Have you ever felt like your mind just won’t shut off about food? You’re in a meeting, at school, or out with friends, and instead of focusing on what’s in front of you, all you can think about is what you’ll eat next, what you shouldn’t have eaten, or what you’ll allow yourself later. That constant mental chatter, what many call food noise, can be exhausting.

Tune in to the full episode to uncover what food noise is really telling you, and what steps you can take to finally quiet it.

“Thinking about food and being interested in food is really another sign of physical hunger.” - Rachelle Heinemann

“Restriction applies to the actual restriction of food not getting in enough, and it applies to the restriction of kinds of foods, types of foods, and the idea that they’re off limits.” - Rachelle Heinemann

“Once you start eating adequately and regularly and consistently, and allowing yourself to have a variety of foods, then you’d be surprised how the food noise starts to quiet.” - Rachelle Heinemann

“If we still have our good foods and bad foods in different camps, then the food noise will probably be there.” - Rachelle Heinemann

“The more you avoid sweets and cakes and all these other kinds of fun foods, it’s going to hold that power over you.” - Rachelle Heinemann

“The most important takeaway from today is ‘Are you restricting? Is there some dieting going on? Are there lots of food rules?’ In which case, you have to address that in order to decrease the food noise that is driving you up the wall.” - Rachelle Heinemann

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Hidden River Healing provides compassionate, residential eating disorder treatment for girls, adolescents, and young women. Their expert clinical team emphasizes family involvement and individualized care in a beautifully designed facility surrounded by nature — a peaceful environment that supports recovery and lasting healing.

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Learn more: hiddenriverhealing.com/about-us
Follow on Instagram: @hiddenrivertx

When it comes to eating disorder treatment, one of the biggest questions people have is simple: What does it actually look like? The reality is that there’s no single answer. Every person’s story with food, body image, and recovery is unique, which means treatment has to be flexible, supportive, and tailored to the individual. Still, there are common building blocks that show up again and again, and understanding them can make the process feel a little less overwhelming.

The number one goal is eating disorder symptom reduction. That means consistent and adequate nourishment as the first and most important goal.

“No two eating disorders are going to look alike. No two people's stories are going to look alike.” - Rachelle Heinemann

“The relationship we have with our people is going to be the catalyst for change.” - Rachelle Heinemann

“Just because the numbers are good doesn’t mean there isn’t still an eating disorder.” - Rachelle Heinemann

“Even if somebody starts to show signs of decreased symptoms, it doesn't necessarily mean that the work is over.” - Rachelle Heinemann

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Ever feel like nothing in your closet feels good, no matter how many outfits you try on? Or maybe you’ve found yourself spiraling about what people will think when they see you at a reunion, a wedding, or even just in the office.

In this episode of Understanding Disordered Eating, I’m joined by my good friend and colleague, Sydney Green, MS, RD, to unpack the truth about body image: what it really means, how it shows up in daily life, and why it’s so intertwined with our relationship to food.

“If you're on outfit seven, nothing's feeling good… can we just go with comfort? Can we just go with, okay?” - Rachelle Heinemann

“Body image is the last to go… which again, I don't even know what that means, although it's true, but it doesn't really mean much without unpacking it.” - Rachelle Heinemann

“The successful woman is looking super chic, and she's really thin, and if I don't look like that, then I'm not successful. I'm not driven. I'm not motivated.” - Sydney Greene

“A huge salad… our stomach is not meant to digest that. We're not rabbits. It just sits there. We get bloated. It doesn't feel good.” - Sydney Greene

“Body image is not a symptom. It's like how we feel about ourselves… there’s so much more richness to how we feel about our body.” - Sydney Greene

“There's an actual word for some of this in research, it's called fat talk… women get together and talk about, pick apart their body, kind of like that Mean Girls scene.” - Sydney Greene

“When somebody is struggling with body image, maybe the point is not to immediately erase it. Maybe we have to see it and acknowledge it and say, you're not alone.” - Rachelle Heinemann

Connect with Sydney here: https://www.sydneygreenehealth.com/

Find her on Instagram!: @greenehealth

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What does it really mean to be fully recovered from an eating disorder?

For decades, the conversation has been clouded by vague definitions, conflicting philosophies, and the fear that “recovery” might not even be possible. In this powerful conversation, I sit down with Carolyn Costin, a renowned therapist, author, and pioneer in the eating disorder field, to dig into what recovery actually looks like, why she believes full recovery is possible, and how to strengthen the “healthy self” rather than fight against the eating disorder voice.

