Dr. Marianne-Land: An Eating Disorder Recovery Podcast

Certain foods can become closely connected to binge eating because they provide more than taste or energy. For people with ADHD or autism, these foods may offer sensory stimulation, predictability, emotional regulation, comfort, or relief after a demanding day.
Dr. Marianne explains why binge foods are not random and why removing them rarely addresses the full problem. She examines the connections among ADHD and binge eating, autism and eating disorders, bulimia, binge eating disorder, sensory processing, interoception, executive dysfunction, and food restriction.
ADHD, Executive Dysfunction, and Binge Eating
ADHD can make consistent eating difficult. Time blindness, hyperfocus, decision fatigue, appetite changes from medication, and the many steps involved in preparing food can lead to delayed meals or inadequate nourishment. By evening, intense hunger may combine with a need for stimulation and immediate energy.
Crunchy, sweet, salty, creamy, cold, or strongly flavored foods can provide rapid sensory input. These foods may help an ADHD brain feel more alert, focused, soothed, or engaged. What appears to be a lack of self-control may actually reflect hunger, executive-function challenges, and a nervous system seeking regulation.
Autism, Sensory Regulation, and Binge Foods
For autistic people, familiar foods can provide sensory safety and predictability. Packaged foods often offer the same flavor, texture, and appearance every time. That consistency may feel especially regulating after sensory overload, masking, social demands, or unexpected changes.
Repetitive eating may also function as stimming. Specific textures, temperatures, and flavors can help an autistic person feel grounded or organized. Interoception differences may make it harder to recognize hunger and fullness until those sensations become intense.
Bulimia vs. Binge Eating Disorder
Bulimia and binge eating disorder both involve recurrent binge-eating episodes and significant distress. Bulimia also includes compensatory behaviors such as vomiting, fasting, excessive exercise, or laxative misuse.
People with binge eating disorder may not use regular compensatory behaviors, but they may still diet, skip meals, or restrict food between binges. Restriction, scarcity, and labeling foods as forbidden can increase preoccupation and intensify the binge-restrict cycle.
Understanding the Function of Binge Eating
Instead of asking only, “How do I stop eating this food?” Dr. Marianne encourages listeners to ask what the food is helping them do. It may provide energy after under-eating, interrupt racing thoughts, soothe emotional distress, support a transition into rest, or meet a sensory need.
Recovery may include mechanical eating, low-effort foods, executive-function accommodations, sensory support, regular nourishment, and less moral judgment around food. Understanding the function of binge foods does not minimize the distress or medical risks of bulimia and binge eating disorder. It creates a more compassionate and effective place to begin.
Who This Eating Disorder Recovery Episode Is For
This episode is for autistic people, ADHDers, and other neurodivergent adults who experience binge eating, bulimia, binge eating disorder, food restriction, delayed eating, sensory-seeking eating, or difficulty recognizing hunger and fullness cues. Eating disorder therapists, dietitians, and other providers may also benefit from this neurodivergent-affirming perspective.
Work With Dr. Marianne
Dr. Marianne provides neurodivergent-affirming, sensory-attuned, trauma-informed, and weight-neutral eating disorder therapy for clients in California and Washington, D.C. She also offers virtual coaching and parent consultations worldwide.
Learn more at drmariannemiller.com.
This podcast provides education and cannot replace individualized medical, nutritional, or mental health care. Bulimia and other eating disorders can cause serious medical complications. Seek medical support if you are purging, severely restricting, or experiencing concerning physical symptoms.
Related Episodes
ADHD & Binge Eating: Why You Feel Like a Bottomless Pit (And Why Traditional CBT Often Fails) on Apple and Spotify.
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.
Autism, Food Rigidity, & Eating Disorders: How Autistic Traits Can Help & Hinder Recovery on Apple and Spotify.

Chronic pain can make eating disorder recovery more complicated. Pain, fatigue, brain fog, medication side effects, nausea, limited mobility, and sensory overload can interfere with shopping, preparing food, recognizing hunger, and eating consistently.
In this solo episode of Dr. Marianne-Land, Dr. Marianne explains why these challenges reflect real barriers to nourishment, not a lack of motivation or commitment to recovery. Drawing from her clinical experience and more than two decades of living with lower back pain, she discusses how chronic pain can become intertwined with food restriction, binge eating, purging, compulsive movement, and body-image distress.
