Do you ever feel like you were born on the wrong planet? That deep sense of alienation – of not quite belonging anywhere – is something many neurodivergent individuals carry throughout their lives. When I sat down with Dr. Marianne Miller for this episode of the Liv Label Free Podcast, I felt that rare and beautiful sense of being truly seen and understood by a fellow "neurodivergent alien."

Dr. Miller and I share experiences as neurodivergent individuals who developed eating disorders, and our conversation reveals the profound connections between autism, existential questions, and disordered eating that are rarely discussed in traditional treatment settings.

The Neurodivergent Energy Coalescence

Livia: I recently had someone ask me how I would describe authentic connection with one of my people. I said it's when you don't need words to know that you are communicating love and abundant energy – there's just that symbiotic energy exchange that I've come to call the "Neurodivergent Energy Coalescence."

When I think of coalescence, I see what I imagine the universe looks like – you know, those intergalactic photos of galaxies. I picture two golden neurodivergent sun beings colliding and creating an explosion of loving energy.

This immediate recognition between neurodivergent minds transcends typical social interactions. As I always say, listening to stories of lived experience is one of the most valuable ways to learn, especially when it comes to the complex web of neurodivergence, eating disorders, and existentialism.

From Ivory Tower to the Trenches

Dr. Miller: I have a PhD in marriage and family therapy. After I got that in 2003, I moved to San Diego where I was a full-time professor while running a side private practice. Initially, I worked with chronic pain and couples, but then I discovered my passion was in working with eating disorders. I got additional training and supervision, and 13 years later, that became my focus. I left the university in 2018 because I realized I loved helping people in the trenches more than being in the ivory tower.

Livia: This distinction between the "ivory tower" and "the trenches" highlights something crucial about traditional eating disorder treatment. There's often a harmful hierarchy of "I am the clinician, I'm the professional, you are the sick patient who is incompetent." But autistic people have this incredible strength of being able to "read right through people". Because we say what we mean with such purity, our hypersensitivity picks up when others aren't being authentic.

Growing Up Neurodivergent with Rules That Don't Fit

Dr. Miller: I'm late-diagnosed and self-diagnosed autistic. I trust myself and my brain, and when I do research, I dig deeply. I was always a really sensitive child – picking up on people's emotions, sensing the energy of rooms even when they were empty. I felt very uncomfortable in social settings, constantly frustrated and trying to figure out the rules.

Back in the eighties, I would read magazines like Seventeen and Glamour because we didn't have social media. That's what defined the social narrative of what a teen girl should look like and act like. I also grew up evangelical Christian, so there were a lot of rules about how I should behave. Part of my autistic brain really liked having rules. I thought, "Okay, I know what to do."

But despite having these rules, I was experiencing so much anguish and emotional dissonance. I got constant messages about being "too much" – too loud, talking too much. My mom would say things like "boys don't like it when you laugh too loud" or "they like girls who are demure and quiet."

This experience of trying to follow rules that never quite fit is so familiar to many of us. We get excited about having structure, but then we're constantly told we're doing it wrong, even when we're following the prescribed guidelines.

Anorexia as the Solution to My Existential Crisis

Livia: I recently did an Instagram post about how my eating disorder was my attempted solution to my existential crisis. Growing up evangelical Christian with undiagnosed autism – how do you feel these elements contributed to developing disordered eating?

Dr. Miller: I remember thinking about myself existentially from a very young age. I was asking questions like "Who am I in this universe? What is my purpose? How do I exist?" But nobody else was really talking about that or asking these questions. So I poured a lot of these existential thoughts into the religion box, looking for answers there.

I did get some relief, but there was always a part of me that questioned and pushed boundaries. I couldn't get all the answers I was looking for from religion. Eventually I left organized religion altogether, though I'm definitely spiritual.

With existentialism can come a lot of distress, plus the distress of not feeling like you fit in anywhere. I remember feeling lonely most of the time, feeling at my core that something was wrong with me – that I was broken, that I was a failure because of some inner core of who I am.

The religion was like a temporary patch that gave me some relief, but it wasn't enough because I was missing this huge piece of being autistic. Nowadays, being able to unmask in so many more settings brings me much more peace, alignment, and authenticity. The existential distress and loneliness really quiet down when I connect with the autism community.