Carolyn Costin MA, MEd., MFT, CEDS, FAED, is a world renowned, highly sought-after eating disorder clinician, author, and international speaker. Recovered from anorexia in her twenties, as a young therapist Carolyn recognized her calling after successfully treating her first eating disorder client. Carolyn was first to publicly take the position that people with eating disorders can become fully recovered.

“When you are recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size, or reach a certain number on the scale.” - Carolyn Costin

“We are not born with an eating disorder. We were born with this core healthy soul self in there.” - Carolyn Costin

“Instead of getting rid of the eating disorder self, I help strengthen people’s healthy self.” - Carolyn Costin

“When someone has had an eating disorder, I want to be cautious for a while, but I know so many people now being in this for so long who are recovered and shit’s happened in their life… and not slipped back.” - Carolyn Costin

“I don’t weigh myself. It’s like a feminist statement.” - Carolyn Costin

“We have to be careful… but my experience is people who are recovered actually navigate it better because we’ve already been through all that and it’s like we have a bit of a shield up for it.” - Carolyn Costin

Visit Carolyn’s website - www.CarolynCostinInstitute.com

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Have you ever wondered where the line really is between disordered eating and a true eating disorder? It’s not always as clear as we’d like to think. In fact, so much of what we consider “normal” in diet culture—tracking every bite, stressing over body image, or skipping meals in the name of health—can feel harmless at first… until it slowly starts taking over more and more of your life.

If you’ve ever asked yourself, “Is this just disordered eating, or is it something more?”, this conversation is for you.

“You don’t have to have a diagnosable or a life-threatening eating disorder in order to qualify to get help.” - Rachelle Heinemann

“Think of it like an iceberg. Disordered eating is the part you can see… but an eating disorder is the entire iceberg—this massive, dangerous thing that’s hidden.” - Rachelle Heinemann

“With disordered eating, the rules are upsetting if you can’t follow them. With an eating disorder, the rules feel like commands, and breaking them feels like a moral failure.” - Rachelle Heinemann

“To me, one of the most important pieces to keep an eye out for is how your relationship with food is impacting your life—your work, your friendships, even your ability to leave the house.” - Rachelle Heinemann

“No matter if you have a full-blown eating disorder or you struggle with yo-yo dieting, there is help out of it. You don’t have to wait.” - Rachelle Heinemann

Bergen Mental Health Group Inc. is hiring! If you think you’d be a great fit, check it out!

Grab my Journal Prompts Here!

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Now accepting new clients! Find out if we're a good fit!

LEAVE A REVIEW + help someone who may need this podcast by sharing this episode.

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You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com

While we’re on summer break, we’re bringing back some of the most impactful episodes that deserve a second listen—and this one is just too good to pass up. This is our last re-release for the summer. We will be back with new episodes on September 9th, so be sure to tune back in.

In this episode, we’re going deep into the neurobiology of eating disorders with Dr. Jeffrey DeSarbo, a renowned psychiatrist and medical director of ED-180, one of the largest private eating disorder treatment centers in the U.S.

If you’ve ever wondered why eating disorder recovery can feel so hard, or what’s really going on in the brain beneath the behaviors, this episode will open your eyes and deepen your understanding. Dr. DeSarbo explains the science in a way that’s relatable, clear, and deeply compassionate. From the neurological impacts of restriction, binging, and purging to the effects of compulsive exercise and body image distress, we’re unpacking it all.

This conversation is a must-listen for clinicians, individuals in recovery, and anyone curious about the “why” behind the “what.”

In this episode, we’re talking about:

• Dr. Jeffrey De Sarbo’s unique path from finance to psychiatry, and how he became a leading expert in eating disorder neurobiology.

• Why eating disorders are “half medical, half psychiatric”—and how this complexity makes them uniquely challenging and important to understand.

• What neurobiology really means, and how our brains function through electrochemical energy.

• The role of genetics and epigenetics in eating disorders, and why some people are more biologically predisposed than others.

• How brain scans show measurable differences in individuals with eating disorders, especially in how different regions of the brain communicate.

• Why “just eat” or “just stop” is a myth, and how deeply biological factors resist simplistic solutions.

• How behaviors like binging can physically change the brain, creating patterns that mimic addiction and drive compulsion.

• What restriction does to the brain, including loss of gray and white matter and cognitive impairment, even when someone appears high-functioning.

• The dangerous effects of purging, from electrolyte imbalances to cardiac issues, and why “feeling fine” doesn’t mean you’re medically safe.

• The neurobiology of compulsive exercise, and how stress hormones and overtraining harm the brain’s ability to function and recover.

• Why body image distress is not just emotional but neurological, with altered blood flow patterns and measurable differences in perception.

