare system misattributes the financial cost of weight stigma to the O-word and how this distorts public health narratives and patient care. Eating Disorders in Larger Bodies Sharon explains how anti fat bias prevents providers from seeing eating disorders in fat patients. They highlight how common anorexia is in larger bodies and how life threatening it becomes when medical systems refuse to diagnose or treat it. How Anti Fat Bias Harms Everyone Sharon and I talk about how dismantling anti fat bias supports every person in eating disorder recovery. Recovery requires divesting from anti fat bias, reconnecting with the body, and understanding how these biases shape thoughts and behaviors across all sizes. Intersectionality and Medical Harm We explore how harms escalate for people with multiple marginalized identities, including Black patients, Indigenous patients, trans patients, and fat patients who also face racism, transphobia, or medical gatekeeping. Advocacy, Boundaries, and Medical Self Protection Sharon shares concrete strategies for preparing for medical appointments, including: --Bringing notes to stay grounded when hyperarousal hits. --Recording appointments for recall and safety. --Bringing a support person. --Taking intentional rest time afterward. --Establishing boundaries and walking out when providers violate consent. We discuss how exhausting it is to prepare for appointments that should be safe and how necessary these strategies become for survival. Why Sharon Became a Fat Activist After nearly dying because of weight stigma, Sharon left the classroom to educate clinicians, providers, and communities about anti fat bias. They now work with medical systems and general audiences to deconstruct bias, build safer care practices, and illuminate the threads of anti fat culture that harm everyone. Imagining an Ideal World Sharon answers the signature Dr. Marianne Land question. Their ideal world includes accessible spaces for play, joy, rest, and creativity for all bodies. It includes medical care rooted in compassion, humanity, and dignity, and it includes ice cream for everyone with options for all bodies and needs. Who This Episode Is For This episode supports: --People in fat bodies who have experienced medical trauma. --Listeners who lived with eating disorders in larger bodies without diagnosis or care. --Providers wanting to unlearn weight stigma and offer safer treatment. --Clinicians seeking to understand the intersection of eating disorders and anti fat bias. --Anyone navigating healthcare systems that dismiss or harm them. --People exploring intersectionality, fat liberation, and neurodivergent affirming care. Key Themes --Eating disorders in larger bodies are real, severe, and often missed. --Anti fat bias in healthcare prevents accurate diagnosis and lifesaving treatment. --Medical trauma compounds over years and affects every modality of care. --Compassionate providers save lives. --Medical self advocacy is necessary but exhausting. --Intersectionality affects both access to and quality of care. --Joy and play become powerful acts of resistance. --People in larger bodies deserve safety, dignity, and accurate medical treatment. Related Episodes 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. What Is Atypical Anorexia? Challenging Weight Bias in Eating Disorder Treatment with Emma Townsin, RD @food.life.freedom on Apple or Spotify. When Doctors Harm: Medical Weight Stigma & Eating Disorders on Apple & Spotify. Fat Vulnerability & Our Eating Disorder Recovery Stories on Apple & Spotify. Connect With Sharon Maxwell Follow Sharon on Instagram and all social platforms at @heysharonmaxwell. Learn More and Get Support For therapy, courses, and resources on eating disorders, ARFID, binge eating, and neurodivergent affirming care, visit my website at drmariannemiller.com and explore support options inside my binge eating recovery membership and ARFID programs.

