Dr. Marianne-Land: An Eating Disorder Recovery Podcast

This Is Body Grief: How Ableism, Intersectionality, & Eating Disorders Shape Our Body Experiences With Jayne Mattingly

In this conversation, disability advocate, artist, and author Jayne Mattingly joins Dr. Marianne to explore body grief: the very real mourning that happens when your body, health, or identity do not match the life you imagined. Jayne traces how she coined the term from years of counseling work in eating disorders and body image, and from her own shift into disability after sudden illness and 19 brain and spine surgeries. Together, we unpack how ableism, intersectionality, and systemic oppression shape what we grieve about our bodies and how we heal. You will hear practical ways to name body grief, honor it, and build community care that creates room for joy, creativity, and resistance.
This episode covers body grief, disability advocacy, chronic pain, eating disorders, antifat bias, medical dismissal, grief phases, and neurodivergent-affirming, sensory-attuned care. We discuss how ableism and overlapping identities influence recovery, why harm reduction and community care matter, and practical tools for regulation, access planning, and self-advocacy.
CONTENT CAUTION
We discuss medical trauma, dismissal in healthcare, chronic pain, disability, diet culture, and systemic oppression. Please listen with care and pause when needed.
WHAT WE COVER
What “body grief” means and why naming it matters
How eating disorders can function as regulation and why recovery can feel like loss
Jayne’s personal story of sudden illness, surgeries, vision loss, and becoming a wheelchair user
Everyday ableism and why language like “non-disabled” helps decenter harmful norms
The seven phases Jayne observes in body grief and how people move through them
Dismissal in medical settings, internalized dismissal, and how to advocate for yourself
Why body grief grows inside systems of racism, antifat bias, sexism, homophobia, and ageism
Neurodivergence, disability, and how a more accessible world would change the grief we carry
Community care, harm reduction, and finding light without forcing a tidy destination
KEY TAKEAWAYS
Body grief is universal. We all live in bodies that change. Naming the grief opens space for honesty, compassion, and skills.
Oppression intensifies grief. Systems teach us which bodies are “acceptable.” Healing includes unlearning those messages and changing the conditions around us.
Hope and grief can coexist. Progress is nonlinear. You can move in and out of phases and still build a meaningful life.
Language matters. Shifting to terms like “non-disabled” helps challenge ableist defaults.
Community care is protective. Healing grows when we practice access, mutual support, and self-advocacy together.
FAVORITE MOMENTS
Jayne on seeing ableism inside “love your body for what it can do” messages and why that left disabled people out
The dismissal chapter story that shows how easily young people internalize “you’re fine” when they are not fine
“If you design for disabled people first, everyone benefits.”
Body grief as a unifier that crosses political lines through storytelling and clear psychoeducation
PRACTICAL TOOLS MENTIONED
Name your current phase of body grief and set one tiny supportive action for today
Track dismissal patterns you have internalized and write one replacement script for your next appointment
Build a personal access plan: sensory needs, mobility needs, communication needs, and who can help
Use harm-reduction mindset for recovery work and daily life
Create a small “joy and regulation” list that is available on hard days
ABOUT JAYNE
Jayne Mattingly is a nationally recognized disability advocate, body image speaker, and author of This Is Body Grief. She founded The AND Initiative to shift conversations around accessibility, ableism, and healing. Jayne is also the artist behind Dying for Art, a bold abstract series created in partnership with her changing body and chronic pain. She lives in Charleston, South Carolina with her service dog Wheatie.
Find Jayne: Instagram @jaynemattingly, janemattingly.com, and Substack This Is Body Grief.
RELATED EPISODES ON BODY GRIEF & ABLEISM
Body Grief & Body Peace with Leslie Jordan Garcia @liberatiwellness on Apple & Spotify.
Fat Positivity, Accessibility, Body Grief, & Emotions with @bodyimagewithbri Brianna Campos, LPC on Apple & Spotify.
Size Inclusivity & Ableism: Why Body Acceptance is More Than Just "Loving Your Curves" on Apple & Spotify.
Ableism and Common Myths About Diabetes with Kim Rose, RD @the.bloodsurgar.nutritionist on Apple & Spotify.
RESOURCES & LINKS
Book: This Is Body Grief by Jayne Mattingly — available wherever books are sold
The AND Initiative: education and advocacy on accessibility and ableism
Dying for Art: Jayne’s abstract painting series
CONNECT WITH DR. MARIANNE
If you’re struggling with restriction, food obsession, or atypical anorexia and are seeking affirming, experienced support, Dr. Marianne offers therapy in California, Texas, and Washington, D.C. Her approach is weight-inclusive, neurodivergent-affirming, sensory-attuned, and trauma-informed.
Get started here: 👉 https://www.drmariannemiller.com
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Check out my virtual, self-paced ARFID and Selective Eating course
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Live in California, Texas, or Washington D.C. and interested in eating disorder therapy with me? Sign up for a free, 15-minute phone consultation HERE or via my website, and I'll get you to where you need to be!
Check out my blog.
Want more information? Email me at hello@mariannemiller.com
If this episode resonates, share it with a friend, leave a rating, and start a conversation about access in your circles. 💫

