DR MARIANNE MILLER
CARING EATING DISORDER TREATMENT IN SAN DIEGO AND THROUGHOUT CALIFORNIA, TEXAS, AND WASHINGTON D.C. FOR ADULTS & TEENS
The Complexities of Treating ARFID: How a Neurodivergent-Affirming, Sensory-Attuned Approach Works
Avoidant/Restrictive Food Intake Disorder (ARFID) is one of the most misunderstood and often mischaracterized eating disorders, particularly when it presents in neurodivergent individuals. As a neurodivergent therapist specializing in ARFID treatment for both teens and adults in San Diego, Los Angeles, San Francisco, and elsewhere, I’ve seen firsthand how standard treatment approaches often fall short. Models that rely on compliance, exposure, and fixed food goals frequently miss the root causes of food avoidance.
Insights From ARFID Therapy With Neurodivergent Teens
Working with neurodivergent teens who have Avoidant/Restrictive Food Intake Disorder (ARFID) has taught me more than any textbook or training ever could. My clients have shown me that ARFID is a deeply misunderstood eating disorder, especially when it shows up in autistic teens, teens with ADHD, or those with significant sensory processing differences.
Atypical Anorexia Explained: Why Restriction Happens at Every Body Size
When most people hear the word anorexia, they picture someone who is very thin—often white, young, and female. This image has been reinforced for decades by media, medical training, and diet culture. But the reality is much broader, and far more people live with anorexia than the stereotype suggests.
One eating disorder category that challenges this outdated image is atypical anorexia. The name might imply that it is rare, but in truth, there is nothing “atypical” about it. Restriction can—and does—happen in every body size.
Living With Adult ARFID: The Relationship Challenges No One Talks About
When most people hear the term ARFID, or Avoidant/Restrictive Food Intake Disorder, they often imagine children. ARFID is commonly misunderstood as a temporary phase of picky eating. In reality, many adults live with ARFID as a long-term, serious eating disorder that affects far more than just food. It shapes how people relate to their bodies, their emotions, and their relationships.
Adult ARFID can affect every area of life, including dating, long-term partnerships, parenting, friendships, and professional settings. Such relationship challenges are rarely discussed, even though they are often a source of chronic stress and grief. In this blog post, I explore how adult ARFID intersects with connection, autonomy, and sensory food issues, especially from a neurodivergent-affirming and trauma-informed perspective.
ADHD & Eating Disorders: The Overlooked Link
Why Neurodivergent Brains Need a Different Approach to Recovery
If you’re living with ADHD and struggling with disordered eating, you are not alone—and you’re not doing recovery wrong. You might simply need a framework that actually fits your brain. Research has consistently shown a strong link between ADHD and eating disorders. A 2020 meta-analysis found that individuals with ADHD are 3.82 times more likely to develop an eating disorder compared to those without ADHD (Nazar et al., 2020). And the connection doesn’t stop at binge-type disorders. Emerging research also highlights a significant overlap between ADHD and ARFID (Avoidant/Restrictive Food Intake Disorder)—with studies indicating that ADHD traits such as sensory sensitivities, low appetite awareness, and difficulty with food-related routines may increase ARFID risk, especially in children and teens (Kamberelis et al., 2022; Koomar et al., 2021).
Despite these links, ADHD remains widely underdiagnosed in eating disorder treatment settings—especially among women, people of color, and LGBTQ+ individuals. And when it is recognized, the support often isn’t designed to address how ADHD actually affects eating.
Food, Fear & Fixation: How OCD Shapes Eating Disorders
If you’re navigating obsessive thoughts about food, rigid routines, or a deep fear of change in how or what you eat—you’re not alone. Many people across San Diego, San Francisco, the Bay Area, Los Angeles, Orange County, and greater California struggle with the complex intersection of Obsessive-Compulsive Disorder (OCD) and eating disorders. Understanding how OCD shapes food-related behaviors is a key step in finding lasting recovery.
More Than a Mirror: Understanding Body Dysmorphic Disorder (BDD)
Body image distress is something many people experience, whether you live in San Diego, California, NYC, or London, England, UK. Body Dysmorphic Disorder (BDD) is something deeper—and far more consuming. It’s a condition that often flies under the radar, particularly for fat folks, neurodivergent individuals, and humans whose appearance concerns aren’t taken seriously by medical or mental health systems. In this blog post, adapted from a recent Dr. Marianne-Land podcast episode, we’ll explore what BDD really is, how it overlaps with and differs from eating disorders like anorexia and bulimia, and how compassionate, trauma-informed treatment can help.
What Is Binge Eating Disorder? Signs, Symptoms, & Support That Actually Helps
Binge Eating Disorder (BED) is the most common eating disorder in the United States—and yet, it's one of the most misunderstood. While pop culture often paints binge eating as a “lack of willpower” or frames it as a dramatic overeating episode, the truth is much more complex and deeply human.
Let’s explore what Binge Eating Disorder really is, how to recognize the signs, and what kind of support actually makes a difference in recovery—especially for folks who feel unseen in traditional treatment spaces.
Why Am I Eating at Night? Understanding Night Eating Syndrome in Your 30s, 40s, and 50s
Do you ever feel like you “do fine” with food during the day—but the second it gets dark, all bets are off?
🍽️ Maybe you’re constantly eating after dinner.
🌜 Maybe you wake up in the middle of the night to snack.
😞 Maybe you feel ashamed or confused about why this keeps happening.
If this sounds familiar, you're not alone—and you're definitely not broken.
Let’s talk about Night Eating Syndrome (NES): what it is, how it differs from binge eating disorder, and why it so often shows up in your 30s, 40s, and 50s. Whether you’re navigating neurodivergence, chronic stress, hormonal shifts, or just plain exhaustion—your night eating has roots, reasons, and relief is possible.