Dr. Marianne-Land: An Eating Disorder Recovery Podcast

Food rules can make eating feel like a test you have to pass. Dr. Marianne talks with registered dietitian Lauren Hofstee about eating disorder recovery, disordered eating, and building a steadier relationship with food without judgment or guilt.
WHAT YOU’LL LEARN
Lauren explains how “what I eat in a day” videos, body checks, and the thin ideal can shape food choices and body image, especially for teens and young adults. She describes what a first appointment with an eating disorder dietitian can look like and why trust and a workable eating routine matter.
Dr. Marianne and Lauren also discuss fear of carbohydrates, anxiety about weight gain, and the belief that enjoyable food must be “bad” for you. Lauren shares how nutrition education and gradual, collaborative steps can help people question food myths. They discuss why meal plans help some people while others need a different kind of structure.
WHO THIS EPISODE IS FOR
This conversation is for anyone navigating eating disorder recovery, questioning rigid food rules, or feeling nervous about seeing a dietitian. Parents and providers may also find it useful.
CONTENT CAUTIONS
This episode discusses eating disorders, food restriction, fear of weight gain, social media body checks, and diet culture.
TAKEAWAYS
Supportive eating disorder nutrition care starts with a person’s history, fears, and goals. Lauren’s approach makes room for nourishment, pleasure, and connection while helping each client find practical support that fits.
Lauren offers virtual dietitian services in Ontario. Find her on Instagram at @laurenhofstee.rd or visit laurenhofstee.me. For eating disorder therapy with Dr. Marianne in California or Washington, D.C., visit drmariannemiller.com.
RELATED EPISODES
Family Food Rules & Body Image Issues: How Diet Culture Gets Passed Down Through Generations on Apple & Spotify.
OCD & Eating Disorders: Why Food Rules, Rituals, & “Not Feeling Right” Take Over on Apple & Spotify.
 

Nutrition misinformation can make eating disorder recovery feel increasingly confusing. Social media warnings about sugar, carbohydrates, seed oils, processed foods, toxins, inflammation, and “clean eating” often sound scientific, even when they rely on fear, exaggeration, or missing context.
In this solo episode, Dr. Marianne discusses how nutrition myths and conflicting food advice can intensify food anxiety, orthorexia, ARFID, anorexia, bulimia, binge eating, and the binge-restrict cycle. She explains why people with autism, ADHD, OCD, health anxiety, sensory sensitivities, and interoceptive differences may feel especially vulnerable to rigid or fear-based nutrition claims.
What You’ll Learn
Learn how to distinguish legitimate food-safety concerns from eating disorder rules disguised as wellness advice. Dr. Marianne examines the different meanings of “safe,” including medical safety, sensory safety, emotional safety, and the moralized version of safety promoted by diet culture.
You will also hear common warning signs of nutrition misinformation, including claims that one ingredient causes many unrelated health problems, promises that eliminating a food will transform your health, and advice that becomes increasingly restrictive. Dr. Marianne explains how algorithms, personal testimonials, AI-generated nutrition advice, and wellness marketing can make unsupported claims feel credible.
Food Safety, ARFID, and Neurodivergent Eating
For autistic people and individuals with ARFID, packaged foods, familiar brands, frozen meals, snacks, and nutritional drinks may provide sensory predictability and reliable nourishment. Labeling these foods as toxic, fake, or unhealthy can remove foods that already feel accessible.
Real food-safety guidance addresses specific concerns such as allergies, contamination, food recalls, refrigeration, cross-contact, and cooking temperatures. Fear-based nutrition advice often turns a limited risk into a universal warning and leaves people afraid to eat.
Eating Disorder Recovery in an Age of Food Confusion
Dr. Marianne offers practical ways to evaluate nutrition advice without strengthening compulsive checking or dietary restriction. She discusses creating a small circle of trusted sources, pausing before eliminating foods, identifying conflicts of interest, and noticing whether advice increases flexibility or makes your relationship with food more fearful.
Eating disorder recovery does not require perfect nutritional certainty. Adequate nourishment may matter more than following constantly changing wellness rules. Food can support you through pleasure, culture, convenience, affordability, predictability, and sensory comfort.
