How My Chronic Pain and Binge Eating Disorder Recovery Stories Overlap
by San Diego, California Eating Disorder Therapist Dr. Marianne Miller, LMFT
Hey everyone. I’m going to be really transparent right now, because I am in pain today. I have suffered from chronic back pain for 21 years. I injured myself from overexercising less than one month after I graduated with my PhD. It’s been rough. The reason I’m sharing my thoughts and feelings with you is because I want to let you know that I get it. I understand what it’s like to have a chronic condition that you have to learn to manage. I know how you can binge eat to give you just a little relief from your pain—a little escape to help you cope with the unrelenting assault of pain. It can feel similar to chronic illness in that sometimes you can’t know when a flare-up will take place, and food can be there to comfort you, even slightly.
Restricting food can also serve as a distraction. It can give you a semblance of control when it feels like everything is out of control and your body is actually your enemy. Whether you live in San Diego, California like me, or whether you reside in Texas, New York, Florida, Washington D.C.. Even if you’re overseas in London, Manchester, and Birmingham, England, or are in Perth, Australia or Toronto, Ontario, Canada—the combination of eating disorders and chronic pain and chronic illness makes a hard life.
Wherever you are in the far reaches of this planet, I want you to know that I see you. I hear your suffering. In many ways, I AM you. I’m here to share that binge eating recovery is possible, even if you have chronic pain and chronic illness in your life.
Origin Story of My Chronic Pain and Binge Eating Disorder
I’ve detailed the origin story of my binge eating disorder and how it began in Texas and continued in San Diego, California. What I haven’t shared is how it directly related to the beginning of my chronic back pain.
When I graduated from my PhD program in marriage and family therapy (MFT) in Texas, it was December of 2003, and I was EXHAUSTED. I had traveled all over the country, collecting data from COAMFTE-accredited MFT masters and doctoral programs in California, Texas, Indiana, and elsewhere. During that time, I was in the thick of an eating disorder—just not binge eating disorder. I was actually suffering from bulimia while I was at Texas Tech University. Although I didn’t purge or use laxatives as my compensatory behavior, I overexercised…to the point at which I had chronic injuries.
The overexercising continued post-graduation. I was in Colorado over the holidays and was learning how to snowboard and running many miles every week. I arrived home in Texas, still stuck in the eating disorder, and, I continued to see non-eating disorder clients at the Department of Neuropsychiatry at Texas Tech University Health Sciences Center while looking for academic positions in California, Colorado, Illinois, and other states. I continued to binge eat and overexercise…until one day I began to feel pain in my left groin area. The pain increased to the point at which I could barely walk, no less run.
After so many medical appointments, tests, and dismissive physicians, I began to feel pain in my lower back, which I would later learn was connected by the nerves to my left groin area. I saw several physicians, including pain specialists, and they prescribed physical therapy, muscle relaxants, pain medication, and steroid injections.
The pain worsened, and the binge eating increased. The problem was, I could no longer compensate for it through exercising, and my body size changed. I felt shame in my body, I did not have my usual coping mechanism of overexercising to help me feel better, so I increasingly used binge eating to numb my emotions and give me a “boost” of dopamine to help me cope with the pain.
I left my position at the Department of Neuropsychiatry, and I started a therapy private practice in Texas. I began seeing a Texas therapist myself, and she neither specialized in eating disorders nor pain management. She did walk me through visualization exercises that eventually let me to my strategy of “making friends with my pain.” Still, I was in denial that I had an eating disorder.
The pain continued to feel unbearable, so I began looking into spinal fusion therapy. I consulted with a neurosurgeon on a referral from a friend, and I decided to take the plunge and do it. The pain I experienced post-surgery was excruciating. The hospital staff in Texas couldn’t find the morphine pump. I drifted in and out of consciousness.