Interoception, Hunger, and Fullness Cues
Chronic pain can affect interoception, or the ability to notice and interpret signals from inside the body. When pain remains loud and persistent, quieter hunger and fullness cues may become harder to recognize.
Hunger may feel like nausea, shakiness, irritability, anxiety, or general physical distress. Fullness may be confused with pain, bloating, or sensory discomfort. Someone may know that something feels wrong without knowing whether they need food, rest, medication, hydration, or another form of support.
Dr. Marianne explains why relying entirely on hunger cues may not provide enough structure during a pain flare. Flexible mechanical eating, reminders, and predictable eating opportunities can support nourishment when internal signals feel inconsistent or confusing.
Chronic Pain, Food Restriction, and Binge Eating
Eating disorder behaviors can serve understandable functions when someone lives with persistent pain. Restriction may create numbness or a temporary sense of control. Binge eating may offer comfort, stimulation, distraction, or emotional regulation. Purging may feel like a release, and compulsive movement may continue despite pain because rest triggers fear or guilt.
Understanding what a behavior provides can help identify the unmet need underneath it. That understanding does not make a harmful behavior safe, but it can create a more compassionate and effective path toward change.
Medical Weight Stigma and Chronic Illness
People in larger bodies often receive weight-loss advice before healthcare professionals fully investigate their pain. For someone with an eating disorder history, restrictive medical advice can reactivate food rules, obsessive thoughts, compensatory behaviors, and body shame.
Dr. Marianne discusses why people deserve pain treatment that looks beyond body size and why intentional weight loss is not a neutral recommendation in eating disorder recovery.
Accessible Eating During Pain and Fatigue
Recovery may require practical accommodations. Frozen meals, packaged snacks, nutrition drinks, prepared ingredients, repetitive foods, and delivery all count as nourishment.
Creating options for lower-pain, moderate-pain, and severe-pain days can reduce the physical and executive-function demands of eating. Keeping food near the bed, couch, or desk can also make nourishment more accessible. The goal is not to create an ideal meal. The goal is to make eating possible.
Who This Eating Disorder Podcast Episode Is For
This episode is for people navigating chronic pain, chronic illness, fatigue, disrupted hunger and fullness cues, anorexia, bulimia, binge eating disorder, ARFID, compulsive movement, or long-term eating disorder recovery. It may also help therapists, dietitians, caregivers, and medical professionals understand why conventional recovery advice does not always fit people living with pain.
This content provides general education and support, not individualized medical, nutritional, or mental health care. Seek support from qualified professionals who understand your specific medical and eating disorder needs.
Work With Dr. Marianne
Dr. Marianne provides eating disorder therapy for clients in California and Washington, D.C., along with virtual coaching for people worldwide. She specializes in ARFID, binge eating, anorexia, bulimia, neurodivergence, chronic pain, sensory needs, and long-term eating disorder recovery.
Learn more about therapy, coaching, the self-paced ARFID and Selective Eating Course on her website, drmariannemiller.com.
Related Episodes
Chronic Illness, Wellness Culture, & Eating Disorder Recovery: Taking an Anti-Diet Approach With Abbie Attwood, MS, @abbieattwoodwellness on Apple and Spotify.
Anti-Fat Bias in Healthcare & Chronic Illness: Healing Body Image in a Marginalized Body With Ivy Felicia @iamivyfelicia on Apple and Spotify.

Attachment patterns can shape how we seek comfort, respond to uncertainty, and relate to food. Dr. Marianne welcomes back Vanessa Scaringi, PhD, and Kathryn Garland, LCSW, to discuss eating disorder recovery, emotional eating, and finding connection when the world feels unsafe.
The co-owners of CALM Counseling share insights from their book, Hungry for Connection: Heal Your Relationships with Food and People in an Insecurely Attached World. Together, they discuss how supportive relationships, self-compassion, and repair can help us build greater trust with food and ourselves.
ATTACHMENT STYLES & EATING DISORDERS
Learn about secure, anxious, avoidant, and fearful-avoidant attachment patterns and how they may show up in relationships with food and people. Vanessa and Kathryn explain why attachment styles can change and why a particular eating behavior does not automatically correspond to one attachment pattern.
EMOTIONAL EATING, FOOD ANXIETY & SAFETY
Eating behaviors can serve different functions, including seeking comfort and avoiding distress. The conversation considers how isolation, societal uncertainty, and disconnection can intensify food anxiety and disordered eating. Understanding what a behavior does for you can create space for curiosity and additional ways to meet your needs.