Content Cautions
Nutrition misinformation, food contamination, food allergies, vomiting, choking, restrictive eating, orthorexia, binge eating, purging, and compulsive exercise.
Related Episodes
Nutrition Myths Exposed: Protein Obsession, Processed Foods, & Eating Disorder Recovery With Kathleen Meehan, RD @therdnutritionist on Apple & Spotify.
ARFID & Nutrition with Callie Holbrook, RD on Apple & Spotify.
Work With Dr. Marianne
Dr. Marianne provides eating disorder therapy for people in California and Washington, D.C., including support for ARFID, binge eating, anorexia, bulimia, autism, ADHD, and long-term eating disorders. She also offers global coaching, a self-paced ARFID and Selective Eating course, and a Binge Eating Recovery Membership.
Learn more at https://www.drmariannemiller.com and follow Dr. Marianne on Instagram @drmariannemiller.

ADHD and eating disorders often overlap in ways that treatment misses. For adults with late-diagnosed ADHD, chronic restriction, binge eating, bulimia, ARFID, food inconsistency, and repeated eating disorder relapse may reflect more than fear of food or resistance to recovery.
In this solo episode, Dr. Marianne discusses how ADHD executive dysfunction, time blindness, hyperfocus, decision paralysis, sensory needs, emotional dysregulation, and difficulty recognizing hunger can interfere with eating disorder recovery. Knowing what to do does not always mean your brain can consistently organize and complete the steps required to do it.
WHAT YOU’LL LEARN
Learn why late-diagnosed ADHD can change how you understand a long-term eating disorder, including years of forgotten meals, accidental restriction, intense nighttime eating, rigid food rules, and difficulty maintaining progress after structured treatment ends.
Dr. Marianne explains how missing meals can contribute to the binge-restrict cycle, why eating disorder rules may provide structure for an ADHD brain, and how food can support dopamine seeking, stimulation, comfort, and sensory regulation. She also discusses the grief and relief that may follow an adult ADHD diagnosis after years of being described as unmotivated, inconsistent, or resistant to treatment.
ADHD, EXECUTIVE DYSFUNCTION, AND EATING
Eating requires many executive-function skills. You must notice hunger, stop another activity, choose food, prepare it, tolerate the sensory experience, eat enough, and remember to repeat the process. ADHD can interrupt this sequence at several points.
A person may understand their meal plan and genuinely want recovery but still struggle with task initiation, transitions, food preparation, working memory, or decision fatigue. When clinicians treat these difficulties as psychological resistance, they may overlook the accommodations that could make nourishment more accessible.
LATE-DIAGNOSED ADHD AND CHRONIC EATING DISORDERS
Many adults with late-diagnosed ADHD spent years compensating through anxiety, perfectionism, overachievement, or rigid routines. Food rules, calorie tracking, repeated meals, restriction, or compulsive movement may have provided organization and urgency when daily life felt chaotic.
This does not mean ADHD is the only cause of a chronic eating disorder. Trauma, autism, sensory processing differences, weight stigma, chronic illness, food insecurity, and the effects of malnutrition may also contribute. Recognizing ADHD simply widens the treatment picture and helps explain why insight alone may not create lasting behavioral change.
ADHD-AFFIRMING EATING DISORDER RECOVERY
Dr. Marianne shares practical ways to reduce the executive-function burden of eating, including accessible convenience foods, visible snacks, grocery delivery, mechanical eating, body doubling, scheduled reminders, sensory accommodations, and low-effort meal options.
Recovery does not have to look polished to count. Frozen meals, repeated breakfasts, phone alarms, snack baskets, preferred dishes, or eating with a familiar television show may all support consistent nourishment. The goal is not to make eating look conventional. The goal is to create an eating disorder recovery plan that works with your neurodivergent brain.
WHO THIS EPISODE IS FOR
This episode is for adults with ADHD and eating disorders, people diagnosed with ADHD later in life, and anyone living with long-term anorexia, bulimia, binge eating disorder, ARFID, or recurring binge-restrict cycles. Providers and loved ones will also benefit from understanding how executive dysfunction can be mistaken for a lack of motivation.