The Texas hospital discharged me, and I eventually came home and began my recovery process. One week later, I began vomiting uncontrollably, and I had a raging fever and chills. I had developed a staph infection. I returned to the hospital, and they put me on IV antibiotics and eventually prepped me for a second surgery (I found out later that staph infections had been rampant on that Texas hospital floor). They cleaned out my surgery site and determined that it was likely that I had a very serious strain of MRSA staph infection, so I had to stay in the hospital for 10 days, get a port put it, and learned to administer two super-strong IV antibiotics myself, which I had to do for the next six weeks. I then learned that my back was not healing properly, so I had to remain bedridden for two and a half months before I could return to work. The pain was still intense, so the neurosurgeon’s PA put me on heavy-duty pain meds.
Over time, I began physical therapy and returned to my Texas therapy private practice. I had to allow 30-minute breaks in between sessions so that I could lie down on the floor, as it hurt too much to stay sitting. The back surgery did nothing to alleviate my pain—it actually increased it.
How I Learned to Manage Chronic Pain and Began Recovering From Binge Eating Disorder
I continued to look for Assistant Professor positions in COAMFTE accredited MFT programs throughout the U.S., including Kentucky, Chicago, Illinois, and San Diego, California. In fall of 2006, I began working as an assistant professor at Alliant International University in the Scripps Ranch area of San Diego, California. I continued to binge eat, however, and I still was using heavy-duty medications to manage my pain.
The learning curve for working in academia was steep. The workload felt overwhelming. I still had to take one day off completely per week so that I could lie in bed and rest my back. Food continued to be my solace. I loved working with masters and doctoral students who were learning how to be therapists in California. I also enjoyed that I was continuing my learning. And, I began to have an inkling that the eating disorder that I suffered from over a decade ago hadn’t gone away—it had morphed into bulimia in Texas, and then binge eating disorder in California and Texas.
On my own, I began to feel that the pain medications were not working that well anymore, so I decided to cold-turkey quit them. It was not fun. Withdrawal symptoms are REAL. I discovered that I could distract myself from pain by overworking, which I had a tendency to do anyway, so I hyperfocused on my academic and therapy career, and continued to binge eat.
I eventually felt so out of control that I found a San Diego, California therapist who actually WAS qualified to treat eating disorders and who worked with me in learning how to mitigate my perfectionist tendencies, ask for my needs, and set boundaries so that I wasn’t so overworked. That meant that I wasn’t giving 120% on every task; instead, some tasks I would give 70%, others I would give 40%. It made a huge difference.
While I was in eating disorder therapy, I learned about Health at Every Size and about Fat Activism. I read books about diet culture and worked through my family-of-origin issues around food, eating, and negative body image.
I recognized how inconsistently and even restrictively I would eat at times, so I dove into mechanical eating, which improved my mood and blood sugar levels, so that I was able to tolerate distress better, which led to me tolerating pain better. Binge eating episodes decreased, and I was able to join a support group for binge eating recovery that helped me feel heard and understood.
As I learned how to manage my stress and calm down my nervous system through meditation and other techniques, my pain decreased. When it did show up, I used visualization exercises to imagine the lower back area glowing in a royal blue color, which represented the pain. I would picture pain as a friend instead of an enemy—a part of me that was drawing attention to the fact that something was wrong and that I needed help—whether that be rest, emotional support from friends and family, fun distractions (Star Wars!), or prayer. Having pain meant that my body cared enough to let me know that I needed to DO SOMETHING about it—something that was good for me.
As I write this blog, my pain is letting me know that I have been sitting too long in my desk chair working on the laptop, and so I am going to go home, eat lunch and nourish myself, take some over-the-counter pain medicine, and then lie down on a heating pad.
