Dr Marianne Miller, LMFT

Dr Marianne Miller, LMFT Eating disorder therapist in San Diego providing eating disorder treatment for adults and teens.

Long-term anorexia and restrictive eating do not always look the way people expect.They can exist in all body sizes.
The...
04/24/2026

Long-term anorexia and restrictive eating do not always look the way people expect.

They can exist in all body sizes.
They can last for years.
They can be dismissed, missed, or even praised.

And that creates real harm.

If restriction has been part of your life for a long time, you are not doing recovery wrong. You may need a different approach.

This podcast episode focuses on harm reduction.
Not perfection. Not all-or-nothing.
Support that meets you where you are.

We talk about how to increase nourishment, reduce risk, and build something more sustainable over time.

You deserve care that takes you seriously.
You deserve support that actually fits your life.

🎧 Listen to: Long-Term Anorexia & Restrictive Eating: 5 Strategies That Actually Help on all major podcast platforms.

Apple and Spotify links in bio.

Mechanical eating gets recommended a lot in eating disorder recovery.
And it is not a one-size-fits-all solution.If hung...
04/22/2026

Mechanical eating gets recommended a lot in eating disorder recovery.

And it is not a one-size-fits-all solution.

If hunger cues feel confusing, absent, or overwhelming, structured eating can help create stability. It can reduce chaos, support your nervous system, and make eating feel more predictable.

At the same time, it can feel rigid. It can feel like pressure. It can trigger resistance, especially if autonomy, sensory needs, or executive functioning challenges are part of your experience.

That does not mean you are doing it wrong.
It means the approach may need to fit you better.

Mechanical eating is a tool.
Not a rule.

🎧 Listen to the full episode on your favorite podcast platform:
What Is Mechanical Eating? Pros, Cons, & How It Can Work When Eating Feels Hard (ARFID, Binge Eating, Restriction)

Apple and Spotify links in bio.

If you live with ADHD and bulimia or binge eating, this can feel chaotic and out of control.But this is not about willpo...
04/20/2026

If you live with ADHD and bulimia or binge eating, this can feel chaotic and out of control.

But this is not about willpower.

This is about dopamine.

The ADHD brain looks for fast regulation. Food can do that. Restriction can do that. The cycle builds because your brain is trying to cope.

When ADHD is supported, something shifts.

You get a pause.
You get more choice.

Listen to:
ADHD & Bulimia: Dopamine, Impulsivity, & the Hidden Link to Binge Eating
With Kirsten Book, PMHNP-BC on your favorite podcast platform

Apple and Spotify links in Bio.

Most people don’t realize they’re body checking.It can look like mirror checking.
Clothes feeling “off.”
Scanning your b...
04/17/2026

Most people don’t realize they’re body checking.

It can look like mirror checking.
Clothes feeling “off.”
Scanning your body all day without meaning to.

It isn’t random.
It’s a pattern shaped by anxiety, eating disorders, sensory processing, or all of the above.

For some people, body checking connects to anorexia, bulimia, or binge eating.
For others, it connects to autism, interoception, and trying to understand the body.
And for many, it’s both.

You don’t need more control.
You need support that actually works for your nervous system.

🎧 Listen to: Why You Can’t Stop Body Checking: Anxiety, Eating Disorders, Autism, & What Actually Helps on your favorite podcast platform.

Apple and Spotify links in bio.

If recovery has ever felt impossible, it might not be you.Most eating disorder recovery models expect consistency, capac...
04/15/2026

If recovery has ever felt impossible, it might not be you.

Most eating disorder recovery models expect consistency, capacity, and resources that many people simply do not have. They ask for full change, all at once, without always accounting for nervous system overwhelm, executive functioning, sensory needs, or the realities of living in a world that is not neutral.

So when it feels hard to “keep up,” it can start to feel like failure.

But what if the problem isn’t your effort?

What if the model was never built for your life?

Harm reduction offers another way. You focus on safety. You reduce harm. You build support in ways that actually fit your capacity. You create change that can hold over time.

And when you center lived experience, you stop forcing yourself into someone else’s version of recovery. You start building something that works for you.

Small shifts count. Real life counts. You count.

🎧Listen to the following episode on your favorite podcast platform:
Harm Reduction for Eating Disorders: How Lived Experience Shapes Recovery, Support, & Long-Term Healing

Apple and Spotify links in bio.

Midlife does not create eating disorders.
Pressure does.Your body changes.
Diet culture gets louder.
Ageism adds fear.Th...
04/13/2026

Midlife does not create eating disorders.
Pressure does.

Your body changes.
Diet culture gets louder.
Ageism adds fear.

This is where many people feel their relationship with food get harder, not easier.

In this episode, I talk with Deb Benfield, RDN () about how the pressure to stay thin and young fuels restriction, binge eating, and body distrust in midlife.

You are not failing.
You are responding to a system that tells you your body should not change.

Listen to the full conversation on the podcast on your favorite platform.

Apple and Spotify links in the bio.

Pressure around food doesn’t make eating easier. It often makes it harder.When you live with Pervasive Drive for Autonom...
04/10/2026

Pressure around food doesn’t make eating easier. It often makes it harder.