RELATED EPISODES
ADHD & Bulimia: Dopamine, Impulsivity, & the Hidden Link to Binge Eating With Kirsten Book, PMHNP-BC on Apple and Spotify.
Why Eating Feels So Chaotic With ADHD: Binge Eating, Bulimia, & Executive Function Challenges on Apple and Spotify.
Eating Disorders & ADHD: Neurodivergent-Affirming Recovery With Taylor Ashley, RP @taylorashleytherapy on Apple and Spotify.
WORK WITH DR. MARIANNE
Dr. Marianne provides neurodivergent-affirming, trauma-informed, sensory-attuned, and weight-neutral eating disorder therapy for clients in California and Washington, D.C. She specializes in ARFID, binge eating, anorexia, bulimia, ADHD, autism, and long-term eating disorder recovery. Global virtual coaching is also available.
Her virtual, self-paced ARFID and Selective Eating course supports adults with ARFID, parents and caregivers, and providers seeking a collaborative, autonomy-affirming approach.
Learn more about therapy, coaching, the ARFID course, and other resources at drmariannemiller.com.

Binge eating recovery requires more than changing what or how you eat. Chef, eating psychology coach, and author Amber Caudle joins Dr. Marianne to discuss her 30-year struggle with binge eating, restriction, purging, compulsive exercise, and food obsession.
Binge Eating Recovery, Food Freedom, and Self-Trust
Amber shares how she appeared successful while privately living with shame, body dissatisfaction, and a painful relationship with food. At 38, physical and emotional exhaustion led her toward eating disorder recovery, nervous system regulation, spirituality, and a stronger connection with her body.
Amber and Dr. Marianne discuss how curiosity can replace self-criticism during binge eating recovery. They also talk about honoring hunger cues, allowing rest, setting boundaries, reconnecting with pleasure, and rebuilding self-trust after years of disordered eating.
Eating Disorders in Midlife and Perimenopause
Eating disorders do not disappear with age. Amber explains how midlife, perimenopause, body changes, ADHD symptoms, and shifting energy needs challenged her recovery. She shares how she now responds with compassion and curiosity instead of returning to restriction or compulsive exercise.
Nervous System Regulation and the Binge-Restrict Cycle
Amber describes the connections among chronic stress, survival responses, emotional eating, and the binge-restrict cycle. She explains why creating safety in her body became an essential part of finding peace with food.
The conversation also features Amber’s book, Hungry: Reclaiming Food Freedom and Finding Peace in Your Body, in which she asks a deeper question: What are you truly hungry for? The answer may involve rest, connection, intimacy, pleasure, purpose, or the freedom to exist without tying your worth to your appearance or productivity.
Content Cautions
This conversation includes discussion of binge eating, restriction, purging, compulsive exercise, calorie restriction, body checking, eating food from the trash, body dissatisfaction, and eating disorder-related health concerns.
Learn more about Amber Caudle, her book, and her work at GetHungryBook.com. You can also follow her on Instagram @ambercaudlela.
Related Episodes
Eating Disorders in Midlife: Ageism, Body Image, & the Pressure to Stay Thin & Young With Deb Benfield, RDN @agingbodyliberation on Apple & Spotify.
Restrictive Eating in Midlife: Why Eating Disorders Can Begin After 30, 40, 50 on Apple & Spotify
Anorexia & Bulimia After 40: Understanding Midlife Recovery & Change on Apple & Spotify.
The Hidden Pain of Midlife Anorexia: Why Coping Breaks Down & What Heals on Apple & Spotify.
Work With Dr. Marianne
Looking for support with binge eating, ARFID, anorexia, bulimia, or another eating disorder? Dr. Marianne provides eating disorder therapy in California and Washington, D.C., along with virtual coaching for clients worldwide.
To learn more or contact Dr. Marianne, visit https://www.drmariannemiller.com.

ARFID and PDA can make eating feel difficult even when no one is telling you what, when, or how much to eat. For autistic and neurodivergent people with Avoidant/Restrictive Food Intake Disorder (ARFID) and a PDA profile, hunger, meal schedules, food preparation, and even personal recovery goals can sometimes begin to feel like demands.