Why Sensory-Attuned Care Matters More Than Exposure in ARFID Treatment

Exposure therapy often emerges as the gold standard for ARFID treatment, but for many neurodivergent people it does not address the full picture. In this episode of Dr. Marianne-Land, Dr. Marianne Miller explains why exposure therapy on its own often fails and how sensory-attuned, trauma-informed, and autonomy-honoring care creates a more effective path forward.
CONTENT CAUTION
This episode discusses food-related trauma, including pressure and force-feeding. Please listen with care and step away if you notice yourself feeling overwhelmed.
DIVING DEEPLY INTO THIS PODCAST EPISODE ON ARFID
Many autistic and ADHD people experience eating through a sensory lens. The challenge is not only about fear of food, but also about the surrounding environment. A noisy cafeteria, bright lighting, or the stress of being watched while eating can all create overstimulation. In those moments, eating becomes almost impossible. Before trying new foods, individuals often need to regulate, calm their system, or spend time in a sensory safe space.
When therapy ignores these realities and relies only on exposure, it can recreate earlier experiences of pressure and shame. That can retraumatize instead of heal. Sensory-attuned care honors nervous system needs, provides autonomy, and includes supports for executive functioning so that real progress becomes possible.
ARFID treatment requires more than repetition. Many people searching for ARFID therapy or ARFID treatment options want approaches that are neurodivergent-affirming, sensory-attuned, and trauma-informed. This episode highlights why exposure therapy by itself often fails and what actually works for lasting ARFID recovery. If you are seeking ARFID treatment that respects autonomy and integrates executive functioning supports, this episode will give you the insights you need.
If exposure therapy has not worked for you or your child, this episode will help you understand why it is not a personal failure. True recovery requires safety, sensory respect, and trauma-attuned strategies that recognize how neurodivergent brains and bodies experience food.
RELATED EPISODES ON ARFID & SENSORY SENSITIVITIES
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.
Navigating ADHD, Eating Disorders, & Sensory Sensitivities on Apple & Spotify.
LEARN MORE
Explore Dr. Marianne’s self-paced ARFID and Selective Eating course at drmariannemiller.com/arfid. This course is designed for both individuals and families living with ARFID and is also very helpful for providers who want to better understand how to support clients with neurodivergent-affirming and sensory-attuned strategies. Whether you are a parent, an adult navigating ARFID, or a professional working with ARFID clients, you will find practical, trauma-informed tools that go beyond exposure therapy and help create a safer, more compassionate relationship with food.
LEARN MORE & GET ARFID SUPPORT
Want support that respects autonomy, sensory needs, and neurodivergence?
Dr. Marianne’s self-paced course on ARFID and Selective Eating is available for individuals, parents, and providers.
Explore it here: https://www.drmariannemiller.com/arfid
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Check out my blog.
Want more information? Email me at hello@mariannemiller.com
 