When Your Body Becomes a Social Commodity

Dr. Miller: I was put on diets in elementary school by my mom, and then I chose to go on diets myself. I grew up in a big diet culture family where if you feel bad, you must lose weight because then you'll feel better. Well, I felt bad all the time because I was undiagnosed and having all this distress.

I knew one thing I could do to help me get more social commodity – I could get a thin body or thinner body. I remember when I was 11 or 12, I dropped weight, and people acted like I had gone and visited the moon by myself as an astronaut. As a child who felt disenfranchised and like I didn't fit in ever, suddenly I got this feeling like maybe I did fit in.

If I was thinking about food and eating all the time and my body image, then I didn't have to think about the loneliness and existential distress I was experiencing.

This reveals how eating disorders can function as autistic masking – an attempted way to compensate for that existential feeling of being "wrong." It's like: "Yes, my being is wrong, but if I make my body right, I can compensate."

"Atypical" Anorexia and Medical Invalidation

Dr. Miller: Whenever I say or think about "atypical anorexia," it's always in quotes because there really isn't a typical anorexia. It's like asking, "Is there a good anorexia where people have thin bodies?"

I lost weight but wouldn't have met the BMI criteria that insurance companies often require for anorexia coverage. I was at a low weight for me, which wasn't what people typically think of as anorexic according to BMI – which is bullshit, as we all know.

I had all the symptoms: I ate very little during the day, counted calories obsessively. It got to the point where my period should have started but didn't. I had one period when I was 11, then began restricting, and it stopped completely for two years.

Livia: My eating disorder started when I was 11, so I didn't get my first period until I was almost 19! For the autistic body, not going through puberty, not having a period, not dealing with the sensory aspects – these are the "perks" of the eating disorder. I didn't have to deal with uncomfortable physical changes.

Something I hear a lot from my clients is about the fear of being healthy in this world: "What if I can't handle being a meaningful member of society?" This ties back to existentialism: "What if I am wrong in this world?"

Panic Attacks vs. Autistic Meltdowns

Dr. Miller: The fear of not being able to handle things was so real. Everyone just said it was anxiety, but I was overstimulated all the time. My sensory sensitivities are very strong, so it was completely valid for me to say "I don't know if I can handle it." From a sensory perspective, you really can't when you try to push through it.

But when you look at it from a general anxiety disorder lens, the solution is exposure therapy. No...I need to take care of my sensory needs.

For decades, I felt very misunderstood by even the mental health system, labeled with all these diagnoses that weren't my experience. I don't have panic attacks – I have autistic meltdowns. I didn't burn out because I was a perfectionist – I experienced autistic burnout.

Livia: When I was in the throes of anorexia, reaching that last straw moment, I would have panic attacks every day because my brain was starving and rational thought didn't exist. If it was three almonds instead of four, it felt like the end of my life.

In treatment, they said the panic attacks were caused by malnutrition. And to a certain extent, they were right. But later, after I was "weight restored," I was still having what I now know were autistic meltdowns. When I would have these meltdowns, my mom would ask if I'd been restricting again because it looked the same.

It was so invalidating because I'm like, "No, this has nothing to do with that!" Same presentation, different root cause. That's why, when healing from an eating disorder as a neurodivergent person, it's so important to always come back to intention.

Counting Calories as Stimming: Reframing "OCD" Behaviors

Livia: For many of my autistic clients, counting calories to actually eat more is a way they're using their number attachment trait to help them. It doesn't help everyone – I can't count calories anymore – but when I was initially in recovery, I needed to count something because I didn't know how to eat otherwise.

Dr. Miller: I think counting calories can be like a form of stimming. That's what I would do in my mind, just go over and over the calories. You know what I do now? I count in different ways. I count from one to 100, and 100 down to one. I count from 0 to 100 in French, then from 100 down to 0 in French. I know some Russian and Italian, so I count as high as I can go in those languages.

When I'm having an intense conversation with my husband and visible rocking would be distracting for him, I just count and it helps me so much. There has to be an overlap – there's something about counting calories that might be a form of stemming or self-soothing.

Livia: We're inviting curiosity to what are often labeled as OCD behaviors. Could these be forms of stimming?

Dr. Miller: I was totally misdiagnosed with OCD by my eating disorder therapist. Forever I thought I was, but something about it didn't seem to fit. Now I realize it was all stimming and self-soothing. The ultimate point of stimming is regulating yourself and feeling safe.