In this solo episode, Dr. Marianne explains how ARFID, autism, PDA, sensory sensitivities, executive functioning, and interoception can intersect around food. A person may genuinely want to eat and still struggle to initiate eating. For some people, the thought “I need to eat” creates additional resistance, especially when eating already requires significant sensory and executive-function effort.
ARFID, PDA & Demand Avoidance Around Food
Dr. Marianne discusses why demand avoidance isn't always caused by another person applying pressure. Hunger cues, scheduled meals and snacks, meal plans, and self-imposed recovery goals can create their own sense of expectation. She also explains why this experience shouldn't automatically be interpreted as stubbornness, lack of motivation, or unwillingness to recover.
You'll learn how autism and ARFID can make the process of eating more complex through sensory differences, low interest in food, fear of choking or vomiting, inconsistent hunger cues, transitions, decision fatigue, and executive-function challenges. When PDA is part of the picture, even a desired activity such as eating a familiar safe food may become harder to access once it feels required.
Neurodivergent-Affirming ARFID Support
Dr. Marianne offers practical ways to make nourishment more accessible without losing sight of nutritional and medical needs. She discusses low-lift eating, safe foods, sensory accommodations, reducing food preparation demands, simplifying choices, flexible eating environments, and autonomy-supportive language.
For parents supporting an autistic child or teen with ARFID and PDA, the episode also offers a different question to consider when eating breaks down: What is making food difficult to access right now? Sensory overload, nausea, fear, executive dysfunction, transitions, too many choices, or the eating environment may each require a different type of support.
ARFID Treatment, Medical Safety & Autonomy
ARFID can have serious medical and nutritional consequences. Reducing unnecessary pressure does not mean ignoring inadequate nutrition, dehydration, nutritional deficiencies, weight loss, or medical instability. Appropriate ARFID treatment may include medical monitoring, nutrition support, and mental health care.
The goal of neurodivergent-affirming ARFID care isn't to eliminate every expectation around eating. It's to support adequate nourishment with as much collaboration, predictability, sensory accommodation, dignity, and autonomy as safely possible.
Learn More About ARFID
Want a deeper understanding of ARFID treatment, autism, ADHD, PDA, sensory needs, food avoidance, and selective eating? Dr. Marianne's self-paced ARFID & Selective Eating course is designed for adults with ARFID, parents and caregivers, and providers. It uses a neurodivergent-affirming, sensory-attuned, trauma-informed approach to understanding why eating becomes difficult and what may help.
Learn more and purchase the course at drmariannemiller.com/arfid.
Dr. Marianne Miller is an eating disorder therapist with nearly 30 years of experience in the mental health field. She specializes in ARFID, anorexia, bulimia, binge eating, autism, ADHD, and neurodivergent-affirming eating disorder therapy. She provides eating disorder and ARFID therapy in California and Washington, D.C., including the San Diego area, as well as consultation and coaching for people outside those locations.
Visit drmariannemiller.com to learn more about working with Dr. Marianne, her ARFID course, and other eating disorder recovery resources.
Related Episodes
PDA, ARFID, & Food Avoidance: Why “Just Eat” Doesn’t Work & What to Do Instead on Apple & Spotify.
When PDA Drives ARFID: Understanding Food Refusal, Control, & Safety on Apple & Spotify.
ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify.
Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify.

Tradwife culture is having a moment, but what happens when traditional femininity, purity culture, the thin ideal, and disordered eating begin to overlap?
In this SOLO episode, Dr. Marianne Miller examines the growing popularity of tradwives and renewed interest in conservative Christianity among some young women. She considers why messages about modesty, discipline, self-denial, homemaking, and being a “good woman” may feel especially appealing during a time of uncertainty, loneliness, and cultural change.
Tradwives, Purity Culture, & the Thin Ideal
Tradwife content often presents an idealized picture of femininity: beautiful homes, homemade food, motherhood, marriage, modesty, and clearly defined gender roles. Yet many of the women who represent this aesthetic online are also conventionally attractive and thin.
