Dr. Marianne-Land: An Eating Disorder Recovery Podcast

The Truth About "High-Functioning" People With Lifelong Eating Disorders

Do people praise your discipline while ignoring your struggle with a long-term eating disorder?
In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller, LMFT, unpacks the cultural myth of the “high-functioning” eating disorder and explores why so many lifelong eating disorders go unnoticed, untreated, or mislabeled as willpower or success.
Episode Overview
So many people live for decades with an eating disorder that never fully goes away—because the world keeps rewarding them for being productive, disciplined, or “healthy.” Dr. Marianne explains how functioning can become a form of masking, how trauma and safety patterns reinforce chronic disordered eating, and why recovery often requires dismantling the very systems that taught us to perform instead of rest.
This episode brings honesty and compassion to those who have felt unseen by treatment models that only recognize crisis, and validation to those who have carried invisible pain behind competence and control.
Key Topics Covered
What “high-functioning” really means and why it’s a harmful label
How lifelong eating disorders become normalized and overlooked
The hidden costs of functioning and perfectionism
Trauma, safety, and why control feels protective
How privilege shapes who gets labeled “high-functioning”
Recovery pathways for long-term and late-stage eating disorders
The difference between surviving and actually living
Who This Episode Is For
This episode is for anyone who has lived with chronic disordered eating, for those who have been told they “don’t look sick,” and for clinicians seeking to better understand the quiet suffering that hides behind high performance. It’s also for neurodivergent listeners and those in larger bodies who have felt unseen in traditional eating disorder spaces.
Related Episodes
Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify.
Navigating a Long-Term Eating Disorder on Apple & Spotify.
Why Eating Disorder Recovery Feels Unsafe: Facing Ambivalence in Long-Term Struggles on Apple & Spotify.
Perfectionism, People-Pleasing, & Body Image: Self-Compassion Tools for Long-Term Eating Disorder Recovery With Carrie Pollard, MSW @compassionate_counsellor on Apple & Spotify.
Learn More and Get Support for Lifelong Eating Disorders
You can explore therapy, coaching, and recovery resources at drmariannemiller.com.
If you’re ready to deepen your healing, check out Dr. Marianne’s virtual, self-paced ARFID and Selective Eating Course, designed to support autonomy, sensory needs, and manageable recovery.
You can also follow Dr. Marianne on Instagram @drmariannemiller.

Why I’m Done Saying “Atypical Anorexia” (It’s All Anorexia, Period.)