Letting Go of the Guilt Around Emotional Eating

Have you ever reached for food when you were stressed, lonely, or overwhelmed, only to feel guilty afterward? In this episode of Dr. Marianne-Land, Dr. Marianne Miller, LMFT, explores the guilt so many people carry around emotional eating and why that guilt does more harm than the eating itself. She shares how comfort eating has always been a part of human connection, memory, and regulation, and why diet culture has twisted it into something we’re told to feel ashamed of.
CONTENT CAUTION
This episode includes discussion of emotional eating, guilt, diet culture messages, and eating disorder recovery. Please take care while listening and step away if you need to.
WHAT'S IN THIS PODCAST EPISODE ON EMOTIONAL EATING
Dr. Marianne discusses what she’s noticed while eavesdropping at restaurants when people turn down dessert by saying they “don’t want to be bad.” This everyday example highlights how morality gets tangled up with food, especially with foods that often bring us joy and comfort. Instead of labeling emotional eating as wrong, Dr. Marianne reframes it as information about what we need in the moment.
Listeners will learn practical strategies for releasing guilt, including naming emotions before and after eating, shifting language around food choices, and building a toolkit of regulation strategies that includes but isn’t limited to food. Dr. Marianne also speaks directly to neurodivergent listeners, offering sensory-based and executive functioning supports like low-lift eating, grounding practices, and compassion for how food can play an important role in daily self-care.
This episode is for anyone who has ever felt stuck in the cycle of eating for comfort, feeling guilty, and then eating again to soothe that guilt. Dr. Marianne offers a liberation-based perspective, showing how every act of compassion toward yourself is also resistance to diet culture, fatphobia, and ableism.
If emotional eating has ever left you feeling guilty, this conversation will help you release shame and see food as a source of connection, care, and freedom.
RELATED EPISODES ON SHAME & BINGE EATING
Overcoming Shame in Eating Disorder Recovery on Apple & Spotify.
How to Manage Triggers & Cravings During Recovery From Binge Eating & Bulimia on Apple & Spotify.
Binge Eating Urges: Why They Happen & How to Manage Them Without Shame on Apple & Spotify.
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Check out my virtual, self-paced ARFID and Selective Eating course
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Live in California, Texas, or Washington D.C. and interested in eating disorder therapy with me? Sign up for a free, 15-minute phone consultation HERE or via my website, and I'll get you to where you need to be!
Check out my blog.
Want more information? Email me at hello@mariannemiller.com

The Middle Place in Eating Disorder Recovery: How Slips Can Be Stepping Stones With Mallary Tenore Tarpley, MFA @mallarytenoretarpley