Dr. Marianne asks whether the resurgence of traditional femininity is happening alongside another cultural shift: the return of an increasingly narrow thin ideal. In the age of GLP-1 medications, “what I eat in a day” videos, wellness culture, and shrinking celebrity bodies, young women are once again receiving powerful messages about how much physical space they should occupy.
Disordered Eating, Diet Culture, & the “Good Girl”
Diet culture and purity culture can also share a familiar vocabulary: discipline versus indulgence, clean versus contaminated, good versus bad, and control versus temptation.
For people vulnerable to eating disorders, self-denial can easily receive praise. Food restriction may look like discipline. Compulsive exercise may look like dedication. Orthorexia may look like wellness. Ignoring hunger may look like self-control.
This episode also examines a striking contradiction in tradwife culture: women may be celebrated for producing abundant homemade food for their families while still being expected to maintain thin bodies themselves. Feed everyone else, but keep your own appetite contained.
Eating Disorder Recovery Means Reclaiming Appetite
Dr. Marianne expands the meaning of “shrinking” beyond body size. Women have long been encouraged to minimize their hunger, anger, sexuality, ambition, needs, and voices. Eating disorders can turn those cultural expectations inward.
Eating disorder recovery can involve reclaiming appetite in a much broader sense: permission to want food, pleasure, rest, relationships, independence, motherhood or no motherhood, a career or homemaking, and a life that does not require becoming smaller to belong.
Rather than mocking women drawn to tradwife culture or conservative Christianity, Dr. Marianne encourages curiosity about what these movements may provide: certainty, community, spirituality, belonging, structure, or relief from hustle culture. At the same time, we can question any system that ties women's goodness to restraint, purity, desirability, self-denial, or thinness.
In this episode: tradwives and eating disorders, disordered eating, the thin ideal, purity culture, conservative Christianity, diet culture, orthorexia, wellness culture, GLP-1s, body image, traditional femininity, women and food, and eating disorder recovery.
Work With Dr. Marianne
Dr. Marianne Miller is an eating disorder therapist with nearly 30 years of experience in mental health. She specializes in ARFID, anorexia, bulimia, binge eating, neurodivergence, autism, ADHD, and complicated relationships with food and body image.
Learn more about eating disorder therapy with Dr. Marianne in California and Washington, D.C., her neurodivergent-affirming ARFID resources and course, and additional support at drmariannemiller.com.

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

Autism and eating disorders can create a complicated relationship with food rigidity, routines, sensory needs, and predictability. For autistic people recovering from anorexia, ARFID, bulimia, or other eating disorders, repetitive eating patterns aren't always symptoms that need to be challenged. Sometimes autistic food routines and preferred foods make consistent nourishment more accessible.
In this solo episode, Dr. Marianne explores the difference between autistic food rigidity and eating disorder rigidity, including why they can be difficult to separate. Sensory processing differences, executive functioning challenges, autistic inertia, interoceptive differences, and a strong preference for sameness can all shape autistic eating and eating disorder recovery.
Autism, Food Rigidity & Eating Disorder Recovery
A familiar breakfast, preferred brand, predictable meal schedule, or small rotation of foods may look rigid from the outside. For an autistic person, however, these routines can reduce sensory overwhelm, decision fatigue, and the executive functioning demands involved in eating.
Dr. Marianne explains why autism and eating disorder recovery may require a different definition of flexibility. Mechanical eating and predictable meal routines can be particularly helpful for autistic people who experience inconsistent hunger cues or difficulty interpreting internal body signals.
You'll also learn how the same autistic traits can sometimes complicate recovery. Changes to meal timing, unfamiliar foods, unexpected sensory experiences, and disruptions to established routines can create significant distress. What appears to be eating disorder resistance may actually involve autistic sensory needs, difficulty with transitions, interoceptive differences, or a need for predictability.
Autism, ARFID, Anorexia & Sensory Issues With Food
Food variety is another area where neurodivergent eating disorder treatment requires nuance. Expanding someone's range of foods can be important when limited intake creates nutritional or medical concerns, particularly with autism and ARFID. But eating more variety isn't automatically the same as eating disorder recovery.
