Episodios

  • Why You Can’t Stop Body Checking: Anxiety, Eating Disorders, Autism, & What Actually Helps

    Why You Can’t Stop Body Checking: Anxiety, Eating Disorders, Autism, & What Actually Helps
    Apr 17 2026
    If you feel stuck in constant body checking, repeatedly scanning, measuring, or monitoring your body throughout the day, you are not alone and there is a real reason this pattern is so hard to break. Body checking is not about vanity or lack of willpower. It is a nervous system response shaped by anxiety, eating disorders, sensory processing, and a culture that teaches you to constantly evaluate your body. In this episode, we unpack why body checking becomes compulsive, how it connects to eating disorders, anxiety, and autism, and what actually helps when trying to reduce body monitoring behaviors in a sustainable, neurodivergent-affirming way. If you have ever wondered why you cannot stop checking your body, even when it increases distress, this episode offers a deeper, more compassionate framework for understanding what is really happening. What Is Body Checking? (Eating Disorders & Body Image) Body checking includes behaviors like mirror checking, weighing yourself frequently, comparing your body to others, scanning how your clothes fit, or mentally monitoring body size and shape throughout the day. These patterns are strongly linked to eating disorders such as anorexia, bulimia, binge eating disorder, and ARFID, and they often reinforce body image distress and food-related anxiety. Rather than helping you feel more in control, body checking tends to increase preoccupation with the body over time, creating a cycle that is difficult to interrupt. Why Body Checking Feels So Hard to Stop (Anxiety & Control) Body checking is deeply tied to anxiety and the need for certainty. When the nervous system feels overwhelmed, the brain looks for something to track and control. The body becomes that focus because it is always accessible. Even though body checking may briefly reduce anxiety, it reinforces the cycle long term. The more you check, the more your brain learns that checking is necessary to feel okay. This is why stopping body checking is not about discipline. It is about understanding the anxiety-body checking loop and finding other ways to create safety. Body Checking in Autism & Neurodivergence (Sensory & Interoception) For autistic individuals and other neurodivergent people, body checking can serve additional functions related to sensory processing and interoception. Internal body signals may feel unclear or inconsistent, which can lead to relying on external cues like mirrors, touch, or clothing fit to understand what is happening in the body. At the same time, heightened sensory awareness and pattern recognition can increase focus on subtle body changes. This makes body checking not just about body image, but also about making sense of sensory experiences in a body that may feel unpredictable. The Hidden Cycle of Body Checking & Eating Disorders Body checking creates a reinforcing loop. Anxiety increases the urge to check. Checking temporarily reduces distress. The relief fades. The urge returns stronger. Over time, this cycle strengthens eating disorder behaviors, body image distress, and compulsive monitoring. Understanding this cycle is key to shifting your relationship with body checking. The goal is not immediate elimination, but gradual change that reduces intensity and frequency. What Actually Helps: Neurodivergent-Affirming Strategies Reducing body checking requires a different approach than simply trying to stop. In this episode, we explore harm reduction strategies that support long-term change. We talk about identifying the function of body checking, building alternative ways to regulate anxiety, and using sensory supports that actually work for your nervous system. We also explore how to gently reduce checking behaviors without increasing distress, and how to shift from constant body monitoring toward a more flexible and compassionate relationship with your body. A Liberation-Based Approach to Body Image & Recovery Body checking does not exist in isolation. It is shaped by diet culture, weight stigma, and systemic pressure to monitor and control bodies. Recovery is not about perfect body acceptance or never noticing your body again. It is about moving from surveillance to relationship. This episode offers a neurodivergent-affirming, harm reduction approach to body checking that centers curiosity, flexibility, and sustainability rather than rigid rules. Related Episodes Autism, ADHD, & Eating Disorders: Recovery, Sensory Needs, & Late Diagnosis With Margo White, CPN @margo_wholebodynutrition on Apple & Spotify. “Stuck” Isn’t Lazy: Inertia in ADHD, Autism, & Eating Disorder Recovery With Stacie Fanelli, LCSW on Apple & Spotify. Autism & Eating Challenges: Understanding Sensory Needs, Routines, & Safety on Apple & Spotify. Eating Disorders & ADHD: Neurodivergent-Affirming Recovery With Taylor Ashley, RP @taylorashleytherapy on Apple & Spotify. Work With Dr. Marianne If you are struggling with body checking, eating disorders, ARFID, binge eating, or anxiety around food and your body...
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    14 m
  • Harm Reduction for Eating Disorders: How Lived Experience Shapes Recovery, Support, & Long-Term Healing