What if recovery isn’t about a finish line but about finding meaning in the messy middle? In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller welcomes journalist, professor, and author Mallary Tenore Tarpley to talk about her groundbreaking new book, Slip: Life in the Middle of Eating Disorder Recovery.
Mallary shares her powerful story of developing anorexia at age 12 after her mother’s death, navigating years of treatment, and later facing a decade-long cycle of bingeing and restricting. She describes how she reframed her experience through the concept of “The Middle Place,” which is a space between acute illness and full recovery where slips are not failures but opportunities for growth.
Through her lens as a journalist and storyteller, Mallary highlights the importance of expanding the language of recovery. Instead of labeling experiences as “quasi-recovery” or “pseudo-recovery,” she offers a more compassionate and nuanced perspective...one that validates ongoing struggles while still holding space for progress and hope.
💡 If you’re looking for real conversations about eating disorder recovery, this episode offers hope and honesty. Mallary Tenore Tarpley shares her lived experience with anorexia recovery, binge eating recovery, and navigating the ups and downs of healing. Listeners will learn why the idea of the middle place in eating disorder recovery resonates with so many people and how reframing “slips” as stepping stones can support long-term healing. Whether you are in recovery yourself, supporting a loved one, or seeking insights as a clinician, this episode highlights the importance of compassionate eating disorder treatment, nuanced recovery language, and ongoing self-reflection.
Listeners will hear about:
Why “slips” can be stepping stones in the recovery process.
How perfectionism and all-or-nothing thinking can keep people stuck.
The importance of nuance, grace, and self-compassion in recovery.
Mallary’s research process, which included interviewing 175 people and surveying over 700 individuals worldwide with diverse lived experiences.
How storytelling, whether through journalism, memoir, or simply pen and paper, can be a lifeline and invitation for connection.
CONTENT CAUTION
This episode includes discussion of eating disorders, including anorexia, binge eating, relapse, hospitalization, and recovery. Listeners may hear mentions of grief, loss of a parent, and treatment experiences. Please take care while listening and step away if you need to.
ABOUT MALLARY TENORE TARPLEY, MFA
Mallary is a journalism professor at the University of Texas at Austin and the author of Slip. Her writing has appeared in The New York Times, The Washington Post, Los Angeles Times, Teen Vogue, and more. She publishes a weekly Substack newsletter on personal writing at mallary.substack.com and shares openly on Instagram at @mallarytenoretarpley.
📖 Slip is available wherever books are sold. Support your local bookstore, or find it on Amazon and Barnes & Noble.
OTHER INTERVIEWS & ARTICLES ON MALLARY
Live 1A interview about SLIP: https://the1a.org/segments/eating-disorders-and-the-space-between-sickness-and-recovery/
Nieman Storyboard podcast: https://niemanstoryboard.org/2025/08/14/mallary-tenore-tarpley-writing-about-eating-disorders-recovery/
NPR story about SLIP: https://www.npr.org/2025/08/10/nx-s1-5495664/eating-disorder-recovery-anorexia-slip
RELATED EPISODES ON RELAPSE & LIFELONG EATING DISORDERS
Slips, Setbacks, & Relapses in Eating Disorder Recovery on Apple & Spotify.
Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify.
Why Is Anorexia Showing Up Again in Midlife? You're Not Imagining It on Apple & Spotify.
WORK WITH DR. MARIANNE
If you’re struggling with restriction, food obsession, or atypical anorexia and are seeking affirming, experienced support, Dr. Marianne offers therapy in California, Texas, and Washington, D.C. Her approach is weight-inclusive, neurodivergent-affirming, and trauma-informed.
Get started here: 👉 https://www.drmariannemiller.com
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Check out my virtual, self-paced ARFID and Selective Eating course
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Live in California, Texas, or Washington D.C. and interested in eating disorder therapy with me? Sign up for a free, 15-minute phone consultation HERE or via my website, and I'll get you to where you need to be!
Check out my blog.
Want more information? Email me at hello@mariannemiller.com