In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, fat-positive therapist and eating disorder specialist Dr. Marianne Miller, LMFT explains why she no longer uses the label “Atypical Anorexia.” She discusses how anti-fat bias, weight stigma, and systemic discrimination in eating disorder treatment have shaped the diagnostic criteria for anorexia and harmed people in larger bodies.
Listeners will learn how the term “atypical” upholds thinness as the standard for illness, why that belief leads to delayed diagnoses, and how shifting our language can expand access to inclusive, weight-neutral, and neurodivergent-affirming eating disorder care.
Through clinical insight, real-world examples, and liberation-focused analysis, Dr. Marianne reframes what anorexia recovery truly means: healing one’s relationship with food, body, and self without hierarchy, shame, or size bias.
Key SEO Topics Covered
What Is “Atypical Anorexia”? Understanding the origins of the term and how it reinforces weight stigma and anti-fat bias.
Why Thinness Shouldn’t Define Anorexia: How body diversity challenges outdated diagnostic models.
The Role of Weight Stigma in Anorexia Recovery: How medical bias limits access to eating disorder therapyand treatment coverage.
Cultural and Systemic Bias in Eating Disorder Diagnosis: How fatphobia, whiteness, and ableism distort who gets diagnosed.
Intersectionality and Neurodivergence: How autism, ADHD, race, and gender identity affect the experience and recognition of anorexia.
What Inclusive Eating Disorder Treatment Looks Like: How clinicians can provide weight-inclusive, trauma-informed, neurodivergent-affirming care.
Body Liberation and Recovery: Why reclaiming the word “anorexia” for all bodies fosters belonging and healing.
Who This Episode Is For
This episode is for anyone interested in inclusive anorexia recovery and liberation-centered eating disorder treatment. It’s especially for:
People in larger bodies who have experienced restriction or medical dismissal.
Clinicians seeking to decolonize their approach to eating disorder therapy.
Neurodivergent listeners navigating food restriction or sensory challenges.
Individuals recovering from anorexia who were told they are “not sick enough.”
Advocates, parents, and students learning about anti-fat bias and weight-inclusive recovery models.
Why This Conversation Matters
The label “Atypical Anorexia” perpetuates harmful myths about body size, illness, and worthiness. It tells people in larger bodies that their pain is less valid and their recovery less urgent. In reality, anorexia occurs in every body size, race, gender, and neurotype.
By challenging the term “atypical,” Dr. Marianne advocates for body-liberation-aligned, anti-bias eating disorder therapy that validates all lived experiences. This conversation helps listeners unlearn weight stigma and invites the eating disorder field to adopt inclusive, evidence-based, fat-positive practices that honor every body’s right to care and nourishment.
Other Episodes on "Atypical Anorexia"
Atypical Anorexia Explained: Why Restriction Happens at Every Body Size on Apple or Spotify.
Atypical Anorexia with Amy Ornelas, RD on Apple or Spotify.
Atypical Anorexia: Mental & Physical Health Risks, Plus How the Term is Controversial on Apple or Spotify.
What Is Atypical Anorexia? Challenging Weight Bias in Eating Disorder Treatment with Emma Townsin, RD @food.life.freedom on Apple or Spotify.
Learn More and Get Support
Visit drmariannemiller.com to learn more about Dr. Marianne Miller’s eating disorder therapy, coaching, and educational resources. Her website offers blog posts, podcast transcripts, and tools for people seeking anorexia recovery support, ARFID education, and neurodivergent-affirming treatment.

Unmasking, Embodiment, & Trust: A Neurodivergent Approach to Eating Disorder Recovery With Dr. Emma Offord @divergentlives

In this powerful and affirming conversation, Dr. Marianne Miller welcomes Dr. Emma from Divergent Life, a UK-based neuroaffirming clinical psychologist and thought leader. Together, they explore the intersections of neurodivergence, eating disorders, masking, trauma, and embodiment, examining what true safety and self-trust look like in recovery.
Dr. Emma shares her journey toward becoming an eating disorder specialist, her resistance to standardized and compliance-based treatment models, and how her activist, trauma-informed, and social justice-oriented approachshapes her work.
Listeners will hear both clinicians reflect on their lived experiences, discuss the harm of medicalized narratives, and explore how therapy can become a form of activism, embodiment, and reclamation.
Who This Episode Is For
This episode is for anyone who has ever felt unseen or invalidated by traditional eating disorder treatment systems. It is especially meaningful for:
Neurodivergent individuals who have struggled with masking, sensory sensitivities, or feelings of disconnection from their bodies
People in eating disorder recovery who have not found healing in standardized or compliance-based programs
Clinicians and therapists who want to practice from a neurodivergent-affirming, trauma-informed, and social justice lens
Parents and caregivers of neurodivergent loved ones seeking compassionate, autonomy-honoring approaches
Anyone interested in embodiment, body trust, and authentic recovery
Key Topics Covered
Why standardized and compliance-based eating disorder treatments can be retraumatizing
The effects of masking and self-abandonment in neurodivergent people
How embodiment and sensory awareness support authentic healing
Understanding neurodivergent trauma and nervous system responses
Reclaiming autonomy and agency in recovery
How therapy can serve as a tool for social justice and liberation
The importance of lived experience in guiding compassionate care
About the Guest
Dr. Emma (she/her) is a neuroaffirming clinical psychologist, coach, and founder of Divergent Life, a UK-based service that challenges outdated mental health systems and centers neurodivergent and trauma-informed care. Through her work, she helps clients move from masking and compliance toward embodiment, agency, and trust in their own inner wisdom.
Instagram: @divergentlivesWebsite: divergentlife.co.uk
Why This Episode Matters
This conversation redefines what healing can look like for neurodivergent people with eating disorders, particularly those who have felt unseen or misunderstood by traditional models. Dr. Marianne and Dr. Emma discuss how masking and system-based approaches can lead to disembodiment and how safety, trust, and agency can guide recovery instead.
If you have ever questioned why “one-size-fits-all” therapy has not worked for you, or if you are a clinician seeking to practice in a way that honors autonomy and lived experience, this episode offers deep insight, compassion, and hope.
Related Episodes on Neurodivergent Needs & Experiences
Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify.
Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat via Apple & Spotify
Minding the Gap: The Intersection Between AuDHD & Eating Disorders With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify
Our Personal Neurodivergent Stories via Apple & Spotify.
Learn More and Get Support
Check out  drmariannemiller.com for blog posts, therapy services, more podcast episodes, and other offerings.
To learn about Dr. Marianne’s ARFID and Selective Eating Course, visit drmariannemiller.com/arfid.