    Harm Reduction for Eating Disorders: How Lived Experience Shapes Recovery, Support, & Long-Term Healing
    Apr 15 2026
    What if eating disorder recovery didn’t have to be all-or-nothing to be real, valid, and life-changing? If traditional eating disorder recovery models have ever felt too rigid, too fast, or disconnected from your real life, this episode offers a different way forward. In this solo episode, I explore how harm reduction for eating disorders creates space for sustainable, real-world healing, and why lived experience is essential for shaping recovery that actually works. This conversation is especially important for people navigating long-term eating disorders, neurodivergence, chronic stress, and systems that make access to care more complicated. What Is Harm Reduction in Eating Disorder Recovery? Harm reduction in eating disorder recovery shifts the focus away from perfection and toward safety, stability, and sustainability. Instead of asking how to eliminate every behavior immediately, this approach asks how to reduce harm, support the body, and create change that is actually possible in the context of your life. This includes working with capacity, honoring sensory needs, and building consistency in ways that feel accessible rather than overwhelming. Why Lived Experience Matters in Eating Disorder Recovery Lived experience in eating disorder recovery refers to the knowledge that comes from actually living through an eating disorder. This concept has roots in phenomenology and has been shaped by mental health and disability advocacy movements that center the voices of those most impacted. When lived experience is included in recovery spaces, it brings nuance, context, and practical insight that cannot be captured through clinical knowledge alone. How Lived Experience Strengthens Harm Reduction Approaches When lived experience is centered, harm reduction becomes more grounded and responsive. It reflects how people actually navigate food, body, and daily life. It allows for strategies that support executive functioning, sensory preferences, and fluctuating capacity. It also acknowledges the role eating disorder behaviors can play in coping with distress, rather than ignoring their function. Eating Disorders, Intersectionality, and Real-Life Barriers Eating disorder recovery does not happen in a vacuum. Factors like weight stigma, racism, ableism, financial barriers, and access to care all shape what recovery can realistically look like. A harm reduction approach informed by lived experience takes these realities seriously and creates space for recovery that is flexible, inclusive, and grounded in the context of people’s lives. Long-Term Eating Disorders and Non-Linear Recovery For many people, eating disorders are long-term and symptoms can shift over time depending on stress, life transitions, and health changes. Harm reduction supports this reality by allowing recovery to evolve, rather than forcing a fixed endpoint. This includes focusing on reducing risk, maintaining stability, and supporting the body across different phases of life. Expanding What Recovery Can Look Like Recovery does not have to be defined by perfection or full symptom elimination to be meaningful. It can include small, sustainable shifts that support your body and your life. Harm reduction creates space for multiple pathways to recovery, especially for those who have felt excluded from traditional models. Related Episodes Harm Reduction for Long-Term Eating Disorders: Peer Support, Healing, & Hope With Johanna Scoglio, M.Ed., M.B.A. on Apple and Spotify. Understanding Harm Reduction: Why "Full Recovery" May Not Be the Goal for Lifelong Eating Disorders on Apple and Spotify. Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Navigating a Long-Term Eating Disorder on Apple & Spotify. Work With Dr. Marianne If you are looking for eating disorder therapy or coaching that centers lived experience, neurodivergence, and harm reduction, I offer support that is grounded in real-world sustainability. You can learn more about working with me at my website, drmariannemiller.com.
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    13 m
  • Eating Disorders in Midlife: Ageism, Body Image, & the Pressure to Stay Thin & Young With Deb Benfield, RDN @agingbodyliberation