The Difference Between OCD and Autistic Behaviors

Dr. Miller: I think with OCD, engaging with the compulsions actually makes you feel distressed. If you wash your hands or check locks a certain number of times, it can cause distress. But using stimming and repetitive movements actually causes you to relax; it calms your nervous system down.

Livia: With OCD, they check the locks 100 times and it's still not okay. With autism, once we've checked it, we feel safe. It's done. The OCD fuels the OCD, but when it's rooted in autism, the behavior actually relieves the anxiety that results from unaccommodated autism.

With numbers and counting calories, you're turning abstract, intangible concepts of life into something you can see, feel, and touch – something concrete. That's exactly what eating disorders give you.

Existential questions by their nature will never have an answer, otherwise they wouldn't be existential questions. But with the eating disorder, there are always answers: Apple or cookie? The apple. High-calorie milkshake or light ice cream? The light ice cream. The answers are black and white, always on the same side.

When Existential Suffering Increases in Eating Disorder Recovery

Livia: Recovering from an eating disorder doesn't magically make your life happier and better. When I see those Instagram montages showing someone crying over pasta, then dancing and smiling – this is such a highlight reel. For me, the existential suffering actually increased after my eating disorder.

Dr. Miller: I see that with my clients too, and no one is talking about that. If we see eating disorders as a form of masking, the existential distress underneath is still there. You're so preoccupied by the food and body stuff that when that settles down, the existential experiences and feelings really come up.

Livia: The existential angst was always already there – the eating disorder was your attempted solution to it. That's why I prefer the term "discovery" over recovery. You're not recovering from anything, you're discovering who you are without the masks of fear and limitation.

Making the Intangible Tangible

Through my recovery work, I've learned that anything truly important cannot be grasped: love, abundance, trust, safety. I used to be materialistic, with every surface covered in Teletubbies that had to match perfectly. But now I know what's truly important to me: connection, contribution, and creativity. That's my existential purpose, though I try not to get too attached because then I spiral into "Who am I when I'm not creating and connecting?"

The eating disorder gives you something tangible when life feels overwhelmingly abstract. You turn the intangible concepts of existence into something concrete you can control. But eating disorders themselves are the most intangible, complex things – manifestations of feeling unsafe, which you can never truly grasp because safety isn't something you can possess.

Autistic Unmasking and Authentic Connection in ED Recovery

Dr. Miller: One thing I love about you is that you unmask unapologetically. That inspires me because I have a PhD, but I also have a PhD in masking. With my generation (Gen X), the journey of realizing I'm autistic has been a journey in unmasking.

The more I do it, the better I feel. It's interesting to see who I'm becoming – though I don't think it's something that wasn't always there. It's just been repressed by society, family, religion, sexism, and misogyny. Lifting off this yoke of masking has been amazing for my mental health and relationships. I just feel more relaxed.

Livia: That really means a lot, especially now because I have this constant sense that no matter what I do, I'll never be good enough. In today's world, I often ask myself at the end of the day: "What for? What am I doing all of this for?"

Conversations like these are a gentle, loving hug reminding me this is what I'm doing it for – for people who need examples, models, and words to describe their experience.

Key Takeaways

This conversation illuminates several crucial points often missing from traditional eating disorder treatment:

Eating disorders as adaptive responses: Rather than pathological behaviors to eliminate, these patterns often serve as attempts to navigate an overwhelming neurotypical world.

The existential component: Many neurodivergent individuals develop eating disorders as escape routes from profound questions about identity, purpose, and belonging that feel too overwhelming to face directly.

Misdiagnosis concerns: What appears as OCD, panic disorder, or generalized anxiety may actually be autistic traits, meltdowns, or stimming behaviors that serve important regulatory functions.

Recovery complications: Traditional recovery models don't account for the increased existential distress that often emerges when food-focused coping mechanisms are removed without addressing underlying neurodivergent needs.

The importance of community: Finding others who share similar experiences—that "neurodivergent energy coalescence"—provides healing that clinical settings often cannot replicate.

For neurodivergent individuals struggling with disordered eating, understanding these connections can transform the recovery journey from trying to eliminate "problematic" behaviors to discovering authentic ways of being in the world.

Do you want to be part of a community where your experiences are experiences are validated, your neurodivergence is embraced, and you learn to use your autistic traits to your advantage in eating disorder recovery? Join us in the Autistically ED-Free Membership!