Struggling to tell the difference between OCD and ARFID—or wondering if you or your client might be dealing with both? You’re not alone. In this episode of Dr. Marianne-Land, Dr. Marianne explores the nuanced relationship between Obsessive-Compulsive Disorder (OCD) and Avoidant/Restrictive Food Intake Disorder (ARFID)—two conditions that often overlap and require very different support.

Learn how to differentiate between OCD rituals and ARFID food avoidance, what misdiagnosis of OCD in ARFID can look like (especially in neurodivergent individuals), and how these conditions show up differently in children versus adults. You'll also hear how nervous system regulation and sensory attunement play a central role in supporting sustainable recovery.

Whether you’re a therapist, caregiver, or neurodivergent person navigating food fears, this episode offers a validating, trauma-informed, and practical perspective on complex eating presentations.

🎧 LISTEN NOW AND EXPLORE:

• What makes ARFID and OCD different—and where they overlap

• Why OCD is often misdiagnosed in people with ARFID

• How to identify OCD–ARFID presentations in adults vs. children

• What sensory regulation and autonomy-based care really look like in treatment

👍 IF YOU FOUND THIS EPISODE HELPFUL:

• Share this episode to help others struggling with food avoidance or fear

• Subscribe on Apple Podcasts, Spotify, or your favorite platform

• Leave a review so more people can discover these neurodivergent-affirming insights

Thank you for listening—and remember, your sensory experience around food makes sense, and healing looks different for everyone.

🔗 LOOKING FOR SUPPORT WITH ARFID? Check out Dr. Marianne’s ARFID and Selective Eating Course—a self-paced, neurodivergent-affirming program designed for therapists, parents, and individuals who want practical tools to support eating without shame or pressure.

RELATED EPISODES ON ARFID: Want to learn more about ARFID and sensory-based eating challenges? Here are four related Dr. Marianne-Land episodes to check out:

• Living with Adult ARFID: Relationship Challenges No One Talks About on Apple & Spotify.

• Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify.

• Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat on Apple & Spotify.

• ARFID in Adults vs ARFID in Children 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

Struggling with bulimia in your 30s, 40s, 50s, or beyond? You’re not alone. In this solo episode, Dr. Marianne Miller explores what bulimia can look like in midlife, why the internal chaos may actually intensify with age, and how to approach healing without shame.

We dig into the unique emotional and physiological challenges of recovering from bulimia later in life, including how hormonal shifts, grief, caregiving roles, and long-term masking can impact eating behaviors.

Dr. Marianne also unpacks how neurodivergence—especially autism, ADHD, and PDA—can intersect with bulimia symptoms, intensifying binge-purge cycles and making traditional recovery models inaccessible or even harmful.

You’ll learn why your body’s responses make sense, how to regulate your nervous system with neurodivergent-affirming strategies, and what it actually takes to move toward healing—on your terms.

WHAT WE COVER IN THIS EPISODE

• Why bulimia often resurfaces or intensifies in midlife

• How midlife stress, identity shifts, and cultural stigma contribute to internal chaos

• The link between bulimia, sensory overwhelm, and emotional regulation

• How neurodivergent traits like executive dysfunction, masking, and interoceptive challenges affect eating behaviors

• Why shame-based approaches don’t work—and what actually helps

• Practical, compassionate tools for managing binge urges, purging, and nervous system dysregulation

• Why recovery in midlife is not only possible—but deeply liberating

THIS EPISODE IS FOR YOU IF...

• You feel stuck in a binge-purge cycle despite years of effort

• You’re neurodivergent and traditional ED treatment hasn’t helped

• You’ve been quietly struggling with bulimia in midlife and feel alone in it

• You want recovery tools that are sensory-attuned, autonomy-affirming, and realistic

🔗 RESOURCES & SUPPORT Learn more about how to recover from bulimia and how to join the Binge Eating Recovery Membership here: https://www.drmariannemiller.com/binge-eating-101-class-1

LISTEN TO OTHER EPISODES ON BULIMIA RECOVERY

• A Bulimia Recovery Story + How Weight-Neutral Fitness Can Help Eating Disorder Recovery With Abbey Griffith @claritydecatur on Apple or Spotify.
• Lived Experience of Having Both Bulimia & Binge Eating Disorder with Milda Zolubaite @nutrition.path on Apple or Spotify.
• Understanding Bulimia: Causes, Solutions, & Coping Strategies 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

In this powerful conversation, Dr. Marianne welcomes back body image coach and anti-diet educator Debbie Saroufim for a candid discussion about what happens when weight loss triggers eating disorder thoughts—even in solid recovery.

Debbie opens up about how recent stress and anxiety have impacted her appetite and body, and how unsolicited weight-related comments from others can be both activating and isolating. Together, we unpack why even “positive” feedback about weight loss can be harmful, how body changes can feel destabilizing, and what it means to hold complex emotions without slipping back into disordered behaviors.

We also talk about:

• The problem with equating weight loss with wellness

• How eating disorder thoughts can show up years into recovery

• The myth of a “correct” body image or recovery experience

• Perimenopause, changing bodies, and the grief that can follow

• Why body neutrality may offer more freedom than forced body positivity

• Mindfulness, fart metaphors (yay!), and how to let thoughts pass without bottling them up

Whether you’re in recovery, supporting someone who is, or navigating your own relationship with body changes, this episode offers honesty, compassion, and tools to help you stay grounded.

🧠 Want to connect with Debbie Saroufim? Visit thebodyacceptancecoach.com or follow her on Instagram @bodyacceptance_coach

🎧 Listen now wherever you get your podcasts and don’t forget to subscribe, rate, and review!