Healing Completely From Binge Eating Disorder
The fabulous thing about learning how to manage pain is that I had fewer triggers for binge eating episodes. My toolbox of coping skills was bursting at the seams. When I felt stressed or upset, I would either reach out to friends or to my spouse, or just work on desensitizing myself. I learned that part of my struggle was because I’m neurodivergent and have strong sensory sensitivities. When I felt overstimulated, I felt more pain. In the past, overstimulation plus pain had led to binge eating episodes. After going through a lot of eating disorder therapy in San Diego, California, I would wrap myself in a soft blanket, put in earplugs, and either close my eyes or read on my lighted e-reader in a dark room. If you suffer from migraines, the need to desensitize yourself may feel similar.
Over time, the binge eating episodes decreased in amount and frequency. Months passed until one day, I woke up and realized that I couldn’t even remember the last time I had binged. It was the best feeling on the planet.
Yes, the Pain is Still Here, AND…
Now, when my pain flares up, I have a huge toolbox of coping skills to manage it. I honestly don’t even think about food when I’m in pain…which is a big change from when I was in the thick of my eating disorder in San Diego, California, Texas, and Colorado. I recognize how feeling overstimulated and not getting enough sleep can lead to increased pain. I also know that sometimes, pain just happens, for no reason at all.
So I accept it. I see it as a friend, telling me to take care of my body, mind, and nervous system. It actually helps me feel more connected to my body, in a weird way. Being neurodivergent, I have struggled with interoception, which is body awareness. Now, I’m more cognizant of how tight my muscles can get and how I need to stand up and walk around when I’ve been sitting in my office chair for a while. I also stretch more consistently—when I’m in the shower and after I go to the bathroom, which helps a lot.
That said, I’m not perfect at it…and I never will be. Having self-compassion for how the pain affects me and my perceived “productivity,” as well as for how I may not always manage it well, is vital. Falling into the trap of self-criticism leads to shame, which can lead to more pain.
Despite the pain, and despite how it can limit what I do at times, I still can have joy in my life. I lean into the dialectical aspects of DBT (dialectical behavior therapy): Joy and pain can coexist. Self-love and sadness can coexist. Gratitude and grumpiness can coexist. 😉
I want to encourage those of you who are struggling with chronic pain, chronic illness, and eating disorders. Whether you live in California, Texas, Florida, or elsewhere, there is hope. I’m living proof of it.
Sending lots of love to all of you today. ♥️
💫 Transform Your Relationship with Food: Work with Me in Recovery
If you’re ready to take the first step toward binge eating recovery, there are several ways to get started:
🧡 Work with Me in Therapy or Coaching
💡 Eating Disorder Therapy – Seeking specialized therapy for binge eating disorder, ARFID, or related concerns? I provide clinical therapy in California, Texas, and Washington, DC. As a fat eating disorder therapist, I offer compassionate, neurodiversity-affirming, and LGBTQIA+ affirming care tailored to your unique needs.
🚀 Elite Binge Eating Recovery Method – A 3-month virtual program designed for students, professionals, athletes, and high achievers ready to break free from binge eating or binge/purge behaviors. This method pairs binge eating education with live coaching for lasting recovery.
🌍 Binge Eating Recovery Membership – Join my online membership that combines an in-depth binge eating classwith email support. Perfect for high achievers looking to change their relationship with food through education, mindset shifts, and a private support group.
🎓 Masterclasses for Bulimia & Binge Eating Disorder – I offer specialized masterclasses for those in London, the UK, Ontario, Canada, and the U.S. These sessions provide practical tools and recovery strategies to support your healing journey.
🎧 Additional Support for Your Recovery Journey
📖 Dr. Marianne-Land: An Eating Disorder Recovery Podcast – Listen on Apple or Spotify for expert insights on binge eating disorder, ARFID, bulimia, anorexia, neurodiversity, and mental health.
📲 Follow Me on Instagram – Stay connected at @drmariannemiller for daily reels, posts, and updates on eating disorder recovery.
⚠️ Important Notes
The Binge Eating Recovery Membership and Elite Binge Eating Recovery Method are coaching programs focused on education, behavioral changes, and mindset shifts. They are not clinical therapy or treatment programs.