    Eating Disorders in Midlife: Ageism, Body Image, & the Pressure to Stay Thin & Young With Deb Benfield, RDN @agingbodyliberation
    Apr 13 2026
    Eating disorders in midlife are increasing, yet they are often missed, misunderstood, or dismissed as “normal” aging concerns. During midlife, many people notice a sudden intensification of food struggles, body dissatisfaction, and eating disorder symptoms such as restriction, binge eating, or food anxiety. This is not random. It is the result of a powerful intersection between ageism, diet culture, and midlife body changes. In this episode, I sit down with Deb Benfield, RDN (@agingbodyliberation), to break down why eating disorders can become more complex during midlife and how pressure to stay thin and young directly fuels disordered eating patterns and recovery challenges. Ageism, Body Image, & Diet Culture in Midlife Ageism and diet culture work together to shape body image and eating behaviors in midlife. During this stage of life, messaging around anti-aging, weight loss, and “fixing” your body becomes louder and more targeted. Cultural narratives reinforce that thinness and youth equal worth, increasing body dissatisfaction and pressure to control food, weight, and appearance. During this conversation, we explore how diet culture does not fade with age. It adapts. Wellness culture, anti-aging industries, and weight-focused health messaging continue to position the body as a problem. This environment can intensify eating disorder symptoms, especially for those with a history of dieting, binge eating, restriction, or ARFID. Midlife Body Changes, Menopause & Eating Disorder Triggers Midlife body changes, including perimenopause and menopause, can act as major triggers for eating disorders. Hormonal shifts, metabolism changes, and body composition changes often occur outside of personal control, which can feel destabilizing and distressing. During midlife, messaging about menopause, weight gain, and “optimal health” often promotes restriction, rigid eating rules, and increased exercise. These approaches can worsen eating disorder symptoms and create more disconnection from hunger, fullness, and body cues. We discuss how these pressures contribute to food anxiety, body monitoring, and difficulty trusting your body during eating disorder recovery. The Pressure to Stay Thin & Young in Midlife The pressure to stay thin and young intensifies during midlife and is reinforced through diet culture, wellness culture, and anti-aging messaging. From weight loss interventions to GLP-1 medications to strict health routines, the message is clear: your body must be controlled to remain acceptable. Deb invites us to ask a critical question: who benefits from your fear of aging and body change? When fear drives behavior, it becomes easier to stay stuck in cycles of restriction, binge eating, or compulsive movement. This section explores how fear-based messaging disrupts body trust and reinforces eating disorder patterns. Body Image, Identity & Eating Disorders in Midlife Body image in midlife is deeply connected to identity, belonging, and perceived social value. During this stage, changes in appearance can feel like a loss of visibility or relevance in a culture that prioritizes youth and thinness. This can lead to increased body monitoring, comparison, and attempts to control weight or shape. We also explore how intersectionality shapes eating disorder experiences. Factors such as race, body size, disability, gender identity, and neurodivergence can amplify pressure and marginalization. Eating disorders in midlife are influenced by these broader systems, which affect access to care, safety, and support. Eating Disorder Recovery in Midlife: Rebuilding Body Trust Eating disorder recovery in midlife is not about returning to a previous version of your body. It is about building a new relationship with your body that is rooted in trust, nourishment, and care. Deb shares how recovery can include untangling internalized ageism, challenging diet culture beliefs, and reconnecting with hunger, fullness, and rest. Creating a sense of safety in the body is essential, especially during a time when cultural messaging promotes undernourishment and overexertion. Recovery in midlife can support greater flexibility, connection, and sustainability in your relationship with food. A More Expansive Approach to Aging, Body Image & Body Diversity During this episode, we explore the limitations of pro-aging and body image spaces that still center thin, white, able-bodied bodies. Expanding the definition of beauty and embracing body diversity across ages is essential for meaningful eating disorder recovery. Midlife can offer an opportunity to reconnect with your values, shift away from body control, and move toward a more expansive understanding of yourself. Aging does not have to be something to fight. It can create space for clarity, autonomy, and deeper connection. Key Takeaway Your body is not the project of your life. Your body is your partner. Eating disorder recovery in midlife can include more trust, flexibility, and ...
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    34 m
  • PDA, ARFID, & Food Avoidance: Why “Just Eat” Doesn’t Work & What to Do Instead