Binge Eating & Shame: Why Willpower Isn’t the Problem

In this episode of Dr. Marianne-Land, Dr. Marianne Miller explores one of the most misunderstood experiences in eating disorder recovery: binge eating and shame.
She explains why binge eating is not caused by lack of willpower. It develops from deprivation, unmet emotional needs, and internalized shame. You will learn how restriction fuels binge urges, how shame keeps you stuck, and how compassion-based recovery helps you rebuild trust with food and your body.
Why Binge Eating Isn’t About Willpower
Many people believe binge eating happens because they lack control. In truth, binge eating is a biological and emotional response to restriction. When your body senses scarcity, it does what it was designed to do: it pushes you to eat.
Dr. Marianne discusses how diet culture and fear-based food rules create deprivation and shame. The body responds to this deprivation by seeking safety through eating, sometimes in large quantities. The solution is not to control yourself more, but to give your body the consistent nourishment and compassion it needs.
How Shame Fuels the Binge Cycle
Shame is one of the strongest emotional drivers of binge eating. After a binge, thoughts like “I failed again” or “I’ll start over tomorrow” appear. Those thoughts lead to more restriction, which triggers another binge.
Dr. Marianne explains how shame disconnects you from your body and keeps you in a cycle of punishment and control. The shift begins when you replace blame with curiosity. Asking “What does my body need right now?” helps you reconnect to your needs instead of silencing them.
The Biology Behind Binge Eating
Binge eating is a predictable response to restriction. When your body does not receive enough food, hunger hormones increase, reward pathways in the brain intensify, and cravings become urgent. Binge eating is your body’s attempt to restore balance.
Mental restriction has the same effect. When you label foods as bad or forbidden, your body perceives danger and increases urgency around those foods. Regular meals, adequate nutrition, and permission to eat satisfying foods restore body trust and calm the nervous system.
Emotional Safety and Recovery
Binge eating is often a way to self-soothe when emotions feel too big or overwhelming. If you have been taught that sadness, anger, or fear are unsafe, food may have become your most accessible form of comfort.
Dr. Marianne talks about creating emotional safety through self-soothing, sensory grounding, and compassion. When your nervous system feels supported, the intensity of binge urges begins to soften.
From Control to Compassion
Recovery is not about fighting yourself into change. It begins when you stop using control as protection and start practicing compassion.
Dr. Marianne shares ways to replace critical self-talk with kind, curious reflection. Instead of saying “I have no willpower,” try “My body is asking for care.” That language shift helps rewire your nervous system to expect gentleness instead of punishment.
Reclaiming Pleasure and Satisfaction
Food is meant to be enjoyable, not a test of discipline. When you allow yourself to experience satisfaction without guilt, eating becomes calmer and more connected.
Dr. Marianne encourages listeners to practice mindful eating, notice textures and flavors, and reconnect with the sensory experience of food. Pleasure is not indulgence; it is information that helps you understand what your body needs.
Content Caution
This episode includes open discussion about binge eating and emotional distress related to food and body image. Please listen with care and take breaks as needed.
Who This Episode Helps
This episode is for anyone who feels stuck in binge-restrict cycles or wants to understand the emotional roots of binge eating. It is also helpful for clinicians supporting clients with binge eating disorder, and for neurodivergent listeners who need a sensory-attuned and trauma-informed approach to recovery.
Related Episodes on Binge Eating
Binge Eating in Midlife: Why It Starts (or Resurfaces) in Your 30s, 40s, 50s on Apple & Spotify.
Binge Eating Urges: Why They Happen & How to Manage Them Without Shame on Apple & Spotify.
How to Manage Triggers & Cravings During Recovery From Binge Eating & Bulimia on Apple & Spotify.
Join the Binge Eating Recovery Membership
If you are ready to heal your relationship with food, Dr. Marianne invites you to join her Binge Eating Recovery Membership at drmariannemiller.com.
This membership offers accessible lessons, community support, and practical tools to help you move beyond shame, regulate emotions, and create consistency with food without dieting or control.
Inside, you will learn how to rebuild body trust, reduce binge frequency, and practice compassionate recovery at your own pace.