Creating an ADHD-Affirming Relationship With Food

How do you feed yourself when cooking feels overwhelming, grocery shopping is exhausting, and you forget to eat until you're already past the point of hunger? In this episode, Dr. Marianne explores what it means to create a truly ADHD-affirming relationship with food. It isn't about meal plans or rigid rules. It’s about honoring the way ADHD brains actually work and making food more accessible, sustainable, and compassionate.
You’ll hear why executive functioning challenges make traditional approaches to eating difficult for many ADHDers, and how time blindness, sensory sensitivities, and decision fatigue all contribute to inconsistent eating patterns. We’ll also talk about the concept of low-lift eating—strategies that reduce steps and overwhelm—and why accommodations and external support are often the missing link to more stable nourishment. From meal delivery to co-eating with a friend, this episode is packed with options that honor your autonomy and needs.
If you’re looking for ADHD and food support, low-effort meals for ADHD, help with executive dysfunction and eating, or ADHD meal planning tools, this episode offers practical strategies through a neurodivergent-affirming lens. Learn how to reduce food-related overwhelm, support sensory needs, and embrace low-lift, realistic ways of eating without shame. This episode is a guide to creating sustainable food routines that center ADHD needs, not punish them.
CONTENT CAUTION:
This episode includes discussions of ADHD, disordered eating, and eating challenges related to executive functioning, decision fatigue, and internalized shame.
RELATED EPISODES ABOUT ADHD & EATING:
ADHD & Binge Eating Disorder on Apple & Spotify.
Overexercising, ADHD, and eating disorders via Apple and Spotify.
Set-Shifting, AuDHD, & Eating Disorders on Apple & Spotify.
Navigating ADHD, Eating Disorders, & Sensory Sensitivities on Apple & Spotify.
ADHD & Eating Disorders: The Overlooked Link on Apple & Spotify.
WANT MORE SUPPORT?
Want more support around ADHD and eating challenges? My ARFID and Selective Eating Course is designed for both adults with ARFID and parents of kids who struggle with eating. It’s trauma-informed, neurodivergent-affirming, and sensory-attuned. Learn more at drmariannemiller.com/arfid.
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Check out my blog.
Want more information? Email me at hello@mariannemiller.com

Quasi-Recovery Explained: When Eating Disorder Recovery Feels Incomplete

What happens when you're no longer engaging in dangerous eating disorder behaviors, but food still feels like it controls your life? In this episode, Dr. Marianne Miller unpacks the concept of quasi-recovery, a space that can feel both safer than active illness and yet not fully free.
Quasi-recovery often includes improved behaviors, such as more regular meals or weight restoration, but leaves behind the deeper work of healing food fear, body shame, and internalized rules. It can be an especially frustrating and lonely experience, because it is often praised by others even when it does not feel like real recovery on the inside.
Dr. Marianne explores how quasi-recovery can shape lifelong eating struggles and why people often get stuck there. This episode also considers how neurodivergent and marginalized folks are particularly vulnerable to staying in quasi-recovery when treatment does not address trauma, sensory needs, systemic harm, or body autonomy.
This episode covers:
What quasi-recovery is and how it shows up in daily life
Why healing requires more than just behavior change
How fear and food rules quietly persist in this phase
Why some people believe they will struggle with food forever
What a more liberating vision of recovery can look like
If you have ever wondered whether you are truly recovered or just surviving in a different way, this episode offers clarity, compassion, and hope. You do not have to stay stuck in a version of recovery that does not meet your full needs. There is more available to you.
CONTENT CAUTION:
This episode discusses eating disorder behaviors, body image distress, and systemic oppression. Please take care while listening.
RELATED EPISODES ON QUASI-RECOVERY & ORTHOREXIA:
Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify.
Orthorexia Uncovered: Causes, Challenges, & Pathways to Healing on Apple & Spotify.
An Orthorexia Recovery Story with Sabrina Magnan, @sabrina.magnan.health on Apple & Spotify.
LEARN MORE:
Dr. Marianne Miller is a fat, neurodivergent eating disorder therapist and ARFID educator. She supports individuals recovering from ARFID, binge eating disorder, anorexia, bulimia, and quasi-recovery. Her work centers autonomy, sensory attunement, and liberation. It is also neurodivergent-affirming and trauma-informed. She provides Queer-affirming and gender-affirming care. Dr. Marianne is late-diagnosed autistic.
For those who connect with this discussion and suspect ARFID may be part of their experience, or for clinicians seeking to better understand this overlap, Dr. Marianne offers her ARFID and Selective Eating Course. This self-paced program provides neurodivergent-affirming strategies and tools to address ARFID, including its intersection with anorexia, in both teens and adults.
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Go to my website https://www.drmariannemiller.com
Follow me on Instagram @drmariannemiller
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Check out my blog.
Want more information? Email me at hello@mariannemiller.com
 

