What happens when medical care reduces a whole human being to a number on a scale? In this episode of Dr. Marianne-Land, I’m joined by Ivy Felicia, Body Relationship Coach and founder of Luxuriant Life, for a deeply grounding conversation about anti-fat bias in healthcare, chronic illness, and what it actually takes to build peace with your body in a system that often causes harm.

Ivy shares her lived experience as a Black woman of size navigating PCOS, autoimmune illness, thyroid disease, and repeated medical dismissal. We talk openly about the moment a provider told her weight loss surgery was the only option and what it meant to be treated as disposable when she declined. That moment became a turning point that reshaped her relationship with her body and ultimately led to the creation of her Body Relationship Method, a size-inclusive, weight-neutral approach grounded in compassion, self-trust, and holistic wellness.

Throughout this conversation, we explore how chronic illness, medical trauma, and anti-fat bias intersect, and why body positivity is not always accessible or supportive for people living in pain, disability, or marginalized bodies. Ivy explains why she centers body peace rather than body love, and how choosing neutrality and non-violence toward your body can be a more realistic and healing place to start.

We also discuss the role of spirituality and surrender in healing a relationship with your body. Ivy describes how prayer, connection to nature, journaling, and honoring ancestors support her through periods of overwhelm, and why taking healing one breath at a time can feel far more attainable than one day at a time when you live with chronic pain or illness.

This episode also dives into internalized anti-fat bias and internalized ableism. Ivy shares how listening, witnessing, and affirming someone’s lived experience can be profoundly reparative, especially for people who have spent years being dismissed or erased by medical systems. We talk about visibility, self-advocacy, and how being truly heard can help people reclaim their voice and their worth.

If you’ve ever felt disconnected from your body because of chronic illness, eating disorder recovery, medical trauma, or weight stigma, this conversation offers a gentler way forward. There is no finish line here. There is no pressure to love your body. There is space to move toward peace, at your own pace, one breath at a time.

Ivy Felicia is a Body Relationship Coach, certified holistic wellness practitioner, speaker, and founder of Luxuriant Life, LLC. She is the creator of the Body Relationship Method, a trademarked, size-inclusive, weight-neutral approach that helps people heal body image, navigate chronic illness with compassion, and rebuild self-trust. Through coaching, community, and education, Ivy supports people in marginalized bodies in cultivating peace with their bodies without dieting, scale-based wellness, or toxic positivity.

Ivy offers support through her Body Relationship Circle membership, group coaching programs, and one-on-one coaching. You can learn more and sign up for her newsletter at ivyfelicia.com. Follow Ivy on Instagram and Threads at @iamivyfelicia.

This episode includes discussion of anti-fat bias in healthcare, chronic illness, medical dismissal, and weight loss surgery recommendations.

If anti-fat bias, chronic illness, or medical trauma has impacted your relationship with food or your body, you’re not alone. I offer eating disorder therapy and recovery support with a liberation-oriented, neurodivergent-affirming, trauma-informed approach. I work with clients in California, Texas, Washington, D.C., and globally via coaching and education.

You can learn more about working with me and explore my courses and resources at drmariannemiller.com.

Listen in, take a breath, and remember: peace is allowed to come before love.

If you are in an activated state right now, this episode meets you where you are. You do not need to make decisions or figure anything out while you listen. The focus is on calming the body first, not fixing the behavior.

Dr. Marianne guides you through simple, accessible grounding and nervous system regulation that can help reduce urgency without judgment or pressure. This episode is designed to be replayed during urge peaks and listened to in real time.

Urges often show up when something feels overwhelming, unsafe, or out of control. This episode reframes urges as signals from the nervous system rather than failures or moral flaws. You will hear reminders that urges are learned responses meant to create relief, even when they no longer serve you.

This compassionate perspective can help soften shame and create space for choice, even when the urge still feels loud.

Whether your urge is to restrict, binge, purge, compensate, avoid food, or delay eating, this episode centers safety and connection. It offers reassurance that you are not broken for having urges and that even small shifts in support can matter.

This is a listen for one minute at a time. Five percent safer still counts.

You can return to this episode whenever urges spike. Let it keep you company. Let it remind you that this moment has edges and that you are not alone in it.

If you need additional support beyond this episode, working with an eating disorder therapist can help you build more tools for navigating urges with care and compassion. Check out drmariannemiller.com for more resources.

#EatingDisorderRecovery #UrgeSupport #NervousSystemRegulation

When ARFID is shaped by a PDA profile, eating challenges are not simply about sensory preferences, fear foods, or appetite. PDA, or a pervasive drive for autonomy, means the nervous system experiences demands as threats. Even gentle encouragement around eating can trigger shutdown, panic, or refusal. In this episode, Dr. Marianne Miller explains why PDA fundamentally changes how ARFID shows up and why traditional explanations often miss what is really happening beneath the surface.

