Navigating a Long-Term Eating Disorder
by San Diego eating disorder therapist Dr. Marianne Miller, LMFT
Long-Term Eating Disorders: What They Really Look Like
Eating disorders are often described as short-term struggles, something you move through in a few years before recovery. Although that is true for some, the reality is very different for many people. For countless individuals, eating disorders can be long-term, lasting years or even decades. When an eating disorder becomes chronic, it does not mean you have failed. It means your nervous system, life experiences, and the conditions around you have combined in ways that make recovery more complex.
Living with an eating disorder in Los Angeles, San Diego, and the Bay Area for a long time can feel exhausting. You may feel as if it has taken up too much space in your life in California. It has shaped your identity and even dictated your relationships and daily routines. The idea of who you might be without the eating disorder can feel both freeing and frightening.
Grief and Long-Term Eating Disorders
One of the most painful realities of long-term eating disorders is grief. You might look back at your life and wish things had been different. Maybe you spent college years in San Diego and elsewhere focused on restricting or controlling food instead of building friendships. Perhaps family dinners felt like battles instead of moments of connection. You may recall vacations where food fears overshadowed joy.
Acknowledging this grief matters. It is okay to feel sadness over the time lost. At the same time, grief does not need to close the door to healing. It can be a pathway to reclaiming the future and choosing something different for yourself.
Why Recovery From a Long-Term Eating Disorder Feels Harder
The longer an eating disorder has been present, the more ingrained the patterns may feel. Habits and thoughts practiced for decades can feel automatic. Recovery may feel slow, which can be discouraging. Yet slow does not mean impossible. Healing often looks like a gradual loosening of the eating disorder’s grip, not an overnight transformation.
Recovery does not need to be perfect. It may mean building more flexibility around food, creating more trust with your body, or reducing the obsessive thoughts that dominate your day. Every small step forward matters.
Neurodivergence, Trauma, and Chronic Eating Disorders
For many neurodivergent people, long-term eating disorders are tied to sensory sensitivities and executive functioning challenges. Certain textures or tastes may feel overwhelming, leading to very limited food options. Planning meals, shopping, and cooking can feel like too many steps for an already taxed brain. Trauma adds another layer, where food and body behaviors serve as coping strategies for overwhelming experiences.
Recognizing these realities shifts the conversation away from blame and toward compassion. Eating disorders are not about weakness. They are survival responses.
Aging and Eating Disorders Across the Lifespan
Another rarely discussed reality is how eating disorders intersect with aging. Although many assume they only affect young people, eating disorders persist across the lifespan. They can intensify or resurface during transitional stages such as menopause, retirement, or later life changes.
Aging adds challenges like body changes, health conditions, and ageism. At the same time, many people in midlife and older adulthood feel more ready to let go of patterns that no longer serve them. Healing is possible at every age, and you deserve peace with food throughout your entire life.
Systemic Oppression and Why Many Eating Disorders Last for Decades
Long-term eating disorders cannot be separated from systemic oppression. Many people live with symptoms for years because they were denied care. If you are fat, you may have been encouraged to restrict in harmful ways under the name of “health.” If you are a person of color, you may have been told eating disorders do not happen in your community. If you are LGBTQIA+, your identity may have been pathologized instead of affirmed.
These realities delay treatment and create long-term struggles. Healing means not only addressing your relationship with food, but also recognizing and resisting the systems that have harmed you.
Types of Long-Term Eating Disorders: Anorexia, Bulimia, Binge Eating Disorder, and ARFID
Long-term eating disorders come in many forms. Some people live for decades with anorexia, including atypical anorexia, where the severity of restriction is overlooked because of body size. Others live with bulimia, binge eating disorder, or ARFID. All of these conditions are serious, and all deserve affirming, compassionate care.
Finding Eating Disorder Therapy in San Diego, Los Angeles, and the Bay Area
Living with an eating disorder for decades does not mean your story is over. Recovery may not erase every thought or behavior, yet it can open up more space for joy, connection, and a sense of agency. Healing is possible even when the disorder has been part of your life for a long time.
If you are looking for eating disorder therapy in San Diego, Los Angeles, or the San Francisco Bay Area, know that you deserve support from a professional who understands the complexity of long-term struggles. Working with a top eating disorder therapist can help you move toward healing at your own pace.
Work With Dr. Marianne Miller: Top Eating Disorder Therapist
If you are living with anorexia, atypical anorexia, bulimia, binge eating disorder, or ARFID, you do not have to navigate this alone. I offer eating disorder therapy that is sensory-attuned, trauma-informed, and neurodivergent-affirming.
I work with clients in San Diego, Los Angeles, and the San Francisco Bay Area, as well as throughout California, Texas, and Washington, D.C. I am a licensed marriage and family therapist with nearly 30 years of experience, Often described as a top eating disorder therapist, I bring both expertise and compassion to support your journey.
You can also learn more about me by checking out my Instagram @drmariannemiller and listening to my eating disorder recovery podcast called Dr. Marianne-Land.