ARFID Help for Parents: How to Support Your Child’s Eating With Compassion

Parenting a child with ARFID (Avoidant/Restrictive Food Intake Disorder) can feel confusing and overwhelming. In this episode, Dr. Marianne Miller shares practical and compassionate strategies for parents who want to help their children eat with less fear and more confidence.
You will learn why pressure and negotiation tend to backfire, how to create low-stress mealtimes that build safety, and how to attune to your child’s sensory needs through a neurodivergent-affirming approach. Whether your child experiences food texture issues, fear of choking, or intense sensory overwhelm, this episode provides grounded, actionable steps for supporting eating with care and collaboration.
Key Topics Covered
Understanding ARFID beyond “picky eating” and recognizing it as a real eating disorder rooted in fear, sensory distress, or trauma
Why pressure and negotiation can increase distress and decrease trust
How sensory context affects eating and what small environmental changes can help
Transitioning from authoritative to consent-based parenting that prioritizes autonomy and emotional safety
Building trust through predictable, transparent, and compassionate mealtime practices
Knowing when to seek professional ARFID-informed, trauma-aware, and neurodivergent-affirming support
Who This Episode Is For
This episode is for parents, caregivers, and family members who are trying to understand and support a child living with ARFID or selective eating. It is also helpful for therapists, dietitians, educators, and healthcare providers who want to better understand the family dynamics that shape mealtime stress and recovery.
Why This Episode Matters
Many families are told to use pressure or rewards to encourage eating. While this advice may seem helpful, it often increases distress for children with ARFID. In this episode, Dr. Marianne explains why traditional approaches like “one more bite” or “if you eat your veggies, you can have dessert” can erode trust and worsen fear.
Instead, you will hear how shifting toward collaboration, sensory awareness, and emotional safety supports genuine progress. Learning to trust your child’s signals and prioritize consent around food can transform your home and restore connection at the table.
Content Caution
This episode includes discussion of children’s eating distress, food avoidance, and anxiety around eating. Please listen with care if these topics may be sensitive for you or your family.
Related Episodes
ARFID Explained: What It Feels Like, Why It’s Misunderstood, & What Helps on Apple & Spotify.
Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment on Apple & Spotify.
ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify.
Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify.
Get Additional ARFID Help
To learn more about supporting your child’s eating with compassion, visit drmariannemiller.com/arfid to explore Dr. Marianne’s ARFID & Selective Eating Course.
This self-paced, online course provides practical tools, scripts, and real-world examples to help parents reduce mealtime stress, build trust, and approach food in a supportive, neurodivergent-affirming way.

