OCD & Eating Disorders: Why Food Rules, Rituals, & “Not Feeling Right” Take Over

Do you feel like eating has to happen a certain way or your anxiety spirals? Do food rules, rituals, or intrusive thoughts take over your day in ways that feel exhausting but impossible to stop? In this episode of The Dr. Marianne-Land Podcast, Dr. Marianne Miller explores the complex overlap between OCD and eating disorders, including how compulsions, “just-right” feelings, anxiety, sensory sensitivities, and rigid food patterns can quietly shape someone’s relationship with eating. Many people with OCD and eating disorders do not fit stereotypes. Some people struggle with restrictive eating, binge eating, ARFID, food avoidance, or repetitive rituals around meals without realizing that obsessive-compulsive patterns may be part of what is driving the cycle. This episode breaks down why food can become attached to safety, certainty, and relief from distress, and why recovery requires more than simply “stopping” the behavior. Dr. Marianne also explores how neurodivergence, including ADHD and autism, can overlap with OCD and eating disorders in ways that are frequently misunderstood in traditional treatment spaces. What OCD and Eating Disorders Can Look Like Around Food This episode explores how OCD can show up through food rituals, rigid eating rules, repetitive behaviors, intrusive thoughts, contamination fears, and overwhelming “not-right” feelings connected to meals and eating experiences. Dr. Marianne explains why these patterns often become reinforced over time and why eating can begin to feel emotionally loaded, exhausting, and difficult to navigate. The Difference Between Food Preferences, Rituals, and Compulsions Not every food routine is automatically OCD, and not every eating disorder behavior comes from body image concerns. Dr. Marianne discusses the difference between supportive structure versus compulsive rigidity and explains why understanding the function of behaviors matters so much in eating disorder recovery. OCD, Neurodivergence, and Eating Disorders Many autistic people and ADHDers rely on predictability, sensory consistency, and routines to reduce overwhelm. This episode explores how OCD can intensify those needs and why treatment must account for sensory processing, executive functioning, anxiety, and nervous system regulation instead of relying on shame or force. Why “Just Stop the Behavior” Usually Does Not Work When providers or loved ones do not understand OCD and eating disorders, people often receive advice that increases distress instead of helping. Dr. Marianne explains why compulsions and rituals are not simply habits people can turn off instantly and why recovery requires compassion, pacing, flexibility, and support for the nervous system. Recovery From OCD and Eating Disorders This episode also explores what can actually help when food rules and compulsions take over. Dr. Marianne discusses building tolerance for uncertainty, gently interrupting rituals, supporting sensory needs, reducing shame, and creating more flexibility around eating without overwhelming the nervous system. Related Episodes When Eating Disorders Meet Anxiety, OCD, or Depression: Co-Occurring Challenges & Recovery Strategies on Apple & Spotify. Obsessions, Compulsions, and Control: How OCD Intertwines With Eating Disorders on Apple & Spotify. Food, Fear, & Fixation: How OCD Shapes Eating Disorders on Apple & Spotify. Work With Dr. Marianne Miller Dr. Marianne Miller is a Licensed Marriage and Family Therapist (LMFT) and eating disorder therapist who specializes in ARFID, binge eating disorder, anorexia, bulimia, OCD, and neurodivergent-affirming care. She works with teens and adults in California and offers coaching support more broadly. Learn more about therapy, coaching, and eating disorder recovery support on her website drmariannemiller.com. Listen and Subscribe If this episode resonated with you, follow The Dr. Marianne-Land Podcast on your favorite podcast platform and share this episode with someone who feels trapped in food rules, rituals, anxiety, or intrusive thoughts around eating.