In this solo episode, Dr. Marianne Miller, LMFT, speaks directly to the body that carries fear, memory, and longing for safety. Through a poetic open letter, she explores why recovery can feel unsafe even when life begins to stabilize. Instead of treating fear as resistance, she reframes it as communication and wisdom. In this episode, she invites listeners to move from fighting their bodies to listening to them. Dr. Marianne explores how trauma, neurodivergence, and systemic oppression live in the body, and how tenderness can become a bridge between fear and trust. It is not a set of instructions. It is an act of witnessing. Why This Episode Matters Many people in eating disorder recovery are told that getting better should feel empowering. But for those whose bodies have been sites of trauma, shame, or disconnection, recovery can feel unbearable. This episode reframes that discomfort as an intelligent response from the body, not as failure or lack of willpower. By turning recovery into a dialogue instead of a demand, listeners learn how to approach healing at the pace of safety. Dr. Marianne shares how fear is not the opposite of progress but a sign that the body is asking for gentler evidence that the world can hold it safely. Her trauma-informed, neurodivergent-affirming, and liberation-based approach helps listeners replace control with curiosity and build trust with the body through compassion. Key Topics Covered In this episode, Dr. Marianne reflects on: The nervous system’s memory of trauma and how it interprets safety Why the body resists calm and how to rebuild trust slowly The grief that comes with letting go of control and perfectionism How sensory sensitivities and neurodivergence affect recovery pacing The intersectional realities that make safety harder for fat, queer, trans, BIPOC, and neurodivergent people What it means to redefine “getting better” as coming home to yourself Listeners will come away with a new way to understand their bodies. They will learn that healing does not require pushing through fear but learning to listen to what fear is trying to protect. Who This Episode Is For This episode is for anyone who has ever felt frightened by their own progress in recovery. It will resonate with: People in eating disorder recovery who feel ambivalent about healing Neurodivergent listeners who experience overwhelm or shutdown during recovery Fat, queer, trans, and BIPOC individuals navigating systems that equate safety with conformity Clinicians and caregivers who want to understand the embodied realities of fear and healing It is also for those who need permission to slow down, to stop performing readiness, and to honor the body as a partner in recovery rather than an obstacle. Content Caution This episode includes discussion of eating disorder recovery, body distrust, trauma, and the emotional experience of fear during healing. It also references restriction, bingeing, and body-based distress without graphic detail. Please take care while listening. Pause or return to the episode later if it feels overwhelming. You are encouraged to have support in place as you engage with this material. Related Episodes How Childhood Trauma Shapes Eating Disorders & Body Shame (Content Caution) 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. Why Letting Go 0f Restriction Feels Unsafe in Eating Disorder Recovery on Apple & Spotify. Learn More and Get Support To continue exploring how to build safety with your body, visit drmariannemiller.com. There you will find: The ARFID & Selective Eating Course, a self-paced program offering sensory-attuned and neurodivergent-affirming tools for individuals and caregivers. The Binge Eating Recovery Membership, a space for ongoing support, education, and compassionate community that moves beyond diet culture. Blog posts, podcast episodes, and free resources on trauma-informed, consent-based, and liberation-centered recovery. Each offering is grounded in curiosity, respect, and collaboration.

What happens when your survival strategy becomes the thing standing between you and full recovery? In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores how masking and camouflaging shape the lives of neurodivergent people living with eating disorders. Through a trauma-informed, neurodivergent-affirming lens, she unpacks how chronic masking affects body trust, executive functioning, and safety in recovery. This conversation goes beyond the surface, offering insight into the deep intersection between identity, safety, and healing for autistic and ADHD people navigating disordered eating. Why This Episode Matters Masking, also known as camouflaging, is often praised as adaptability, but for many neurodivergent people it is a survival response that comes at a high cost. When you spend years performing normalcy, you can lose touch with your body’s natural rhythms, sensations, and needs. This episode reveals how masking contributes to disordered eating patterns and burnout, and why many neurodivergent individuals struggle to connect with hunger, fullness, and safety cues. Dr. Marianne explains how unmasking can become an essential part of recovery when it is grounded in safety and choice. She also highlights the collective responsibility of clinicians, families, and communities to create environments where authenticity does not come with punishment. Key Themes Covered What masking and camouflaging look like for autistic and ADHD people How chronic masking disconnects you from body cues and emotions The relationship between executive function burnout