    PDA, ARFID, & Food Avoidance: Why “Just Eat” Doesn’t Work & What to Do Instead
    Apr 10 2026
    When eating feels like a demand, everything changes. For people with a Pervasive Drive for Autonomy (PDA) profile, especially those navigating ARFID (Avoidant/Restrictive Food Intake Disorder), pressure around food can quickly backfire. What may look like refusal or lack of motivation is often a nervous system response to perceived threat. In this episode, Dr. Marianne explores why common advice like “just eat” can make eating more difficult and how shifting toward autonomy-supportive, neurodivergent-affirming approaches can reduce food avoidance and increase access to nourishment. What Is PDA and How Does It Affect Eating Disorders? Pervasive Drive for Autonomy (PDA) is a nervous system profile, often associated with autism, where everyday demands are experienced as threats to autonomy. These demands are not always obvious. They can be subtle, internal, or socially implied, such as expectations around mealtimes or internal pressure to eat “normally.” When PDA intersects with ARFID and other eating disorders, eating becomes tied to autonomy, control, and safety rather than just hunger. This can lead to increased avoidance, shutdown, or distress when food is introduced with pressure or expectation. Why “Just Eat” Backfires in PDA and ARFID For individuals with PDA, “just eat” is not neutral. It is experienced as a demand, and often a high-pressure one. This activates the nervous system’s threat response, which can reduce appetite, increase avoidance, and create anxiety or distress around meals. Over time, repeated pressure can make eating feel less accessible rather than more. What is often interpreted as resistance is more accurately understood as a protective response. Recognizing this shift from behavior to nervous system response is essential for supporting meaningful change. SEO keywords: why ARFID gets worse with pressure, food refusal PDA, eating anxiety autism, demand avoidance food, why “just eat” doesn’t work PDA, ARFID, and Food Avoidance Across Ages This episode walks through the experience of Drew, who navigates both ARFID and a PDA profile. Whether Drew is an adult or a child, the pattern is similar. Increased reminders, prompting, or pressure around food lead to increased distress and decreased access to eating. When Drew is a child, this often requires a shift in parenting approach. Moving toward a more child-led, autonomy-supportive feeding style can reduce power struggles and support long-term nourishment. This does not mean removing structure, but rather changing how it is offered so that autonomy and safety are prioritized. What Helps: Reducing Food Pressure and Supporting Autonomy Supporting PDA and ARFID requires moving away from demand-based approaches and toward autonomy-supportive ones. This includes softening language around food, reducing pressure, and offering limited, manageable choices that allow for a sense of control. It also involves creating low-lift eating options that are easy to access and sensory-safe, reducing the effort required to eat. Adjusting the environment, timing, and expectations around meals can help lower the intensity of the experience and support nervous system regulation. When autonomy increases and pressure decreases, eating often becomes more possible. Not perfectly or immediately, but in ways that are more sustainable and less distressing. Neurodivergent Eating, Executive Functioning, and Sensory Needs Eating is not just about appetite. For many neurodivergent individuals, it is also shaped by executive functioning capacity, energy levels, and sensory experiences. Food accessibility, predictability, and tolerability all play a role in whether eating feels possible in a given moment. Low-lift eating strategies and honoring sensory preferences are essential supports. These approaches help reduce barriers and create more consistent access to nourishment without increasing demand. A Liberation-Focused Approach to Eating Disorders and PDA A liberation-focused lens challenges rigid expectations around food and bodies. It makes space for different ways of eating and recognizes that autonomy is central to safety. When we reduce pressure and support nervous system regulation, we create conditions where eating can become more accessible over time. This approach shifts the focus from compliance to collaboration, from control to support, and from urgency to sustainability. Related Episodes When PDA Drives ARFID: Understanding Food Refusal, Control, & Safety on Apple & Spotify. ARFID, PDA, and Autonomy: Why Pressure Makes Eating Harder on Apple & Spotify. 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. Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works on Apple & Spotify. Learn More: ARFID Course with Dr. Marianne If this episode resonated with you, Dr. ...
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    17 m
  • Chronic Eating Disorders: Why Some Anorexia & Bulimia Become Long-Term