When you live with Pervasive Drive for Autonomy (PDA) and ARFID, eating can feel like a demand, not a choice.

Your nervous system responds exactly how it’s designed to when something feels like a threat. It protects you.

If meals keep feeling like a power struggle, it’s not about trying harder. It’s about changing the approach.

Less pressure. More autonomy. More support that actually works with your nervous system.

I break this down in the episode and walk you through what helps instead.

Some eating disorders don’t just “go away.”They shift.
They quiet down.
They come back during stress.And for so many peo...
04/09/2026

Some eating disorders don’t just “go away.”

They shift.
They quiet down.
They come back during stress.

And for so many people, this creates a painful story:
“Why is this still happening?”

But what if the better question is:
What has this been helping me survive?

Chronic anorexia and bulimia are not about failure.
They are about adaptation.

Your nervous system learned something.
It found patterns that created relief, control, or release.
And it held onto them.

That doesn’t mean you’re stuck.
It means you may need support that actually meets the complexity of your experience.

You are not the only one living this.

🎧 Listen to the episode on Dr. Marianne-Land Podcast via your favorite platforms:

Chronic Eating Disorders: Why Some Anorexia & Bulimia Become Long-Term

Apple & Spotify links in bio.



Nutrition advice got louder
But it didn’t get clearerProtein became the focus
Processed foods became the fear
And sudden...
04/06/2026

Nutrition advice got louder
But it didn’t get clearer

Protein became the focus
Processed foods became the fear
And suddenly eating feels like something you have to get “right”

If you feel overwhelmed, you’re not doing anything wrong
You’re responding to messaging that leaves out context, access, and real life

You don’t need perfect nutrition
You need enough support to eat consistently, flexibly, and in a way that works for your body

In this episode, I talk with about protein trends, processed foods, and what actually supports eating disorder recovery

🎧 Listen to the full episode on the Dr. Marianne-Land Podcast:: Nutrition Myths Exposed: Protein Obsession, Processed Foods, & Eating Disorder Recovery

Available on your favorite podcast platform.

Apple and Spotify links in bio.

High achievers still develop eating disorders.Discipline, follow-through, and pushing through often get praised.
Those s...
04/03/2026

High achievers still develop eating disorders.

Discipline, follow-through, and pushing through often get praised.
Those same traits can hide anorexia and bulimia.

You show up.
You produce.
You hold everything together.

At the same time, your relationship with food and your body can feel rigid, exhausting, or out of control.

It is not about willpower.
It is not about caring “too much.”

Your system learned to cope in environments that reward performance and disconnect you from your body.

You can stay driven and build a life that does not require constant control.

🎧 Listen to the full episode on the Dr. Marianne-Land Podcast:
Why “High Achievers” Develop Anorexia & Bulimia: Perfectionism, Control, & Hidden Struggles

Available on your favorite podcast platform.

Apple and Spotify links in bio.

PCOS can change how hunger feels.Not a little.
Not subtly.It can make hunger feel louder.
More urgent.
Harder to ignore....
04/01/2026

PCOS can change how hunger feels.

Not a little.
Not subtly.

It can make hunger feel louder.
More urgent.
Harder to ignore.

And then the world tells you to eat less.

So you try.
You restrict.
You push it down.

But your body pushes back.

That is not a failure.
That is biology.

Insulin resistance, hormone shifts, and blood sugar changes can all increase hunger and cravings. When you layer restriction on top of that, eating can start to feel intense, chaotic, or out of control.

This is one of the ways polycystic o***y syndrome and eating disorders become connected.

Not because you lack discipline.

Because your body is trying to keep you alive.

If you have felt confused about your hunger, your cravings, or your eating patterns, you are not alone. And you are not broken.

🎧 Listen to the full episode on the Dr. Marianne-Land Podcast: What Is PCOS & Why Is It Linked to Eating Disorders? Hormones, Hunger, & Insulin Resistance Explained

Available on all major podcast platforms.

Apple & Spotify links in bio.

ARFID gets misunderstood all the time.People see “picky eating.”
They miss sensory overwhelm.
They miss the nervous syst...
03/30/2026

ARFID gets misunderstood all the time.

People see “picky eating.”

They miss sensory overwhelm.
They miss the nervous system response.
They miss how hard eating can actually feel.

And when you add autism, ADHD, culture, and access into the mix, it becomes even more complex.

Not everyone has the option to choose foods that feel safe.
Not everyone can just try something new.
Not everyone experiences food as neutral.

Eating can take planning, energy, and regulation.

It can bring anxiety, shutdown, or panic.
It can shape how someone connects with others.

This conversation with Dr. Panicha McGuire () centers lived experience, not just theory.

If you’ve ever felt confused about your own eating
or misunderstood by others
this episode will land.

🎧 Listen to:
ARFID in Autistics & ADHDers: Sensory Survival, Misunderstanding, & Lived Experience on your favorite podcast platform. Apple and Spotify links in bio.

Address

9820 Willow Creek Road Suite 245
San Diego, CA
92131

Opening Hours

Monday 8am - 6pm
Tuesday 8am - 6pm
Wednesday 8am - 6pm
Thursday 8am - 6pm
Friday 8am - 6pm

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