INTUITIVE EATING, DIET CULTURE & SELF-TRUST
Diet culture and wellness messaging often encourage people to question their bodies and fear food. The guests discuss intuitive eating, health optimization, and the moral judgments embedded in “clean eating.” Their alternative, “messy eating,” makes room for flexibility, imperfection, and a more compassionate relationship with food.
GLP-1s, FOOD NOISE & UNMET NEEDS
Dr. Marianne, Vanessa, and Kathryn discuss GLP-1 medications and the complexity of “food noise.” They consider biological hunger, cultural messaging, and emotional needs while encouraging ongoing conversation about food and eating, including when medication changes someone’s appetite.
EATING DISORDER RECOVERY THROUGH CONNECTION & REPAIR
Secure relationships allow room for disappointment, conflict, and reconnection. Vanessa and Kathryn explain how rupture and repair can support healing and why sustainable change takes time. Recovery can include building community, expanding coping strategies, and practicing a kinder internal voice.
WHO THIS CONVERSATION IS FOR
People navigating eating disorder recovery, emotional eating, food anxiety, or a difficult relationship with food may find this conversation helpful. Eating disorder therapists, dietitians, and loved ones can also gain insight into an attachment-informed approach to support.
CONTENT CAUTIONS
Discussion includes restrictive eating, compulsive exercise, orthorexia, diet culture, food insecurity, food fear, GLP-1 medications, weight-loss messaging, and purity culture. No specific weights, calorie counts, or instructions for eating disorder behaviors are provided.
CONNECT WITH VANESSA & KATHRYN
Learn about CALM Counseling and Hungry for Connection at keepcalmatx.com. Follow them on Instagram @keepcalmatx.
CONNECT WITH DR. MARIANNE
Visit drmariannemiller.com to learn about eating disorder therapy in California and Washington, D.C., global virtual coaching, and additional recovery resources. Find her on Instagram at @drmariannemiller.
If this episode resonates with you, follow Dr. Marianne-Land on Apple Podcasts, on Spotify, or wherever you listen. Share it with someone who could use a more compassionate perspective on food, relationships, neurodivergence, and recovery.
RELATED EPISODES
Attachment Theory & Our Relationship With Food, Eating, & Body Image With Dr. Vanessa Scaringi & Kathryn Garland, LCSW-S on Apple & Spotify.

Fear of weight gain is not always about appearance. For many people, the desire for thinness reflects a fear of rejection, medical weight stigma, dating discrimination, family criticism, workplace bias, or losing social acceptance.
In this solo episode, Dr. Marianne examines how anti-fat bias can make thinness feel like protection. Fear of fatness is real, and people in larger bodies often receive worse treatment in healthcare, relationships, employment, clothing spaces, and everyday life. Recognizing that reality does not mean accepting an eating disorder’s claim that changing your body is the only way to stay safe.
THE DESIRE FOR THINNESS IN EATING DISORDER RECOVERY
Dr. Marianne discusses how anorexia, bulimia, binge eating disorder, orthorexia, and compulsive exercise can become attempts to gain approval or avoid weight-based discrimination. She also explains why receiving compliments at a lower or medically unsafe weight can complicate eating disorder recovery.
For autistic people, ADHDers, and other neurodivergent people, body control may become another form of masking. When you already feel pressure to monitor your behavior, communication, sensory needs, or emotional responses, thinness may seem like one more way to appear socially acceptable.
WEIGHT STIGMA, BODY IMAGE, AND SOCIAL SAFETY
You’ll learn how to identify the social fear beneath body-image distress, separate discomfort from danger, and build safety without restriction, purging, bingeing, or compulsive exercise. Dr. Marianne also offers practical ways to respond to body comments, advocate for weight-neutral healthcare, find clothes that fit your current body, and develop relationships that do not require you to shrink.
Eating disorder recovery does not require perfect body acceptance. It can begin with naming the deeper truth: “I am not only afraid of being fat. I am afraid of how people may treat me.”
SPECIAL THANKS
Special thanks to Stacie Fanelli, LCSW, @edadhd_therapist, for the topic idea that inspired this episode.