    Chronic Eating Disorders: Why Some Anorexia & Bulimia Become Long-Term
    Apr 8 2026
    Not all eating disorders follow a short or linear recovery path. For many people, anorexia and bulimia become long-term, shifting over time rather than disappearing. In this episode, Dr. Marianne explores why eating disorders become chronic, how symptoms can wax and wane across life stages, and what this means for recovery, support, and understanding your nervous system. This episode offers a deeper look at chronic eating disorders, including the roles of nervous system regulation, trauma, neurodivergence, and environmental stressors, while challenging the idea that long-term symptoms reflect failure. Why Do Eating Disorders Become Chronic? Many people search for answers to why anorexia and bulimia become long-term. This episode reframes that question by focusing on function rather than blame. Eating disorders often persist because they provide structure, predictability, and a way to regulate overwhelming internal states. Dr. Marianne explains how anorexia can create a sense of control and stability, while bulimia can help discharge emotional intensity and reduce distress. Over time, these patterns become deeply learned and reinforced, making them more automatic, especially during periods of stress or uncertainty. Chronic Eating Disorders Change Over Time A key theme in this episode is that chronic eating disorders are not static. Symptoms often wax and wane depending on life circumstances, developmental stages, and stress levels. Periods of stability may bring some quieting of symptoms, while transitions, uncertainty, or increased demands can lead to intensification. Dr. Marianne explores how both micro-stressors, such as daily overwhelm, and systemic stressors, such as financial strain or societal pressures, can influence the presence and intensity of eating disorder behaviors. This perspective helps reframe symptom shifts as a nervous system response, rather than a personal setback. The Role of the Nervous System in Long-Term Eating Disorders Chronic anorexia and bulimia are deeply connected to nervous system regulation. Eating disorder behaviors can shift emotional states, reduce overwhelm, and create a sense of safety when other forms of support are not accessible. This episode explains why behavior-focused approaches alone are often not enough. Without alternative ways to support regulation, the body will often return to familiar patterns that have provided relief in the past. Understanding this connection is essential for long-term change. Trauma, Neurodivergence, and Chronic Eating Disorders This episode explores how trauma and neurodivergence intersect with long-term eating disorders. Eating disorder behaviors can help manage trauma-related distress by creating distance from overwhelming emotions or offering a sense of agency. For neurodivergent individuals, including those who are autistic or ADHD, eating patterns may also be shaped by sensory needs, routine, and predictability. What is often labeled as rigidity can be understood as an adaptive response that helps maintain equilibrium in an overstimulating or unpredictable world. Why Eating Disorder Treatment May Not Stick Many people with long-term anorexia or bulimia have engaged in treatment multiple times. When symptoms return, it can lead to frustration or self-blame. This episode offers a different perspective by highlighting how treatment may not always address the underlying functions of eating disorder behaviors. Dr. Marianne discusses how approaches that focus only on symptom change, without addressing nervous system needs, lived experience, and environmental context, may not lead to sustainable shifts. This insight helps explain why eating disorders can persist even when someone is deeply committed to recovery. Rethinking Recovery for Chronic Eating Disorders Recovery from chronic eating disorders does not have to follow a rigid or time-limited model. This episode introduces a more flexible framework that centers on understanding function, increasing support, and expanding options over time. Dr. Marianne explores how recovery can include harm reduction, gradual change, and nonlinear progress, while still being meaningful and valid. This approach allows for a more compassionate and sustainable path forward for individuals living with long-term anorexia or bulimia. Related Episodes Chronic Eating Disorders in 2026: What Hope Can Actually Look Like on Apple and Spotify. Why Some Eating Disorders Don’t Resolve: Understanding Chronic Patterns & What Actually Supports Change on Apple and Spotify. When an Eating Disorder Becomes Chronic: Recovery Tools for Persistent Anorexia & Bulimia on Apple and Spotify. Work With Dr. Marianne If this episode resonated and you are looking for support with chronic eating disorders, long-term anorexia, or bulimia, you can work with Dr. Marianne through therapy or coaching. Dr. Marianne offers neurodivergent-affirming, liberation-focused eating disorder support that integrates nervous system regulation,...
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    16 m
  • Nutrition Myths Exposed: Protein Obsession, Processed Foods, & Eating Disorder Recovery With Kathleen Meehan, RD @therdnutritionist