What Your Therapist Needs to Know About Eating Disorders With Edie Stark, LCSW @ediestarktherapy

What should every therapist truly understand before working with clients who have eating disorders? In this insightful interview, Dr. Marianne Miller talks with Edie Stark, LCSW (@ediestarktherapy) about what ethical, inclusive care really means.
Together, they explore why “gold standard” approaches like Family-Based Treatment (FBT) often miss the mark for neurodivergent, fat, queer, and BIPOC clients. The conversation highlights the importance of cultural humility, anti-fat bias awareness, trauma-informed care, and intersectional understanding in every therapeutic setting.
Whether you are a clinician, a student, or someone in recovery who wants to understand what quality treatment should look like, this episode offers a thoughtful look at how therapists can grow, unlearn, and create safe, collaborative spaces for healing.
Key Topics Covered
Why “gold standard” models like Family-Based Treatment (FBT) do not fit everyone
How anti-fat bias and wellness culture shape eating disorder care
The importance of cultural humility and intersectionality in therapy
Ways to create trauma-informed, consent-based, and collaborative care
What ethical practice looks like when working with neurodivergent and marginalized clients
How therapists can identify and challenge their own internalized biases
Why eating disorder work requires humility, continual learning, and self-reflection
Who This Episode Is For
Therapists and dietitians who want to provide ethical and inclusive eating disorder care
Students and early-career clinicians who are beginning to work with eating disorders
Supervisors and consultants who guide others in complex clinical cases
People in recovery who want to understand what to expect from truly affirming treatment
Anyone curious about how bias, culture, and power dynamics affect eating disorder recovery
Other Episodes With Edie
The Hidden Risks of Non-Specialized Eating Disorder Treatment on Apple & Spotify.
The Diet/Wellness Industry, Accessibility, & Diet Culture on Apple & Spotify.
Anti-Fat Bias & the Importance of Advocacy on Apple & Spotify.
About My Guest
Edie Stark, LCSW, is the founder of Stark Therapy Group in California and Edie Stark Consulting, where she supports therapists through business consulting, case consultation, and supervision. She’s also a feature writer for Psychology Today and advocates for ethical, media-accurate portrayals of eating disorders.
Connect with Edie on Instagram at @ediestarktherapy and @edies_edits, or visit ediestark.com.
About Dr. Marianne Miller
Dr. Marianne Miller is a Licensed Marriage & Family Therapist specializing in eating disorders, ARFID, and binge eating disorder. She practices in California, Texas, and Washington D.C., and teaches self-paced, virtual courses through her binge eating recovery membership and her course ARFID and Selective Eating.
Learn more at drmariannemiller.com or follow her on Instagram @drmariannemiller.

How Discovering You’re Autistic Later in Life Can Change Eating Disorder Recovery