and chaotic eating Masking inside therapy and recovery spaces How unmasking becomes a healing process when safety is prioritized The crucial role of neurodivergent-affirming, sensory-aware support The realities of intersectionality and why unmasking is not equally safe for everyone The Big Intersectionality Caveat Unmasking can be freeing, but it is not always safe. For people living at the intersections of multiple marginalized identities, such as people of color, fat people, queer and trans individuals, and those with disabilities, authentic self-expression often carries real risks. Systems rooted in racism, fatphobia, ableism, and heteronormativity still punish difference. In this segment, Dr. Marianne offers guidance on how to navigate those risks without self-betrayal. She invites listeners to think of unmasking as a gradual and relational process rather than a demand for constant transparency. Authenticity must coexist with safety, and strategic masking can be a legitimate survival tool. Recovery is not about abandoning the mask everywhere; it is about finding and creating spaces where the mask can come off without harm. Who This Episode Is For This episode is for: Neurodivergent adults and teens in eating disorder recovery Autistic and ADHD individuals struggling with food, body image, or ARFID Therapists seeking to provide neurodivergent-affirming, sensory-informed care People navigating multiple marginalized identities who feel unsafe unmasking in treatment Parents and partners who want to better understand masking, executive functioning, and sensory needs in eating behaviors Content Caution This episode includes discussion of eating disorder behaviors, masking fatigue, and systemic oppression. Listener discretion is advised, especially if you are in early recovery or working through trauma related to identity or body shame. 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. Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat via Apple & Spotify Minding the Gap: The Intersection Between AuDHD & Eating Disorders With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify Our Personal Neurodivergent Stories via Apple & Spotify. Learn More and Get Support If today’s episode resonated with you, explore Dr. Marianne’s ARFID & Selective Eating Course, a self-paced, neurodivergent-affirming resource that supports sensory-based eating, autonomy, and compassion in recovery. Learn more at drmariannemiller.com.

What happens when a physician, trained to prioritize science and performance, discovers that her own healing requires compassion, spirituality, and trust in her body? In this powerful interview, we explore one woman’s story of recovering from binge eating disorder while navigating the pressures of medicine, diet culture, and systemic weight bias. You’ll hear how early messages about food and scarcity shaped her relationship with eating, how medical training reinforced body shame, and how she ultimately reconnected to herself through self-compassion, intuitive eating, and body trust. This episode offers both a deeply personal narrative and a professional perspective on how healthcare can move toward weight-neutral, compassionate care. Key Topics Covered How childhood scarcity and fear can shape lifelong eating patterns The pressures physicians face to conform to body ideals in medicine How chronic stress and sleep deprivation in residency can trigger binge eating Why self-compassion—not willpower—became the turning point in recovery What it takes to unlearn diet culture within the healthcare system The rise of GLP-1 medications and how they complicate conversations about body autonomy Healing the disconnect between professional identity and personal recovery Building a weight-neutral, compassionate approach to health and wellbeing Who This Episode Is For This episode is for anyone who has struggled with binge eating, body shame, or internalized weight stigma—especially those in helping professions. It’s also for clinicians, therapists, and healthcare providers seeking to understand how medical culture perpetuates harm and how to bring more compassion into patient care. If you’ve ever felt like your professional role or perfectionism made recovery harder, this episode will remind you that you’re not alone—and that healing is possible, even in systems that don’t always make room for it. Why This Conversation Matters In a world where doctors are often seen as immune to body image struggles, this story reveals how deeply systemic fatphobia and diet culture reach—even into the halls of medicine. It challenges the myth that knowledge alone heals disordered eating and instead centers nervous system safety, self-compassion, and intuitive wisdom as the foundation for recovery. Resources Mentioned Intuitive Eating by Evelyn Tribole and Elyse Resch Reclaiming Body Trust by Hilary Kinavey and Dana Sturtevant Wayza Health (wayzahealth.com)--Dr. Michelle's website Research on GLP-1 medications and long-term outcomes Center for Body Trust Related Episodes  When Doctors Harm: Medical Weight Stigma & Eating Disorders on Apple & Spotify. Fat Vulnerability & Our Eating Disorder Recovery Stories on Apple & Spotify. Challenges of Weight-Loss Surgery & Medical Anti-Fat Bias on Apple & Spotify. Learn More and Get Support If you or someone you love is navigating binge eating, emotional eating, or recovery after years of dieting, visit drmariannemiller.com to explore specialized support. You’ll find resources for binge eating recovery, ARFID support, and neurodivergent-affirming therapy and courses.