Perfectionism, Bulimia, & Recovery: Harnessing Your Strengths to Heal With Dr. Amanda Marie @glitterypoison

What happens when perfectionism, academic pressure, and athletics collide with body image struggles? In this powerful episode of Dr. Marianne-Land, I sit down with Dr. Amanda Marie, a psychologist, educator, and mental health advocate who shares her story of battling bulimia throughout her teen years, college, and into her PhD program.
Amanda opens up about how her eating disorder began at 15, fueled by a drive for perfect grades, external validation, and the pressure to perform. She talks about how restriction, bingeing, and purging shaped her daily life and how she balanced secrecy, martial arts training, and academic achievement while silently struggling.
We explore:
How perfectionism and self-worth tied to grades, sports, and appearance can feed into disordered eating
The hidden toll bulimia took on Amanda’s body, mind, and relationships
How academia and high-achieving environments can intensify eating disorders
The turning point that inspired Amanda to pursue recovery after years of secrecy and shame
The importance of support systems, therapy, and using determination as a strength in healing
What Amanda would say to her 15-year-old self and to anyone listening who feels stuck in their eating disorder
Amanda’s story is one of survival and transformation. She explains how she reclaimed her grit and perseverance, once tied to her eating disorder, and redirected them toward recovery, authenticity, and compassion.
💡 Whether you are in recovery, supporting someone you love, or navigating perfectionism and pressure yourself, Amanda’s insights will resonate deeply.
CONNECT WITH DR. AMANDA MARIE
Instagram: @glitterypoison
TikTok: @mandiPhD
LinkedIn: Amanda Cason (searchable by name)
CONTENT CAUTION:
This episode discusses bulimia, restrictive eating, bingeing, purging, over-exercising, and body image struggles. Please listen with care.
RELATED EPISODES ON BULIMIA & OVEREXERCISING: 
A Bulimia Recovery Story + How Weight-Neutral Fitness Can Help Eating Disorder Recovery With Abbey Griffith @claritydecatur on Apple or Spotify.
Understanding Bulimia: Causes, Solutions, & Coping Strategies on Apple & Spotify.
Overexercising, ADHD, and Eating Disorders via Apple and Spotify.
ABOUT DR. AMANDA
Amanda Marie, PhD, is a psychologist, educator, and mental health advocate. After years of battling bulimia while striving for success in academics and competitive sports, she is now in full recovery and dedicated to inspiring others to heal and discover their self-worth. Her journey from perfectionism and secrecy to confidence and authenticity guides her work and message. With experience as a martial arts instructor, teacher, and coach, Amanda is passionate about empowering others to embrace their stories and grow with compassion.
🎧 Listen now to hear Amanda’s inspiring journey from secrecy to self-worth and why recovery is always possible, no matter how long you have struggled.
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Check out my virtual, self-paced ARFID and Selective Eating course
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Live in California, Texas, or Washington D.C. and interested in eating disorder therapy with me? Sign up for a free, 15-minute phone consultation HERE or via my website, and I'll get you to where you need to be!
Check out my blog.
Want more information? Email me at hello@mariannemiller.com