Food refusal in PDA-driven ARFID is not defiance or manipulation. It is a protective response rooted in survival. When autonomy feels compromised, refusal becomes the fastest way to restore safety. This episode reframes refusal as communication and explores how control is not the goal, but a tool the nervous system uses to stay regulated.

For PDA nervous systems, eating can shift from a neutral or pleasurable act into a moment of danger. Being observed, reminded, praised, or monitored can turn food into a demand. Dr. Marianne breaks down how this happens in both children and adults with ARFID, and why eating often becomes harder the more support is applied.

This episode includes clinical case examples that illustrate how PDA-driven ARFID can look very different on the surface while operating from the same nervous system logic. One example focuses on a child who eats until attention is placed on them. Another highlights an adult who deeply wants recovery but feels trapped by structured treatment approaches. These examples help clarify why motivation alone does not resolve PDA-related eating challenges.

Many standard ARFID interventions rely on structure, goals, exposure, and accountability. For PDA profiles, these tools can unintentionally increase threat and shutdown. Dr. Marianne explains why treatment plans that ignore autonomy often backfire and how mislabeling this response as resistance can cause harm.

Supportive care for PDA and ARFID prioritizes safety, consent, and flexibility. This does not mean removing all structure, but changing how structure functions. The episode explores what real choice looks like, why opt-out options matter, and how slowing down can create conditions where eating feels safer over time.

If ARFID has felt impossible to “fix,” this episode offers a compassionate reframe. PDA-driven eating challenges are not failures of willpower or commitment. They reflect a nervous system doing its best to survive. Understanding this opens the door to approaches that are more humane, effective, and sustainable.

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.

Dr. Marianne Miller is a licensed marriage and family therapist who specializes in ARFID, binge eating disorder, and long-term eating disorder recovery. She offers therapy, consultation, and a virtual, self-paced ARFID course grounded in neurodivergent-affirming, sensory-attuned, trauma-informed care. Learn more at drmariannemiller.com

What if eating disorder recovery was not defined by a clean, linear arc, but by honesty, self-compassion, and forward movement even when setbacks happen? In this January 2026 conversation, Dr. Marianne Miller welcomes back journalist, author, and professor Mallary Tenore Tarpley, MFA, to reflect on how readers have responded to her book SLIP: Life in the Middle of Eating Disorder Recovery, and how the language of “slips” is quietly reshaping how people understand recovery.

Mallary shares what has surprised her most since the book’s release, including the volume of messages from readers who finally feel seen in what she calls the “middle place,” the gray space between acute illness and full recovery. Many readers describe relief in having language for a recovery that is still in progress, one that allows for growth without demanding perfection.

Throughout the conversation, Mallary and Dr. Marianne explore why slips are not evidence of failure, but often signs that someone is actively engaging in recovery. They unpack how shame around setbacks can cause slips to turn into longer slides, and how naming them openly can interrupt that cycle. This reframing is especially important in 2026, as diet culture and resolution-driven thinking continue to dominate January narratives around control, discipline, and self-improvement.

Mallary also discusses how the “middle place” framework has resonated far beyond eating disorder communities. Readers have applied it to grief, addiction, chronic illness, and other long-term healing processes where vulnerability remains even as life becomes fuller. She reflects on the power of shared language in helping loved ones understand ongoing recovery, including parents and partners who may struggle to grasp why symptoms can persist for years.

The episode also touches on under-discussed risks during life transitions, including pregnancy and postpartum experiences, where socially reinforced behaviors can quietly reawaken eating disorder patterns. Mallary explains why speaking openly about these realities helps both individuals and clinicians respond with more nuance and care.

As the conversation turns toward the new year, Mallary offers a gentler way forward. Instead of setting rigid, all-or-nothing goals, she encourages curiosity, small steps, and values-based intentions that support recovery over time. Slips, she reminds us, can coexist with progress, and often do.

This episode is for anyone who feels caught between wanting change and fearing it, for those exhausted by perfectionism, and for anyone who needs permission to keep moving forward without pretending to be “all better.”

Follow Mallary on Instagram: @mallarytenoretarpley Learn more about her book: SLIP: Life in the Middle of Eating Disorder Recovery

Check out another episode with Mallary on Apple or Spotify.

This brief guided episode is designed for moments when eating disorder recovery feels unsafe, overwhelming, or frightening. It is meant to be listened to when fear spikes, urges intensify, or doubt about recovery takes over.