WORK WITH DR. MARIANNE
Dr. Marianne Miller is a neurodivergent-affirming, fat-positive eating disorder therapist with nearly 30 years of experience as a therapist. She offers eating disorder therapy for anorexia, bulimia, binge eating disorder, ARFID, body-image concerns, autism, and ADHD in California and Washington, D.C.
Learn more about therapy, global coaching, and the ARFID and Selective Eating Course, at https://www.drmariannemiller.com.
Follow Dr. Marianne on Instagram: @drmariannemiller

Autism, ADHD, and other forms of neurodivergence can make eating far more complicated than simply recognizing hunger and choosing food. Sensory sensitivities, executive dysfunction, time blindness, interoception differences, demand avoidance, decision fatigue, and neurodivergent burnout can all interfere with regular nourishment.
Dr. Marianne explains the hidden work behind eating and why many common food environments were not designed for neurodivergent people. Schools, workplaces, healthcare systems, diet culture, and eating disorder treatment programs often expect people to tolerate noisy spaces, rigid meal schedules, complicated preparation, unfamiliar foods, and standardized treatment plans.
When someone cannot meet these expectations, they may be labeled resistant, lazy, difficult, or unmotivated. A neurodivergent-affirming approach asks a different question: What barriers are making food inaccessible?
WHAT YOU’LL LEARN
Learn how autism and ADHD can affect hunger cues, food choices, meal preparation, transitions, sensory processing, and the ability to eat consistently. Dr. Marianne discusses why autistic people may depend on safe foods, why ADHD can make planning and initiating meals difficult, and why AuDHD can create competing needs for familiarity and novelty.
You will also hear how demand avoidance, chronic illness, fatigue, pain, financial limitations, workplace expectations, and inaccessible eating disorder treatment can make food struggles worse. Convenience foods, repeated meals, grocery delivery, body doubling, external reminders, and sensory accommodations can provide meaningful access to nourishment.
AUTISM, ADHD, AND EATING DISORDERS
Neurodivergent eating does not always look conventional. Eating alone, separating foods, relying on screens during meals, repeating familiar foods, or using packaged meals may support regulation and adequate nourishment.
These patterns should not automatically be treated as eating disorder behaviors. Effective treatment for ARFID, anorexia, bulimia, binge eating disorder, and other eating concerns must distinguish between harmful restriction and accommodations that help an autistic or ADHD person eat.
The goal is not to make someone’s eating appear more typical. The goal is medical safety, adequate nourishment, sustainable flexibility, and support that respects sensory needs and autonomy.
WHO THIS EPISODE IS FOR
This episode is for autistic people, ADHDers, AuDHD adults, and anyone whose neurodivergence affects food, meal preparation, hunger cues, or daily functioning. It may also help parents, caregivers, eating disorder therapists, dietitians, occupational therapists, and other providers seeking neurodivergent-affirming approaches to food struggles.
CONTENT CAUTION
This conversation includes food restriction, inconsistent eating, binge eating, ARFID, eating disorders, shame, medical risk, and harmful treatment experiences.
If you are eating very little or experiencing rapid weight loss, fainting, chest pain, severe weakness, dehydration, or other concerning symptoms, seek medical support. Inadequate nutrition can become medically serious at every body size.
KEY TAKEAWAY
Food struggles are not always evidence of poor motivation or a lack of discipline. They often reflect real barriers involving sensory processing, executive functioning, interoception, transitions, demands, energy, access, and environment.
Instead of asking why you cannot eat "normally," ask what is making nourishment inaccessible right now. Your needs provide information about the support and accommodations that may help.
RELATED EPISODES
Autism, Food Rigidity, & Eating Disorders: How Autistic Traits Can Help & Hinder Recovery on Apple & Spotify.
ADHD, Autism, & Eating Disorders: When Feeling “Too Much” Makes You Want to Be Smaller With Stacie Fanelli, LCSW on Apple & Spotify.
WORK WITH DR. MARIANNE
Dr. Marianne Miller is a neurodivergent-affirming eating disorder therapist specializing in ARFID, binge eating, anorexia, and bulimia, as well as ADHD and autism. She provides therapy in California and Washington, D.C., along with virtual coaching for clients worldwide.
Her virtual, self-paced ARFID and Selective Eating course offers a sensory-attuned, trauma-informed, and autonomy-affirming approach for adults with ARFID, parents and caregivers, and providers. 
Learn more at https://www.drmariannemiller.com.

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.