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Dr Marianne Miller, LMFT

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San Diego, CA
Dr Marianne Miller, LMFT

Eating disorder therapist in San Diego providing eating disorder treatment for adults and teens.

01/09/2026

If recovery feels unsafe right now, you do not have to push or decide anything.
 Fear can surge when eating disorder behaviors loosen, not because you are doing this wrong, but because your body is trying to protect you.

I recorded a short guided episode for moments like this. It is meant to be listened to when fear spikes and you need grounding, not fixing.

🎧 Listen to If Recovery Feels Unsafe Right Now: A Guided Moment for Eating Disorder Recovery Fear on your preferred app.

Apple and Spotify links in Bio.

01/07/2026

Letting go of eating disorder behaviors can feel terrifying, even when you want recovery.
 Fear often gets louder after change begins, not before.
 That does not mean you are failing. It means your nervous system learned how to survive.

In this episode, I talk about eating disorders as safety systems and why recovery can feel unsafe when those systems loosen. If you are in that scary middle, this conversation is for you.

🎧 Listen to Eating Disorders as Safety Systems: Why Letting Go Can Trigger Fear on your favorite podcast platform.
 Apple and Spotify links in bio.

01/05/2026

A low heart rate in athletes is often praised as a sign of fitness.
 But sometimes it is a sign of underfueling or real medical risk.

In this episode, I talk with Dr. Megan Hellner and Dr. Katherine Hill of about REDS, eating disorders in athletes, and why symptoms are so often minimized in sport and medical settings.

If you are an athlete, parent, coach, or provider, this conversation offers clarity, nuance, and validation.

Listen to Low Heart Rate in Athletes: When “Fit” Can Signal REDS or an Eating Disorder wherever you get your podcasts.

Apple and Spotify links in Bio.

01/02/2026

Why do some eating disorders persist even after treatment?

Long-term eating disorders are often framed as lack of effort or motivation. That framing causes harm.

For many people, symptoms continue because they function as survival strategies in the context of trauma, chronic stress, neurodivergence, and marginalization.

When safety stays limited, when systems fail, and when care does not adapt, eating disorder behaviors can remain necessary. Recovery is not linear, and persistence is not personal failure.

If this resonates, the full conversation is on the podcast.

🎧 Listen to: Why Some Eating Disorders Don’t Resolve: Understanding Chronic Patterns & What Actually Supports Change

Available on nearly all podcast platforms. Apple and Spotify links in Bio.

12/31/2025

Why does eating feel unreal in eating disorders?

For many people, this experience connects to dissociation and nervous system overwhelm, not lack of effort or motivation.

When eating feels automatic, foggy, or disconnected, the body may be protecting itself.

In this episode, I break down how trauma, dissociation, and sensory overload shape eating disorders, and why recovery works best when safety comes first.

🎧 Listen to When Eating Feels Unreal: Dissociation, Trauma, & the Hidden Side of Eating Disorders
 Available on all podcast platforms. Apple and Spotify links in Bio.

12/29/2025

When an eating disorder lasts for decades, nutrition needs change.

Long-term eating disorders often function as protection.

Food can feel unsafe.

Restriction can feel stabilizing.

That does not mean someone has failed. It means the nervous system learned how to survive.

In this episode, Jaren Soloff, RD , and I talk about why nutrition care must move slowly, center safety, and account for midlife body changes like perimenopause and menopause. We also discuss why small, steady shifts matter and why change remains possible at any age.

If you have felt broken because your body no longer responds the way you expect, this conversation offers a different lens. Your body reflects years of adaptation, not failure.

🎧 Listen to Navigating Nutrition in Long-Term Eating Disorders with Jaren Soloff, RD
 Available on all podcast platforms Apple and Spotify links in bio.

12/26/2025

Does it feel like the coping that helped you survive no longer works in midlife?

For many people, anorexia does not disappear with age. Midlife brings hormonal shifts, burnout, identity changes, and cumulative stress that can overwhelm the nervous system.

When restriction resurfaces or intensifies, it is not a failure. It is a signal that something deeper needs care.

Midlife anorexia often reflects unprocessed pain, long-held pressure, and bodies that have carried too much for too long. For neurodivergent people, reduced masking and rising sensory needs can make eating even harder.

Healing in midlife looks different. It centers steadiness instead of control, support instead of discipline, and care that honors trauma, nervous systems, and lived experience.