ARFID, PDA, & Autonomy: Why Pressure Makes Eating Harder

Why does pressuring someone to eat often make things worse, especially when they are neurodivergent? In this solo episode, Dr. Marianne Miller explores the intersection of ARFID (Avoidant/Restrictive Food Intake Disorder) and PDA, which can be understood as either Pathological Demand Avoidance or Pervasive Drive for Autonomy. She breaks down how demands around eating, even gentle ones, can increase distress and shut down the nervous system for people with this profile.
You will learn why pressure often intensifies food refusal and how honoring autonomy can become a foundation for safety, regulation, and healing. Dr. Marianne shares what helps instead, from sensory-attuned environments to co-regulation to collaborative care that supports autonomy instead of undermining it.
This episode is especially relevant for those searching for support with ARFID and PDA, whether you're navigating a Pervasive Drive for Autonomy or supporting someone with autism and food refusal challenges. Dr. Marianne discusses key elements of ARFID therapy in California, Texas, and Washington, D.C., with attention to neurodivergent-affirming approaches for sensory-based eating challenges. Topics include autonomy-centered care, the connection between PDA and eating avoidance, sensory accommodations, and how pressure around food can disrupt progress. This conversation is ideal for anyone exploring eating disorder support that moves beyond compliance and toward collaboration.
Whether you are someone navigating ARFID and PDA yourself, or a clinician or caregiver offering support, this episode will offer a compassionate, liberation-focused, neurodivergent-affirming lens on what really helps and why.
🧠 Topics Covered:
What ARFID is and how it differs from body image-based eating disorders
What PDA looks like and why many prefer the term Pervasive Drive for Autonomy
Why pressure, even subtle, can shut down eating
How the nervous system responds to loss of autonomy
The difference between defiance and nervous system survival
Why same foods, routines, and sensory predictability matter
How to support eating through choice, collaboration, and autonomy
Co-regulation and sensory accommodations as vital tools
Why internal demands can feel just as overwhelming as external ones
The power of trust, pacing, and honoring difference
🧭 Related Episodes on ARFID, PDA, & Autonomy:
Adult ARFID Explained: Real-Life Strategies for Managing Food & Nutrition with Caroline Holbrook, RD on Apple & Spotify.
Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat on Apple & Spotify.
PDA & Eating Disorders: Why the Pervasive Drive for Autonomy Matters in Recovery on Apple & Spotify.
The Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify.
⚠️ Content Cautions:
This episode includes discussion of food refusal, eating challenges, shutdowns, and nervous system dysregulation. Please listen with care and take breaks if needed.
💻 Learn More & Get Support:
Want support that respects autonomy, sensory needs, and neurodivergence?Dr. Marianne’s self-paced course on ARFID and Selective Eating is available for individuals, parents, and providers.Explore it here: https://www.drmariannemiller.com/arfid
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Check out my blog.
Want more information? Email me at hello@mariannemiller.com
 

Why Letting Go of Restriction Feels Unsafe in Eating Disorder Recovery

Why does letting go of food restriction feel unsafe, even when you're ready to recover? In this solo episode, Dr. Marianne explores how restriction can become a form of survival. She discusses the ways restriction may provide a sense of control, structure, or identity, especially for those who are neurodivergent, live in marginalized bodies, or have trauma histories.
You will learn about the difference between egosyntonic restriction, which feels aligned with your values, and egodystonic restriction, which feels distressing. This insight can help make sense of your internal conflict and guide you toward a more compassionate approach to healing.
This episode offers a perspective rooted in liberation, not compliance. Dr. Marianne invites you to honor the role restriction has played in your life while also creating new ways to feel safe and supported in your body.
📌 In This Episode, Dr. Marianne Covers:
Why restriction can feel protective, not harmful
How trauma, sensory overload, and executive functioning challenges influence restrictive patterns
What it means for restriction to be egosyntonic or egodystonic
How restriction can feel both comforting and distressing at the same time
Why grief is a natural part of letting go
What it looks like to build safety, attunement, and structure without relying on restriction
⚠️ Content Cautions:This episode includes discussions of restriction, eating disorders, trauma, and anti-fat bias. Please take care of yourself while listening.
🌱 Want More Support?If you’re navigating sensory-based food challenges or ARFID, and want support that centers neurodivergent needs, explore Dr. Marianne’s self-paced course:👉 https://www.drmariannemiller.com/arfid
📚 Related Episodes on Restriction, ARFID, and Anorexia:
Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe on Apple & Spotify.
Atypical Anorexia Explained: Why Restriction Happens at Every Body Size on Apple & Spotify.
Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify.
Understanding Anorexia: Causes, Solutions, & Coping Strategies on Apple & Spotify.
🎧 Listen NowIf letting go of restriction feels terrifying, you are not alone. In this episode, Dr. Marianne offers grounding, compassion, and support for every step of your recovery.
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Live in California, Texas, or Washington D.C. and interested in eating disorder therapy with me? Sign up for a free, 15-minute phone consultation HERE or via my website, and I'll get you to where you need to be!
Check out my blog.
Want more information? Email me at hello@mariannemiller.com

