Dr. Marianne-Land: An Eating Disorder Recovery Podcast

The Hidden Pain of Midlife Anorexia: Why Coping Breaks Down & What Heals

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.

When Eating Disorders Involve Self-Harm: Breaking the Cycle & Rebuilding Safety

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.

Anti-Fat Bias in Healthcare: What 270 Fat Patients Reported & Why It Matters With Vinny Welsby @fierce.fatty

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.

When Autonomy & Sensory Needs Drive ARFID: Why Pressure Fails & Choice Heals

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 & Spitting in Eating Disorders: Restriction, Sensory Overwhelm, & the Two Paths This Behavior Can Take

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.

When Exercise Becomes Punishment: Body Image, Shame, & Disordered Eating With Dr. Lisa Folden @healthyphit

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.

Autism & Eating Challenges: Understanding Sensory Needs, Routines, & Safety

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 Is Rebranding Diet Culture: The Urgent Harm Behind “Anti-Bloat” & Glow-Up Trends

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.

Eating Disorder Recovery Without Financial Barriers: Project HEAL’s Pathways to Free & Low-Cost Care With Leslie Jordan Garcia @liberatiwellness

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 CareA free, BIPOC only, 8 week support and process group focused on body liberation, community care, and healing from white supremacist body hierarchies.
Cash Assistance ProgramA 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 PlacementLeslie 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 NavigationProject 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 programsVisit 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 consultantYou 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 dietitians, and organizational justice work.
If this episode resonated with you
If you are struggling with an eating disorder and feel blocked by money, insurance, or access, I hope this episode helps you feel less alone and more resourced. There are people and organizations actively working to break financial barriers to care.
If you know someone who could benefit from free or low-cost eating disorder support, especially someone from a marginalized community, please consider sharing this episode with them.
You can also support this work by:
Following @liberatiwellness and @projectheal
Sharing Project HEAL’s application info with your community
If you are a provider, applying to join the Healer’s Circle and offering sliding scale or pro bono care
And as always, thank you for listening and for being part of this conversation about justice, embodiment, and eating disorder recovery.

The Quiet Places Where Anorexia Meets Identity & Expression

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 modelsTrauma-informed careQueer embodiment researchNeurodivergent 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.