Many people discover they are autistic only after years of struggling with eating disorders. This episode explores how a late autism diagnosis can reshape recovery by offering new understanding, compassion, and practical tools that fit the neurodivergent brain.
Understanding a Late Autism Diagnosis
Receiving an autism diagnosis in adulthood can bring both clarity and grief. It helps explain lifelong struggles with sensory overload, food textures, or social expectations, while revealing how years of misdiagnosis delayed meaningful support. In recovery, recognizing autism can change everything by connecting eating patterns to sensory differences and masking rather than willpower or motivation.
Masking, Sensory Needs, and Food
Autistic masking often overlaps with eating disorder behaviors. Restricting food, eating “normally” in social settings, or following rigid meal plans can become ways to hide difference and avoid judgment. This chronic effort to appear typical creates exhaustion and disconnection from true needs.
At the same time, sensory experiences around food are often intense. Taste, smell, temperature, and texture can feel overwhelming or unpredictable. Foods that others find pleasant may feel unsafe or even painful. Sustainable recovery begins when we make space for sensory preferences and allow eating to feel safe rather than forced.
ARFID and Autism Overlap
Avoidant or Restrictive Food Intake Disorder (ARFID) frequently occurs alongside autism. This overlap reflects sensory sensitivities, fear of choking or nausea, and low appetite rather than body image concerns. Recognizing this link shifts the goal of recovery away from compliance and toward creating safety, autonomy, and predictability in eating.
Intersectionality in Diagnosis and Recovery
Autism and eating disorders cannot be separated from the realities of race, gender, body size, class, and sexuality. Marginalized people are less likely to be diagnosed early and more likely to experience bias in treatment. Fat, BIPOC, and queer autistic people are often labeled as resistant when their needs are simply misunderstood.
A liberation-based approach to recovery asks how we can build care that honors the whole person. It challenges systems that pathologize difference and reframes healing as a process of reclaiming identity and dignity, not just changing eating behaviors.
Case Example
Dr. Marianne shares the story of a fat, queer woman of color who learned she was autistic in her late 30s after years of being told she was noncompliant in treatment. Providers dismissed her sensory distress and focused only on weight loss. She masked constantly, pretending to eat foods that overwhelmed her senses in order to appear cooperative.
Her diagnosis transformed her recovery. She began to design meals that respected her sensory needs, sought affirming providers, and connected with other neurodivergent women of color. Once her care aligned with her full identity, shame gave way to self-trust, and recovery finally felt sustainable.
Pathways Toward Neurodivergent-Affirming Recovery
A late autism diagnosis does not make recovery harder, but it does require reframing what recovery means. Sensory-attuned approaches allow individuals to choose foods that feel safe rather than forcing exposure to distressing ones. Predictable meal routines and gentle flexibility can replace pressure to eat intuitively when interoception is limited.
Executive functioning supports such as reminders, meal prep systems, and visual cues make daily nourishment possible. These tools are not crutches; they are accommodations. Recovery also involves boundary-setting and self-advocacy after years of masking needs. Finding autistic and intersectional community can turn isolation into belonging, making recovery not just about food but about identity and connection.
Who This Episode Is For
This episode is for autistic adults in recovery, clinicians learning to support neurodivergent clients, and anyone who has realized that standard eating disorder treatment does not fit. It also speaks to people exploring how autism, sensory processing, and identity intersect with food and body experiences.
Related Episodes for Autistics With Eating Disorders
Autism & Eating Disorders Explained: Signs, Struggles, & Support That Works on Apple & Spotify.
Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe on Apple & Spotify
More Autism Resources for Eating Issues
If these experiences sound familiar, explore Dr. Marianne’s ARFID & Selective Eating Course. This self-paced course teaches consent-based and sensory-attuned strategies for reducing eating distress and building a more supportive relationship with food at your own pace.

When Eating Disorders Meet Anxiety, OCD, or Depression: Co-Occurring Challenges & Recovery Strategies