Dr. Marianne discusses how sensory sensitivities can overlap with ARFID, anorexia, and other restrictive eating disorders, and why clinicians need to understand what a food behavior is doing before trying to change it. Avoiding a food because of texture, smell, temperature, or unpredictability isn't necessarily the same as avoiding it because of eating disorder fears about calories, weight, or body shape. Sometimes both are present.
Neurodivergent-Affirming Eating Disorder Treatment
Successful autistic eating disorder recovery doesn't require making someone's eating look neurotypical. An autistic person may continue to plan meals, repeat breakfasts, rely on preferred foods, check restaurant menus ahead of time, use sensory accommodations, and maintain predictable eating routines after the eating disorder has significantly improved.
Dr. Marianne also explains how autistic traits can become recovery strengths. A preference for routine can support regular meals and snacks, pattern recognition can help identify situations where nourishment breaks down, and understanding sensory needs can make eating more sustainable.
Rather than automatically trying to eliminate food rigidity in autism, neurodivergent-affirming eating disorder treatment asks a more useful question: Does this pattern strengthen the eating disorder, or does it help this person stay nourished?
Dr. Marianne specializes in autism, ADHD, ARFID, anorexia, bulimia, binge eating, and neurodivergent eating disorder recovery. Learn more about working with Dr. Marianne and her eating disorder therapy services at drmariannemiller.com. You can also explore her self-paced ARFID & Selective Eating course for adults with ARFID, parents and caregivers, and eating disorder providers.

Eating disorder recovery can feel surprisingly scary, even when you genuinely want to get better. Letting go of restriction, binge eating, purging, compulsive exercise, food rules, or body checking can trigger intense fear because eating disorder behaviors often serve functions that go far beyond food and body image.
In this solo episode, Dr. Marianne explores why recovery from anorexia, bulimia, binge eating disorder, ARFID, and other restrictive eating disorders can feel unsafe. When an eating disorder has become connected to predictability, emotional regulation, control, or relief from anxiety and sensory overload, changing those patterns may feel threatening rather than freeing.
Fear of Weight Gain, Food Anxiety, & Losing Control
Fear of weight gain is one of the most recognized parts of eating disorder recovery, but the fear underneath it can be more complicated. Body changes may bring up concerns about weight stigma, identity, sensory discomfort, social judgment, loss of control, or being treated differently by others.
Dr. Marianne discusses why food anxiety and fear of eating cannot always be addressed by simply challenging the food itself. Understanding what the eating disorder behavior has been doing for you can help uncover what needs additional support during recovery.
Autism, ADHD, Neurodivergence, & Eating Disorders
Neurodivergent people may experience additional challenges during eating disorder recovery. Autism, ADHD, sensory processing differences, interoception, executive functioning, transitions, routines, and PDA can all shape someone's relationship with food and change.
A neurodivergent-affirming approach to eating disorder treatment recognizes that predictability and sensory accommodations can be genuine needs. Recovery does not have to mean stripping away every source of structure or forcing someone to tolerate overwhelming uncertainty.
Nervous System Safety in Eating Disorder Recovery
Instead of asking only, “How do I stop this eating disorder behavior?” it can help to ask what the behavior has been accomplishing. Restriction may create structure. Binge eating may provide regulation or relief. Exercise may offer predictability. Food rules may reduce uncertainty.
Eating disorder recovery can include building new sources of safety, regulation, flexibility, support, and autonomy so the eating disorder no longer has to carry so much responsibility.
Related Episodes
Eating Disorders as Safety Systems: Why Letting Go Can Trigger Fear on Apple and Spotify.
If Recovery Feels Unsafe Right Now: A Guided Moment for Eating Disorder Recovery Fear on Apple and Spotify.
Eating Disorder Therapy & ARFID Support With Dr. Marianne
Dr. Marianne Miller is an eating disorder therapist specializing in anorexia, bulimia, binge eating, ARFID, and neurodivergent-affirming eating disorder treatment. Learn more about therapy and working with Dr. Marianne at drmariannemiller.com. Dr. Marianne also offers consultation services.
For additional ARFID support, Dr. Marianne's self-paced ARFID & Selective Eating course offers a neurodivergent-affirming, sensory-attuned approach for adults with ARFID, parents and caregivers, and providers. Learn more at drmariannemiller.com/arfid.