🎧 Listen to the full episode The Hidden Pain of Midlife Anorexia: Why Coping Breaks Down and What Heals on the Dr. Marianne-Land podcast.

Available on all major podcast platforms. Apple and Spotify links in bio.

12/24/2025

Have you ever paused to wonder what your eating disorder behaviors are trying to do for you?

Many eating disorder patterns begin as ways to manage overwhelm, trauma, or sensory distress.

Over time, those same behaviors can become rigid, punishing, or disconnecting, even when harm was never the intention.

In this episode, I explore how eating disorders can function like self-harm, why this overlap happens, and how neurodivergent nervous systems often use eating patterns for regulation. I also talk about how to notice when a behavior shifts from soothing to harming and what rebuilding safety can look like in practice.

Healing does not begin with shame. Healing begins with curiosity, compassion, and support.

🎧 Listen to the full episode: When Eating Disorders Become Self-Harm: Breaking the Cycle & Rebuilding Safety on Dr. Marianne-Land: An Eating Disorder Recovery Podcast

Available on all major podcast platforms. Apple and Spotify links in Bio.

12/22/2025

What happens when healthcare treats body size as the problem instead of listening to patients?

In this episode of the Dr. Marianne-Land podcast, I talk with fat activist, author, and intersectionality leader Vinny Welsby .fatty about the truth of anti-fat bias in healthcare.

Vinny shares findings from a survey of 270 fat patients, where 99.25% reported experiencing weight-based discrimination in medical settings.

We talk about how weight stigma shows up through dismissed symptoms, delayed diagnoses, and denied care.

We name the medical trauma that follows and why so many fat people avoid healthcare to protect themselves.

We also explore how intersectionality deepens harm for fat people who are trans, nonbinary, q***r, disabled, or neurodivergent.

This conversation calls out systems, not bodies.

Fat bodies are not the problem. Anti-fat bias is.

🎧 Listen to Anti-Fat Bias in Healthcare: What 270 Fat Patients Reported & Why It Matters on the Dr. Marianne-Land podcast. Links in bio.

12/19/2025

ARFID is not about refusal, defiance, or a lack of motivation.
 It is about nervous system safety, sensory overwhelm, and a deep need for autonomy.

When pressure enters the picture, eating becomes a threat.
 When choice leads the way, the body can soften, trust can grow, and healing becomes possible.

In this episode of Dr. Marianne Land, I unpack why pressure based approaches so often fail people with ARFID and what actually supports recovery instead. I talk about sensory needs, consent, and why autonomy is not optional for many neurodivergent bodies.

Listen to When Autonomy & Sensory Needs Drive ARFID: Why Pressure Fails & Choice Heals wherever you get your podcasts.

Apple and Spotify links in Bio.

12/17/2025

What does chewing and spitting really mean in eating disorders?

Many people experience this behavior in silence because shame keeps it hidden and misunderstanding keeps it misnamed.

Some people chew and spit as part of restrictive or compensatory eating disorder patterns driven by hunger, fear, and control.

Others chew and spit because sensory overwhelm makes swallowing feel unsafe. Both experiences deserve care. Both require different kinds of support.

When providers collapse chewing and spitting into a single explanation, people receive the wrong diagnosis or the wrong treatment. Understanding the pathway matters because it shapes recovery, safety, and trust in care.

I break down both pathways in this week’s podcast episode and explain how restriction, ARFID, neurodivergence, and sensory needs intersect with this behavior.

Listen to the full episode on Dr. Marianne-Land podcast: Chewing & Spitting in Eating Disorders: Restriction, Sensory Overwhelm, & the Two Paths This Behavior Can Take

Available on all major podcast platforms

Apple and Spotify links are in my bio.

12/15/2025

Exercise can start as “self-care” and quietly turn into punishment.

When movement feels mandatory, missed workouts trigger guilt, and rest feels earned, not allowed, exercise no longer supports recovery. It reinforces shame, control, and disordered eating patterns many people work hard to heal.

In this episode of Dr. Marianne-Land, I talk with Dr. Lisa Folden (), a weight-inclusive physical therapist, about how exercise shame develops, how fitness culture rewards punishment over care, and what it takes to rebuild a relationship with movement rooted in trust and compassion.

If exercise feels loaded, exhausting, or tied to worth, this conversation offers language and relief.

🎧 Listen to When Exercise Becomes Punishment: Body Image, Shame, & Disordered Eating on all major podcast platforms.

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

Website

https://www.drmariannemiller.com/

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