When eating disorders overlap with anxiety, OCD, or depression, recovery can feel especially complex. In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller, LMFT, explores how co-occurring mental health conditions interact with disordered eating and body image struggles. She explains how anxiety often fuels food rules and avoidance, how OCD rituals can merge with eating rituals, and how depression can make nourishment feel almost impossible.
Throughout the episode, Dr. Marianne shares intersectional case examples that reflect the diversity of real-world experiences. You will hear about a Black nonbinary person whose anorexia and depression are dismissed by medical providers, a South Asian immigrant coping with OCD and bulimia in a culture where discussing mental health is taboo, and others whose experiences reveal how systemic bias and identity shape recovery. This episode offers understanding, compassion, and realistic tools for healing when multiple conditions overlap.
What You’ll Learn
You will learn how anxiety, OCD, and depression intersect with eating disorders, why eating disorders rarely exist alone, and how each condition influences the recovery process. Dr. Marianne explains why addressing only food behaviors is not enough and how integrative treatment supports both the mind and body. You will also hear about sensory-attuned strategies and community-based care that help people move toward safety, nourishment, and autonomy.
Key Takeaways
Eating disorders often coexist with anxiety, OCD, or depression because they share common roots in trauma, nervous system overwhelm, and attempts to create safety. Anxiety drives control and rigidity, OCD fuels compulsive rituals around food and body, and depression slows motivation and energy, making self-care harder. True recovery acknowledges these overlaps and treats the whole person.
Healing does not mean erasing anxiety, OCD, or depression. It means building a life that includes these realities while reducing their control over food and self-worth. Recovery becomes more sustainable when treatment honors a person’s full identity, including body size, race, gender, and neurotype.
Who This Episode Is For
This episode is for anyone who lives with an eating disorder and another mental health condition such as anxiety, OCD, or depression. It is also for clinicians, family members, and supporters who want to understand how co-occurring challenges interact and how to provide compassionate care.
Content Caution
This episode includes discussion of eating disorders, anxiety, OCD, and depression. Please take care while listening and pause if you need to.
Related Episodes
Anxiety, Meltdowns, Neurodiversity, & Eating Disorders on Apple & Spotify.
Food, Fear, & Fixation: How OCD Shapes Eating Disorders on Apple & Spotify.
Depression & Eating Disorders on Apple & Spotify.
Connect and Learn More
For deeper guidance, visit drmariannemiller.com/arfid to explore Dr. Marianne’s ARFID and Selective Eating Course. The course offers neurodivergent-affirming, sensory-attuned strategies that apply to a wide range of eating struggles.
To learn about Dr. Marianne’s therapy services in California, Texas, and Washington, D.C., or to explore additional blog posts and podcast episodes, visit drmariannemiller.com.
 

Family-Based Treatment for Adolescent Eating Disorders: How to Leave Room For Neuroaffirming Approaches With Dr. Heather Rosen @hrrosen

In this insightful conversation, Dr. Marianne Miller sits down with Dr. Heather Rosen, a licensed clinical psychologist and certified Family-Based Treatment (FBT) supervisor and trainer, to explore how evidence-based treatments for eating disorders can evolve to meet the needs of neurodivergent clients and their families.
Dr. Rosen shares her background working in major hospital settings including Stanford University, Lucile Packard Children’s Hospital, and Mount Sinai Hospital, and now in private practice in Westchester County, New York. Together, she and Dr. Miller unpack the heart of FBT—how involving families in treatment can strengthen recovery for adolescents and young adults with anorexia, bulimia, binge eating disorder, and ARFID.
This episode highlights how food becomes a metaphor for emotional pain, safety, and connection, and why treatment must go beyond meal plans to address the underlying need for autonomy, co-regulation, and family healing.
Key Topics Covered
What Family-Based Treatment (FBT) is and how it supports adolescent recovery
The role of parents in managing eating disorder behaviors at home
How FBT differs from other evidence-based treatments like CBT-E
Adapting FBT for ARFID (Avoidant/Restrictive Food Intake Disorder) and neurodivergent clients
Why flexibility and curiosity are essential when traditional exposure-based methods don’t fit
Understanding food as communication: how eating (or not eating) expresses pain, fear, and the need for control
Shifting from compliance-based models to collaborative, consent-based, and neuroaffirming care
The importance of reducing mental health stigma and improving access to effective treatment
Who This Episode Is For
This conversation is for therapists, dietitians, parents, and educators who want to understand FBT in practice and how to make eating disorder treatment more inclusive for autistic and otherwise neurodivergent youth. It’s also for anyone curious about integrating compassion, family systems awareness, and sensory attunement into recovery work.
Guest Info
Dr. Heather Rosen, PhDLicensed Clinical Psychologist | Certified FBT Therapist & SupervisorPsychology Partners Group – Westchester County, NYWebsite: psychologypartnersgroup.comInstagram: @hrrosen
Related Episodes
Family-Based Treatment and Eating Disorders in Schools With JD Ouellette of Equip Health on Apple & Spotify.
The Nitty Gritty on Family-Based Treatment for Anorexia (Maudsley Method) With Kelly McCullough @mytherapistkelly on Apple & Spotify.
Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify.
About Dr. Marianne Miller
Dr. Marianne Miller, PhD, LMFT, is a fat, neurodivergent eating disorder therapist specializing in ARFID, binge eating disorder, and complex recovery care. She offers therapy in California, Texas, and Washington, D.C., and provides global support through online courses and resources.
Learn more about Dr. Miller’s work and self-paced course on ARFID and Selective Eating at drmariannemiller.com/arfid.