Rather than offering education or advice, this guided moment focuses on nervous system support. Dr. Marianne gently names why fear can surge when eating disorder behaviors loosen and why this response does not mean recovery is failing. The episode centers the experience of being in the middle of recovery, when the body is adjusting to change and searching for safety.

Listeners are invited to pause, slow down, and orient to the present moment without needing to make decisions, take action, or push through discomfort. This guided listen affirms that fear during recovery often reflects protection, not weakness, and that safety can come alongside change.

This episode can be replayed as often as needed. It is especially supportive for people in eating disorder recovery who experience panic, urgency, or nervous system overwhelm when behaviors begin to shift.

This episode discusses eating disorder recovery and fear responses. No weights, numbers, or specific behaviors are described. This is a gentle, non-instructional guided listen.

This guided moment is best used during periods of heightened anxiety, uncertainty, or fear related to eating disorder recovery. Listeners may choose to listen while seated, lying down, or moving gently. There is no requirement to follow instructions or reach a particular outcome.

This episode is for adults in eating disorder recovery who feel unsafe when change begins, people experiencing recovery anxiety or fear of letting go, and anyone who needs nervous system support rather than information. It may also be helpful for clinicians and providers to share with clients during acute moments of distress.

Dr. Marianne Miller is a licensed marriage and family therapist, eating disorder specialist, and host of the Dr. Marianne-Land podcast. Her work centers neurodivergent-affirming, trauma-informed, and liberation-focused approaches to eating disorder recovery. Dr. Marianne also offers a self-paced course on ARFID and selective eating designed to prioritize safety, autonomy, and nervous system care. Learn more at drmariannemiller.com.

Why does eating disorder recovery sometimes feel more frightening after change has already begun? In this solo episode, Dr. Marianne Miller explores a critical but rarely discussed phase of eating disorder recovery: the point where behaviors start to loosen, yet fear, panic, and urges intensify instead of easing.

This episode reframes eating disorders not as irrational habits to eliminate, but as safety systems shaped by the nervous system. Dr. Marianne explains how restriction, binge eating, purging, rigidity, and food avoidance can reduce threat, create predictability, and manage sensory or emotional overwhelm. When those behaviors begin to shift, the body may respond with alarm, even when recovery is wanted.

Rather than focusing on early recovery or long-term outcomes, this conversation stays inside the middle of recovery. The place where letting go feels destabilizing, progress triggers panic, and people begin to question whether healing is actually safe. Dr. Marianne unpacks why fear at this stage does not signal failure, lack of motivation, or resistance, but reflects survival-based nervous system logic.

This episode also centers how neurodivergence, trauma histories, and intersectional oppression amplify fear during recovery. For autistic and ADHD individuals, transitions, loss of structure, and sensory changes can intensify nervous system activation. For people with chronic trauma or marginalized identities, eating disorder behaviors may have provided protection in a world that felt unsafe long before recovery began.

Listeners will hear why the belief that “safety comes after behaviors stop” often backfires, and why scaffolding, autonomy, pacing, and compassion are essential when eating disorder behaviors start to loosen. This episode is especially relevant for adults with long-term eating disorders, people feeling stuck in recovery, and clinicians seeking trauma-informed, neurodivergent-affirming approaches to eating disorder treatment.

This episode discusses eating disorders, recovery-related fear, and nervous system responses to change. No weights, numbers, or explicit behavioral instructions are included. Listener discretion is advised.

Dr. Marianne discusses eating disorders as safety systems, fear of recovery, anxiety during eating disorder treatment, and why symptom spikes often occur after progress begins. The episode explores the role of the nervous system, trauma, neurodivergence, and intersectionality in eating disorder recovery, and explains why grief, panic, and doubt can emerge when behaviors that once felt protective start to loosen. This conversation also highlights why safety, autonomy, and nervous system support must come alongside behavior change, not after it.

This episode is for adults with eating disorders who feel afraid to let go of behaviors, people experiencing recovery anxiety or fear of change, and anyone who feels stuck in the middle of eating disorder recovery. It is also for therapists, providers, and caregivers who want to better understand why eating disorder behaviors can feel necessary, and why fear does not mean someone is failing at recovery.

An Open Letter to the Body: Listening to the Part That Fears Getting Better on Apple and Spotify.

Dr. Marianne Miller is a licensed marriage and family therapist and eating disorder specialist offering therapy, consultation, and education rooted in neurodivergent-affirming, trauma-informed, and liberation-focused care. She is the host of the Dr. Marianne-Land podcast and the creator of a self-paced course on ARFID and selective eating for adults and providers. Learn more at drmariannemiller.com.