DR MARIANNE MILLER
CARING EATING DISORDER TREATMENT IN SAN DIEGO AND THROUGHOUT CALIFORNIA, TEXAS, AND WASHINGTON D.C. FOR ADULTS & TEENS
Why Eating Feels So Hard: ARFID, Sensory Overload, Trauma, Autism, ADHD, and Food Restriction
Sometimes eating feels much harder than it seems like it should.
You may know that your body needs food. You may even want to eat. Yet choosing something, preparing it, tolerating the smell or texture, and actually eating enough can feel overwhelming.
For people with ARFID, autism, ADHD, anorexia, restrictive eating disorders, trauma histories, or sensory processing differences, difficulty eating often has little to do with motivation. Sensory overload, executive functioning, nervous system activation, past experiences with food, and the effects of restriction can all make eating harder.
OCD, Perfectionism, and Eating Disorders: What It Means for Recovery and Treatment
Is it perfectionism, OCD, or part of your eating disorder?
The answer isn't always obvious. OCD, perfectionism, and eating disorders can all involve rigid rules, repetitive behaviors, anxiety, checking, and a strong desire for certainty. This overlap is especially common with anorexia, bulimia, and other restrictive eating disorders.
Understanding what drives a behavior matters because eating disorder therapy should address the function of the behavior, not simply how it looks from the outside
Weight Restoration for Autistic Children and Teens With PDA, ARFID, or Anorexia: A Parent's Guide
If your autistic child refuses food, loses weight, or becomes increasingly distressed around meals, you may feel like every decision carries enormous consequences. Your child's physician tells you that weight restoration is medically necessary. Your child becomes more anxious each time eating feels like another demand.
When Restrictive Eating Lasts for Years: Beyond Anorexia and the Path to Recovery
As an eating disorder therapist in San Diego, California, I've worked with people who began making meaningful progress after living with anorexia, atypical anorexia, ARFID, or another restrictive eating disorder for decades. Recovery didn't happen overnight, but it happened. They found more flexibility, more freedom, and a life that gradually became bigger than the eating disorder.
If you've been living with long-term restrictive eating, you are not alone. More importantly, you are not beyond help.
ARFID Help for Parents in California: Compassionate Ways to Support Your Child's Eating
Many parents search for ARFID help for parents after months or even years of trying every piece of feeding advice they can find. You've offered rewards. You've encouraged "just one bite." You've hidden vegetables in favorite foods. Maybe you've been told your child or teen will eat when they're hungry enough.
But if your teen or child has Avoidant Restrictive Food Intake Disorder (ARFID), those approaches often increase anxiety instead of expanding eating.
ARFID and PDA: Why Pressure Makes Eating Harder for Autistic and ADHD People
If you've ever wondered why someone seems to eat less the harder you encourage them to eat, you're not alone. Many parents, partners, teachers, and healthcare providers assume that more encouragement, reminders, or expectations will help someone with ARFID expand their eating. Unfortunately, when someone has ARFID and PDA, the opposite often happens.
Night Eating Syndrome: Why You Feel In Control Around Food All Day Until Night Hits
If you struggle with Night Eating Syndrome, nighttime eating, or feeling "out of control" around food after dinner, you may wonder why eating feels manageable all day but so much harder at night.
Many people in California or elsewhere assume nighttime eating reflects a lack of willpower. They promise themselves they'll eat less tomorrow, skip breakfast to "make up for it," or try to avoid eating after a certain hour. Unfortunately, these strategies often make the cycle worse.
Understanding Harm Reduction for Long-Term Eating Disorders
Many people living with long-term or chronic eating disorders feel invisible in mainstream recovery culture. Traditional treatment models often position full recovery as the only acceptable goal, without acknowledging trauma history, neurodivergence, sensory needs, or systemic barriers to care. For individuals who have lived with an eating disorder for years or decades, this pressure can create more harm than healing.
Chronic Eating Disorders in 2026: Why These Patterns Are Adaptive Not Failures
If you are living with a long-term or chronic eating disorder in San Diego, California and elsewhere, you have likely encountered the same message repeatedly. Recovery should have happened by now. You must not be trying hard enough. Something is blocking progress.
In 2026, it is time to name a different reality.
Chronic eating disorder patterns are not signs of failure. They are signs of adaptation.