The Connection Between Unresolved Trauma & Long-Lasting Eating Disorders (Content Caution)

Have you ever wondered why recovery feels stuck, no matter how hard you try?
When eating disorder behaviors keep returning despite your best efforts, unresolved trauma may be part of the reason. In this episode of Dr. Marianne-Land, Dr. Marianne Miller, LMFT, explores the deep connection between trauma and long-lasting eating disorders.
Unresolved trauma often lives in the body, shaping the nervous system and influencing how we cope, eat, and relate to ourselves. Many people discover that their eating disorder was never just about food or control—it was about safety, survival, and protection. This episode helps you understand why that makes sense and how healing is possible when both trauma and the eating disorder are addressed together.
Through compassionate storytelling and clinical insight, Dr. Marianne shares how trauma-informed therapy and body-based healing can help release long-held survival patterns. She also discusses how intersectionality, identity, and oppression influence the way trauma shows up in eating disorder recovery.
Who This Episode Is For
This episode is for anyone who has struggled with eating disorder symptoms that seem to linger, shift, or return over time. It will especially resonate with:
People who have been in treatment before yet still feel stuck in their eating disorders
Those who sense their eating disorder is connected to trauma, anxiety, or chronic stress
Neurodivergent individuals navigating sensory or emotional overwhelm around food
Survivors of emotional, physical, or systemic trauma seeking trauma-informed recovery
Clinicians, helpers, or loved ones who want to better understand how trauma and eating disorders overlap
 
If you have ever wondered why recovery feels unsafe, inconsistent, or incomplete, this episode will offer language and insight to help you make sense of your experience.
What You’ll Learn in This Episode
How unresolved trauma keeps eating disorder symptoms active for years or decades
Why eating disorders are often survival strategies, not failures of willpower
The role of the nervous system in trauma and long-term eating disorder recovery
How trauma-informed therapy helps create new pathways to safety and regulation
Why intersectionality matters in trauma and eating disorder treatment
Practical ways to rebuild safety, trust, and connection with your body
Content Caution
This episode includes discussion of trauma, eating disorders, and long-term recovery. Listen with care and pause if needed. If you are in distress, reach out to a trusted support person, therapist, or the 988 Suicide and Crisis Lifeline (U.S.) for immediate help.
Related Episodes
How Childhood Trauma Shapes Eating Disorders & Body Shame (Content Caution) on Apple & Spotify.
Childhood Trauma & Eating Disorders on Apple & Spotify.
Using EMDR & Polyvagal Theory to Treat Trauma & Eating Disorders with Dr. Danielle Hiestand, LMFT, CEDS-S on Apple & Spotify.
Trauma, Eating Disorders, & Levels of Care with Amy Ornelas, RD via Apple or Spotify.
Work With Dr. Marianne Miller
If this conversation resonates with you, therapy can help you begin to heal from trauma while working toward eating disorder recovery.Dr. Marianne Miller, LMFT, @drmariannemiller, offers trauma-informed, neurodivergent-affirming therapy for individuals navigating eating disorders, trauma, and body image distress. Her approach centers on nervous system regulation, sensory attunement, and consent-based care to help you build safety and trust within your body.
She offers therapy in California, Texas, and Washington, D.C.Learn more or schedule a consultation at drmariannemiller.com.