Bulimia Recovery & ADHD Diagnosis: One Woman’s Journey to Healing With Kirsten Book, PMHNP-BC, @bookconciergepsych

In this inspiring and candid interview, Dr. Marianne Miller speaks with psychiatric mental health nurse practitioner Kirsten Book @bookconciergepsych about her powerful journey from living with bulimia for more than a decade to building a successful career in mental health care. Kirsten reveals how her early struggles were shaped by inadequate treatment, provider misconceptions, and the absence of neurodivergent-affirming approaches, especially before her ADHD diagnosis at age 30.
Kirsten describes the turning point that came when she became pregnant with her son, which motivated her to pursue lasting recovery. She discusses her imperfect but determined healing process, her career change from business to nursing, and her passion for treating eating disorders, ADHD, anxiety, depression, and substance use disorders.
Content Caution:
This episode contains discussions of eating disorders, bulimia, anorexia, substance use, and experiences with psychiatric care.
Key Topics Covered
Early signs of bulimia and anorexia, and how puberty shaped her body image and self-esteem
The emotional toll of being dismissed or misunderstood by treatment providers
Why early emotional education should be part of every child’s learning experience
How hope can sustain recovery even in the most difficult moments
The role of a late ADHD diagnosis in helping her maintain stability in recovery
The connection between undiagnosed ADHD, eating disorders, and substance use
Why thorough assessments are essential beyond the presenting symptoms
Benefits of collaborative treatment teams in both higher levels of care and private practice
Designing a concierge psychiatric practice with a focus on quality and accessibility
About Kirsten Book, PMHNP-BCKirsten is a board-certified psychiatric mental health nurse practitioner treating children, adolescents, and adults. She has worked at every level of care and now runs a concierge-style integrative psychiatric practice in Illinois, Arizona, Washington, and California. Her lived experience in recovery shapes her hopeful, compassionate, and personalized care.
Connect with Kirsten:
Website: kirstenbook.com
Email: kbook@kirstenbook.com
Facebook: K Book Psych
Instagram: @bookconciergepsych
Related Episodes on Bulimia & ADHD:
A Bulimia Recovery Story + How Weight-Neutral Fitness Can Help Eating Disorder Recovery With Abbey Griffith @claritydecatur on Apple or Spotify.
Understanding Bulimia: Causes, Solutions, & Coping Strategies on Apple & Spotify.
ADHD & Eating Disorders: The Overlooked Link on Apple & Spotify.
Overexercising, ADHD, and Eating Disorders via Apple and Spotify.
Resources & SupportIf you or someone you know is struggling with an eating disorder, you are not alone. In the U.S., you can reach the National Eating Disorders Association (NEDA) Helpline at 1-800-931-2237 or visit nationaleatingdisorders.org.
INTERESTED IN HANGING OUT MORE IN DR. MARIANNE-LAND?
Follow me on Instagram @drmariannemiller
Check out my virtual, self-paced ARFID and Selective Eating course
Look into my self-paced, virtual, anti-diet, subscription-based curriculum. It is called Dr. Marianne-Land's Binge Eating Recovery Membership.
Live in California, Texas, or Washington D.C. and interested in eating disorder therapy with me? Sign up for a free, 15-minute phone consultation HERE or via my website, and I'll get you to where you need to be!
Check out my blog.
Want more information? Email me at hello@mariannemiller.com