    Nutrition Myths Exposed: Protein Obsession, Processed Foods, & Eating Disorder Recovery With Kathleen Meehan, RD @therdnutritionist
    Apr 6 2026
    What happens when nutrition advice becomes loud, simplified, and everywhere you turn? In this episode, Dr. Marianne welcomes back Kathleen Meehan, RD (@therdnutritionist), an anti-diet, fat-positive dietitian, to unpack the current wave of nutrition myths shaping how people think about food, health, and eating disorder recovery. From protein obsession to processed food panic, this conversation brings nuance back into a space that often lacks it. The Rise of Protein Obsession in Diet Culture Protein is everywhere right now. Social media, food marketing, and even medical guidance are emphasizing high-protein intake as the key to health. Kathleen explains that while protein is important, the current messaging lacks context and balance. This trend often leads to the quiet demonization of carbohydrates and reinforces rigid food rules. It is especially visible in conversations around GLP-1 medications, where protein is framed as a solution for muscle preservation without acknowledging that overall nourishment matters more. Protein cannot compensate for not eating enough. A balanced, consistent pattern of eating is what supports both physical and mental well-being. How Nutrition Messaging Fuels Disordered Eating Many people enter eating disorder recovery already carrying fear and guilt around food. Kathleen highlights how even well-meaning nutrition advice can contribute to disordered eating when it is oversimplified. Messages about avoiding certain foods or “doing it right” can increase anxiety and disconnect people from their internal cues. Over time, this reinforces the belief that food must be controlled, measured, or optimized to be acceptable. Recovery often requires moving away from rigid rules and toward flexibility, trust, and consistency. The Pressure to Optimize Food and Health Wellness culture increasingly encourages people to track and fine-tune every aspect of their health. From wearable devices to food tracking, there is pressure to optimize eating, sleep, and metabolism. This level of monitoring can create stress and a false sense of control. Kathleen emphasizes that focusing on the big picture is often more helpful than micromanaging details. A sustainable relationship with food does not require constant measurement. Zooming out allows for a more realistic and supportive approach to health. Processed Foods and Eating Disorder Recovery Processed foods are often framed as harmful, but this conversation challenges that narrative. Kathleen emphasizes that processed foods are essential for accessibility, convenience, and consistency. For many people, including those with ARFID, processed foods may be the most reliable or tolerable options. Removing them can reduce intake and increase distress. In eating disorder recovery, having access to preferred foods is often more important than striving for an idealized version of eating. Processed foods can support nourishment, especially when life is busy, resources are limited, or sensory needs are present. Food Access, SNAP, and Nutrition Myths Food choices are shaped by access, time, and resources. Kathleen and Dr. Marianne discuss how public conversations about SNAP benefits and food choices often ignore these realities. Shelf-stable and convenient foods can be essential for individuals and families managing work demands, limited access to fresh foods, or financial constraints. Judging food choices without considering these factors oversimplifies complex realities. Nutrition cannot be separated from social context. A broader view of health includes access, stress, and systemic factors. ARFID, Sensory Needs, and Flexible Eating For individuals with ARFID, expanding food options requires safety and flexibility. Kathleen emphasizes that access to preferred foods supports both nourishment and emotional well-being. Pressuring people to eat in a certain way, especially under rigid “clean eating” expectations, can increase distress and reduce intake. Lowering pressure and supporting consistency helps create a more sustainable relationship with food. This approach is especially important for neurodivergent individuals and those navigating sensory sensitivities. A More Nuanced Approach to Nutrition This episode returns to a central theme: nutrition is not meant to be rigid or perfect. Instead of focusing on exact numbers or rules, a more supportive approach asks whether you are eating enough, including a variety of foods, and meeting your needs over time. If nutrition advice feels extreme or overwhelming, it may not be helpful. A flexible, big-picture approach supports eating disorder recovery far more than rigid guidelines. Connect With Kathleen Meehan, RD Follow Kathleen on Instagram at @therdnutritionist or on her website for thoughtful, weight-inclusive perspectives on nutrition, diet culture, and eating disorder recovery. Related Episodes When Children and Teens Struggle With Binge Eating Disorder With Kathleen Meehan, RD @therdnutritionist on Apple...
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    33 m
  • Why High Achievers Can Develop Anorexia & Bulimia: Perfectionism, Control, & Hidden Struggles