ABOUT DEBBIE

LISTEN TO OTHER EPISODES WITH DEBBIE

• Anti-Fat Bias in Schools and Society on Apple or Spotify.
• How Eating Disorder Recovery Heals Life Overall on Apple or Spotify.
• Let’s Talk Recovery: Ditching Diet Culture & Crushing Eating Disorder Thoughts on Apple or 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

In this solo episode, Dr. Marianne Miller explores the powerful and often overlooked connection between masking neurodivergence and eating disorders. If you've ever felt like you're performing just to get through the day—suppressing your sensory needs, camouflaging your communication style, or overriding your body’s cues to fit societal expectations—this episode will resonate deeply.

Dr. Marianne breaks down what masking looks like in autistic and neurodivergent individuals, including social, sensory, emotional, and cognitive masking, and how these patterns can lead to or exacerbate disordered eating behaviors like restriction, bingeing, and compulsive exercise. She also explains the systemic pressures—including ableism, fatphobia, and white supremacy—that reinforce masking, and how this contributes to burnout, identity confusion, and food-related distress.

Most important, Dr. Marianne offers a compassionate look at what it means to unmask as part of eating disorder recovery. You'll learn how reclaiming your sensory needs, autonomy, and embodied preferences can help you heal—not by becoming someone else, but by honoring exactly who you are.

🔗 Learn more about Dr. Marianne’s self-paced, neurodivergent-affirming, ARFID and Selective Eating Course here: https://www.drmariannemiller.com/arfid

KEY TOPICS COVERED:

• What is masking and how does it show up in neurodivergent people

• How masking contributes to disconnection from the body and food

• The role of sensory processing differences in eating disorders

• Systemic factors that reinforce masking (ableism, fatphobia, etc.)

• The emotional and physical toll of long-term masking

• How unmasking can support meaningful, sustainable recovery

🎧 LISTEN TO OTHER EPISODES ON AUTISM, NEURODIVERSITY, & EATING DISORDERS

• 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
• Set-Shifting, AuDHD, & Eating Disorders via Apple & Spotify.
• Our Personal Neurodivergent Stories via 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

What happens when eating disorder care is offered by clinicians with no specialized training? In this vital conversation, Dr. Marianne sits down with Edie Stark, LCSW (@ediestarktherapy), founder of Stark Therapy Group, to unpack the real—and often hidden—dangers of receiving eating disorder treatment from generalist therapists or corporate telehealth platforms like BetterHelp.

They explore why working with an eating disorder specialist matters, how disordered eating can be overlooked or misdiagnosed in non-specialized care, and the serious risks of inaccurate, unethical, or even harmful treatment. Edie also breaks down how to find high-quality, fat-positive, neurodivergent-affirming eating disorder care, even when access feels limited.

Whether you're searching for your own recovery support or you're a clinician trying to do better, this episode is a must-listen.

WHAT WE COVER IN THIS EPISODE

• The rise of venture-capitalist “therapy tech” companies and how they commodify mental health

• Ethical concerns and client horror stories from non-specialized care platforms

• Why generalist therapists are often unequipped to treat eating disorders safely

• What makes someone a true eating disorder specialist

• Why weight-loss goals should never be a treatment focus for ED clinicians

• Red flags to look for on therapist websites

• How to ask the right questions when looking for an eating disorder therapist

• The importance of training, supervision, and collaborative care teams

• The unique risks of misdiagnosis for fat, neurodivergent, BIPOC, and male clients

• Where and how to find safe, inclusive, evidence-based care

🎧 Listen now to learn how to protect yourself or your clients from underqualified treatment—and what truly specialized eating disorder recovery support looks like.

CONTACT AND FOLLOW EDIE

• Edie Stark is a licensed social worker in California, New York, and Florida.
• Connect with Edie at https://starktherapygroup.com or @ediestarktherapy on Instagram.
• Email Edie at hello@starktherapygroup.com

LISTEN TO OTHER EPISODES WITH EDIE

• The Diet/Wellness Industry, Accessibility, & Diet Culture on Apple & Spotify.
• Anti-Fat Bias & the Importance of Advocacy on Apple & Spotify.

CONTACT AND FOLLOW DR. MARIANNE

• Dr. Marianne Miller is a licensed marriage and family therapist in California, Texas, and Washington D.C.
• Visit www.drmariannemiller.com or follow @drmariannemiller on Instagram.
• Email her at hello@drmariannemiller.com

What happens when your eating disorder doesn’t just affect your plate—but every relationship in your life? In this solo episode, Dr. Marianne explores the hidden struggles of living with Avoidant/Restrictive Food Intake Disorder (ARFID) as an adult. From dating and long-term partnerships to parenting, friendships, and work dynamics, adult ARFID can create chronic stress, disconnection, and grief—especially in a world that misunderstands sensory needs and neurodivergent eating.

You’ll hear how ARFID shows up in romantic relationships, what it’s like to parent while navigating your own food limitations, and why shame and social exclusion are such common parts of the adult ARFID experience. Dr. Marianne also shares a powerful lived-experience story and affirms that your food needs are not broken—and your relationships canbe built around what truly supports you.

Whether you’re living with adult ARFID or supporting someone who is, this episode offers validation, insight, and a trauma-informed, neurodivergent-affirming perspective on how ARFID impacts connection.

👉 Want support? Learn more about Dr. Marianne’s self-paced ARFID and Selective Eating Course.

LISTEN TO OTHER EPISODES ON ARFID

• Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify.
• Stuck on Empty: Autistic Inertia, ARFID & the Struggle to Eat on Apple & Spotify.
• ARFID in Adults vs ARFID in Children 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