Supporting a child or teen with an eating disorder can leave parents caught between the urgency to help them eat and the fear that increasing control will create more conflict around food.
In this episode, Dr. Marianne welcomes psychologist and psychoanalyst Dr. Tom Wooldridge to discuss how parents can help a child with an eating disorder by replacing control with connection. Drawing from his book, Ending the Food Fight: Replacing Control with Connection to Help Your Child Heal from an Eating Disorder, Dr. Wooldridge offers a different way to understand eating disorders in children and teens, anorexia recovery, family dynamics, and the role of parents in eating disorder treatment.
WHAT YOU’LL LEARN
Dr. Marianne and Dr. Wooldridge discuss why weight restoration and nutritional rehabilitation are essential in anorexia treatment, but may not address everything happening beneath eating disorder behaviors. A young person may restore weight and normalize eating while still struggling with perfectionism, obsessive thinking, emotional regulation, or other patterns that contributed to the eating disorder. Understanding these underlying dynamics can be an important part of longer-term eating disorder recovery and relapse prevention.
They also explore how an eating disorder can sometimes function as a source of order, regulation, or safety when a child’s internal world feels overwhelming. Dr. Wooldridge explains how attachment and emotional safety can help us understand why moving away from anorexia, binge eating, or other eating disorder behaviors can feel threatening, even when a young person wants to recover.
PARENTS, CONNECTION & EATING DISORDER RECOVERY
When a child or teen has anorexia or another eating disorder, parents may feel frightened, frustrated, angry, or desperate to make their child eat. Dr. Wooldridge describes three important areas for parents supporting eating disorder recovery in children and adolescents: self-regulation, emotional attunement, and the ability to reflect on both their child’s internal experience and their own.
The conversation introduces mentalization, a way of becoming curious about the thoughts, feelings, fears, and needs that may be driving a child’s behavior rather than responding only to the behavior itself. For parents navigating anorexia treatment or adolescent eating disorder recovery, this can create space between the understandable urge to react and the ability to respond with greater connection and emotional attunement.
Dr. Marianne and Dr. Wooldridge also discuss perfectionism and eating disorders, family dynamics, and intergenerational patterns around food, weight, and body image. Parents may carry their own histories of dieting, body shame, weight stigma, trauma, or perfectionism. Recognizing what belongs to the parent and what belongs to the child can help interrupt the unconscious transmission of these patterns.
Importantly, replacing control with connection does not mean abandoning structure, nutritional rehabilitation, medical monitoring, or professional eating disorder treatment. Children and teens with anorexia and other eating disorders need appropriate treatment and a qualified care team. Connection provides an emotional foundation that can support that work.
ABOUT DR. TOM WOOLDRIDGE
Dr. Tom Wooldridge is a board-certified psychologist and psychoanalyst, founding dean of the School of Psychology at Golden Gate University, and an eating disorder specialist. His books include:
Understanding Anorexia Nervosa in Males 
Psychoanalytic Treatment of Eating Disorders: When Words Fail and Bodies Speak 
Ending the Food Fight: Replacing Control with Connection to Help Your Child Heal from an Eating Disorder.
His work brings together eating disorder treatment, anorexia recovery, psychoanalytic therapy, attachment, family relationships, perfectionism, and the psychological factors underlying eating disorders.
EATING DISORDER & ARFID SUPPORT WITH DR. MARIANNE
If you are looking for an eating disorder therapist, ARFID therapist, anorexia therapist, or neurodivergent-affirming eating disorder therapy, Dr. Marianne Miller provides eating disorder therapy for clients in California and Washington, D.C. Her work includes support for anorexia, bulimia, binge eating disorder, ARFID, autism, ADHD, and complex or long-term eating disorders.
Dr. Marianne also offers a self-paced ARFID & Selective Eating Course for adults with ARFID, parents and caregivers of children and teens with ARFID, and providers who want to learn more about neurodivergent-affirming ARFID treatment.
Visit Dr. Marianne’s website to learn more about eating disorder therapy in California, ARFID treatment, eating disorder recovery, parent support, and neurodivergent-affirming eating disorder care, or to explore the ARFID course and additional resources.