    Why High Achievers Can Develop Anorexia & Bulimia: Perfectionism, Control, & Hidden Struggles
    Apr 3 2026

    High achievers are often seen as disciplined, driven, and successful. But behind that external competence, many people are navigating intense internal pressure, perfectionism, and a deep disconnection from their bodies. In this episode, Dr. Marianne explores why high achievers are more vulnerable to eating disorders like anorexia and bulimia, and how these patterns are often hidden in plain sight.

    You will learn how perfectionism, control, and chronic stress shape eating disorder behaviors, why anorexia and bulimia can feel regulating in the short term, and how high-achieving identities can make recovery more complex. Dr. Marianne also shares from her own lived experience with bulimia, where overexercising functioned as a compensatory behavior, and how her relationship with food and her body shifted over time.

    High Achievers and Eating Disorders: Why Anorexia and Bulimia Often Go Unnoticed

    High achievers are less likely to be identified as struggling, even when eating disorder behaviors are present. This section explores how achievement, productivity, and external success can mask anorexia and bulimia, allowing patterns to continue without recognition or support.

    Perfectionism and Eating Disorders: The Link Between Control, Anorexia, and Bulimia

    Perfectionism plays a central role in both anorexia and bulimia. Learn how rigid standards, fear of mistakes, and performance-based self-worth contribute to restriction, binge eating cycles, and compensatory behaviors like overexercising.

    Anorexia vs Bulimia: How Eating Disorders Show Up in High Achievers

    This episode breaks down how anorexia and bulimia can present differently while serving similar functions. Understand how restriction, rigidity, and control show up in anorexia, and how cycles of eating and compensatory behaviors, including overexercise, show up in bulimia.

    Chronic Stress, Nervous System Activation, and Eating Disorders

    High achievers often operate under sustained stress, which can disrupt hunger cues, increase rigidity, and contribute to cycles seen in anorexia and bulimia. Learn how nervous system regulation plays a key role in understanding and healing eating disorders.

    Neurodivergence, Sensory Needs, and Eating Disorders

    Many high achievers are also neurodivergent. This section explores how sensory processing, executive functioning differences, and a need for predictability can intersect with anorexia and bulimia, shaping eating patterns and recovery needs.

    Intersectionality, High Achievement, and Eating Disorder Risk

    The pressure to achieve is not experienced equally. Dr. Marianne explores how systemic factors, identity, and marginalization can increase vulnerability to eating disorders like anorexia and bulimia.

    Eating Disorder Recovery for High Achievers: Moving Beyond Control

    Recovery does not mean losing your drive or ambition. Learn how to build a more flexible, sustainable relationship with food and your body while maintaining your strengths as a high achiever.

