Many people enter eating disorder recovery believing that effort guarantees progress. Follow the meal plan. Use the coping skills. Stay consistent. When recovery still feels stuck, shame often follows. This episode explores a different truth. Recovery can stall even when you are doing everything right, and stalled progress usually reflects misalignment rather than failure.

Dr. Marianne examines the hidden reasons eating disorder recovery plateaus, including nervous system overload, limited capacity, chronic stress, trauma history, neurodivergence, and lack of structural support. She explains why compliance without regulation rarely leads to sustainable healing and why recovery models that ignore real-world context can unintentionally increase distress.

This conversation also centers intersectionality. Systems of oppression such as racism, anti-fat bias, ableism, homophobia, transphobia, and medical discrimination shape both eating disorder development and recovery access. When treatment ignores these realities, people may feel blamed for struggles that are deeply structural. Understanding this context can transform how stalled recovery is interpreted and supported.

Listeners will gain a more compassionate and clinically grounded framework for understanding recovery plateaus, along with language that reduces shame and opens space for more humane, sustainable healing paths.

Dr. Marianne explores why motivation does not equal capacity and why nervous system regulation must accompany behavior change. She discusses how grief, identity shifts, and emotional exposure often emerge during recovery and can be mistaken for failure. She also explains why neurodivergent people frequently experience recovery mismatch due to sensory, executive functioning, and interoceptive differences that traditional treatment overlooks.

The episode highlights the emotional toll of constant self-monitoring, the importance of therapeutic fit, and the role of intersectional stress in shaping recovery progress. Most importantly, it reframes stalled recovery as meaningful clinical information rather than personal weakness.

This episode is for people who feel stuck in eating disorder recovery despite working hard. It is also for clinicians, loved ones, and advocates seeking a more intersectional, nervous-system-informed understanding of recovery plateaus.

“Slips” in Eating Disorder Recovery in 2026: Why Setbacks Are Part of Progress, Not Failure (With Mallary Tenore Tarpley, MFA) on Apple and Spotify.

The Middle Place in Eating Disorder Recovery: How Slips Can Be Stepping Stones With Mallary Tenore Tarpley, MFA @mallarytenoretarpley on Apple and Spotify.

Slips, Setbacks, & Relapses in Eating Disorder Recovery on Apple and Spotify.

If recovery feels confusing, stalled, or misaligned, you do not have to navigate it alone. Dr. Marianne Miller is a Licensed Marriage and Family Therapist who specializes in eating disorder recovery through a neurodivergent-affirming, trauma-informed, and liberation-oriented lens. Learn more about therapy, coaching, virtual courses, and recovery support at her website drmariannemiller.com.

In this solo episode, Dr. Marianne Miller explores how the Emmy-winning and Golden Globe–winning medical drama The Pitt portrays eating disorders, emergency medicine, and bias in ways that feel both culturally meaningful and clinically relevant. She reflects on how the show separates two critical themes across seasons: the medical system’s tendency to miss eating disorders in Black women, and the role of weight bias in emergency department diagnosis and care.

Drawing from years of clinical experience, Dr. Miller discusses how many clients first encounter medical crisis in emergency rooms, often because of dangerously low heart rates, dizziness, fainting, or other complications linked to disordered eating. She explains how ER responses vary widely, and how bias, time pressure, and assumptions about body size or race can shape whether clinicians recognize eating disorder symptoms.

The episode highlights a season two storyline in which a Black woman presents to the ER without classic eating disorder signs, making diagnosis more complex. Dr. Marianne examines why missing textbook symptoms often leads clinicians to overlook bulimia and other eating disorders, especially in populations that medicine historically underdiagnoses. She also reflects on how the show names this reality directly and why that representation matters for visibility, validation, and future care.

Dr. Marianne then turns to season one’s depiction of a physician challenging a resident’s assumption that body weight predicts health. She explores how medical weight bias affects diagnosis, delays treatment, and reinforces stigma in emergency medicine. She also shares the change she wishes the episode had made, noting that many people with bulimia live in bodies that are not thin, and that anti-fat bias and racial bias together create additional barriers for Black women seeking care.

Throughout the episode, Dr. Marianne centers a liberation-informed lens that honors intersectionality, context, nervous system safety, and autonomy in eating disorder recovery. She invites listeners to consider how accurate media representation can shift clinical awareness and expand who medicine recognizes as deserving care.

You can watch The Pitt on HBO and HBO Max.

Eating disorders in Black women Missed diagnosis in emergency medicine Low heart rate and medical risk in eating disorders Bulimia without classic symptoms Medical weight bias in ER care Race, stigma, and underdiagnosis Media representation and clinical awareness Liberation-informed eating disorder therapy

Boundaries, Therapy While Black, & Eating Disorders with Kaela Farrise, LMFT on Apple and Spotify.

Avoidance, Body Image Standards, & the Notion of the Strong, Black Woman with Jasmine Jacquess, MA, PLPC on Apple and Spotify.

-The Body Is Not An Apology, 2nd ed., by Sonya Renee Taylor

-Fearing the Black Body: The Racial Origins of Fat Phobia, by Dr. Sabrina Strings

If you are looking for eating disorder therapy that centers intersectionality, lived context, and liberation-informed care, you can learn more about working with Dr. Marianne Miller through therapy or consultation on her website, drmariannemiller.com. Her approach honors autonomy, neurodivergence, trauma history, body diversity, and systemic realities that shape recovery.

You deserve care that sees the full picture of your life, not just symptoms on a chart.

ADHD, autism, and eating disorders through the lens of inertia. What if feeling stuck is not laziness, resistance, or lack of motivation?

In this conversation, Dr. Marianne Miller speaks with ADHD and neurodivergent-affirming therapist Stacie Fanelli, LCSW, @edadhd_therapist, about how autistic inertia, ADHD hyperfocus, and executive functioning differences shape restriction, bingeing, and symptom cycling. They explore why recovery approaches built on willpower and choice can deepen shame for neurodivergent people and how capacity-aware care offers a different path.

Inertia outside of the ED can be a trigger for EDs existentially because of the sense of “stuckness” it creates; then, the ED swoops in and offers a sense of control.

This episode reframes stuckness as a nervous system experience rather than a character flaw and introduces compassionate, liberation-centered recovery grounded in harm reduction, radical acceptance, and real support for neurodivergent healing.

Contact Stacie

https://www.autonomousmindstherapy.com

Related Episodes

Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) With Stacie Fanelli, LCSW @edadhd_therapist on Apple and Spotify.

Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 2) With Stacie Fanelli, LCSW @edadhd_therapist on Apple and Spotify.

Minding the Gap: The Intersection Between AuDHD & Eating Disorders With Stacie Fanelli, LCSW on Apple and Spotify.