    Related Episodes

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

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

    Work With Dr. Marianne: Eating Disorder Therapy and Coaching

    If you are navigating anorexia, bulimia, binge eating, or patterns of overcontrol around food, Dr. Marianne offers therapy and coaching support. Her approach is neurodivergent-affirming, trauma-informed, and grounded in a liberation-focused framework.

    Learn more about working with Dr. Marianne here: https://www.drmariannemiller.com/
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    16 m
  • What Is PCOS & Why Is It Linked to Eating Disorders? Hormones, Hunger, & Insulin Resistance Explained

    What Is PCOS & Why Is It Linked to Eating Disorders? Hormones, Hunger, & Insulin Resistance Explained
    Apr 1 2026

    If you have PCOS and feel constantly hungry, deal with strong food cravings, or struggle with binge eating, you are not imagining it. PCOS can directly affect hunger, cravings, and eating patterns through insulin resistance and hormone imbalance. In this episode, Dr. Marianne explains the real link between PCOS and eating disorders so you can understand what is happening in your body without blame.

    What Is PCOS?

    PCOS, or polycystic ovary syndrome, is an endocrine and metabolic condition that affects hormones, blood sugar regulation, and appetite. While often labeled as a reproductive issue, PCOS also plays a major role in hunger, food cravings, and disordered eating patterns.

    PCOS, Insulin Resistance, and Food Cravings

    Insulin resistance is common in PCOS and can disrupt blood sugar stability. This can lead to increased hunger, intense food cravings, and energy swings throughout the day. These PCOS symptoms are biological and can strongly influence eating behavior, including binge eating.

    The Link Between PCOS and Eating Disorders

    The connection between PCOS and eating disorders develops when increased biological hunger meets pressure to restrict food. Restriction can intensify cravings, increase food focus, and contribute to binge eating and disordered eating cycles. This is not a failure of willpower. It is the interaction between hormone imbalance, insulin resistance, and external messaging about food.

    Neurodivergence, PCOS, and Eating Patterns

    Neurodivergent individuals may experience additional challenges with eating, including sensory sensitivities, executive functioning differences, and changes in hunger awareness. When combined with PCOS, these factors can make eating feel more complex and require more flexible, individualized support.

    Why Restriction Can Worsen PCOS and Binge Eating

    Restricting food can increase hunger and amplify PCOS-related food cravings. This can lead to stronger urges to eat and cycles of binge eating. Supporting consistent nourishment can help stabilize energy, reduce extremes, and support eating disorder recovery.

    A Non-Restrictive Approach to PCOS and Eating Disorder Recovery

    Recovery from eating disorders with PCOS requires working with your body, not against it. This includes consistent eating, supporting blood sugar regulation, using low-lift meals, and honoring sensory needs. These approaches can support both hormone balance and a more regulated relationship with food.

    The Emotional Side of PCOS and Disordered Eating

    PCOS is often accompanied by body changes and exposure to weight stigma, which can increase distress and drive attempts to control food. Understanding the emotional and social layers of PCOS and eating disorders is an important part of healing.

    You Are Not Broken

    If you are living with PCOS, insulin resistance, food cravings, or binge eating, your experience is valid. Your body is responding to real biological processes. Support is possible without restriction, shame, or rigid food rules.

    Related Episodes

    Polycystic Ovary Syndrome (PCOS) and Nutrition With Eden Davis, RDN, LDN on Apple & Spotify.

    Healing Binge Eating Disorder: One Woman’s Journey Toward Body Trust & Food Freedom With Dr. Michelle Tubman, M.D. @wayzahealth on Apple & Spotify.

    Chronic Binge Eating Disorder: Why It Persists & What Real Recovery Looks Like on Apple & Spotify.

    Work With Dr. Marianne: Binge Eating Recovery Membership

    If you are struggling with binge eating, disordered eating, or PCOS-related food challenges, Dr. Marianne’s binge eating recovery membership offers a non-restrictive, neurodivergent-affirming approach. Learn practical tools to support hunger, reduce food urges, and build a more sustainable relationship with food. Check out more about Dr. Marianne on her website, drmariannemiller.com.
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    15 m