• How neurobiology informs the recovery process, and why rewiring the brain is both essential and entirely possible—with time, persistence, and support.

"Eating disorders are not a choice. It’s something that happens." - Dr. DeSarbo

"Oftentimes, when we work with our eating disorder patients, they have 10,000 plus hours of eating disorder thought processes—so they become experts." - Dr. DeSarbo

"Restriction with anorexia nervosa is giving you a compromised brain." - Dr. DeSarbo

"You're invincible until you are not—and then it is too late." - Rachelle Heinemann

"What percentage of your free thoughts, when you're not busy actively doing something, do you spend thinking about or worrying about food, weight, body image, calories, exercise?" - Dr. DeSarbo

ED180

The Brain and Neurobiology of Eating Disorders

Translating ED

Nora Volkaw

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We’re diving into the archives this summer to bring you some of our most memorable and impactful conversations — and today’s episode is just too good to pass up. While we take a short summer break, we’re re-sharing these standout episodes. So stay tuned all summer long for these gems!

This week, we’re bringing back Episode 27 with Dr. Danielle Novak — a deep and moving conversation that fuses psychoanalytic insight with the complexities of eating disorders.

Dr. Novak, a clinical psychologist with over 20 years of experience and currently in psychoanalytic training at NYU, joins us to unpack one of the most elusive and critical aspects of disordered eating: the role of dissociation. This isn’t just theory — it’s a raw, compassionate exploration of how symptoms aren’t random, but deeply protective mechanisms developed from unspoken, often unconscious emotional pain.

If you’ve ever felt disconnected from your body, confused by your reactions, or wondered why food has such a powerful grip in moments of distress, this conversation will resonate deeply.

In this episode, we’re talking about:

• How eating disorders develop and are maintained as protective responses, not simply destructive habits.

• What dissociation really means and how it can show up subtly or severely in our everyday lives.

• How trauma — both big "T" and small "t" — plays a central role in dissociation and the onset of eating disorders.

• The ways emotions get stored in the body and expressed through symptoms when they can’t be spoken.

• How restriction, binge-purge cycles, and overexercise act as coping mechanisms for overwhelming feelings.

• Why symptoms may provide temporary relief, but ultimately prevent us from connecting with our emotions and others.

• How building awareness and creating a “pause” between urge and action can begin to reconnect dissociated parts of the mind.

• The vital role of the therapeutic relationship in healing dissociation and restoring emotional expression.

• Why treatment often begins with symptom stabilization but must eventually move into deeper emotional territory to be truly transformative.

"I tend to believe that eating disorder behaviors are often sort of stand-ins for feelings that cannot be felt as feelings or expressed through words or through other means." - Dr. Danielle Novack

"People don’t learn how to regulate emotions. Emotions are just put away in a box and not looked at and not dealt with, and become separated from what’s conscious." - Dr. Danielle Novack

"Often people describe restriction as giving them a sense of like numbness and detachment that often feels preferable and safer than actually feeling their feelings." - Dr. Danielle Novack

“Without knowing what’s going on in our body, we can’t possibly create important connections.” -Rachelle Heinemann

Dr. Danielle’s Website

It Takes A Village By Dr. Danielle Novack

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While we take a little breather, we’re diving into the archives to bring you some of the most powerful, thought-provoking episodes from the past. These conversations are just too good to leave behind—and today’s is no exception.

We’re throwing it back to Episode 57, a deeply moving and intellectually rich conversation with Heather Ferguson, one of the most respected voices in trauma-informed psychoanalysis and eating disorder treatment. Heather’s insight into the nuanced connection between trauma and disordered eating is unmatched, and in this conversation, we scratch the surface of a topic that could easily fill a semester-long course.

From childhood trauma and body memory to dissociation, shame, and the slow, compassionate path to healing, this episode is a must-listen whether you're a therapist, a survivor, or simply curious about the deeper psychological layers behind disordered eating.

In this episode, we’re talking about:

• What trauma really means—including the difference between "Big T" and "small t" trauma—and how it shows up in unexpected ways.

• How the context and response to a traumatic event can shape the severity and meaning of the trauma.

• How eating disorders can act as survival strategies: tools for self-soothing, control, and numbing.

• What it means when an eating disorder serves both soothing and self-punishing functions.

• Why the healing process must include not just the mind, but the body—and how we create space for that in therapy.

• How early trauma and misattunement can shape our beliefs about ourselves and our bodies.

• How intergenerational trauma, secrecy, and silence can pass psychological pain down through families.

• Why creating a coherent narrative and reclaiming agency are essential to healing.

• How somatic awareness and slowing down automatic behaviors are key to shifting patterns of disordered eating.

• How cultural, familial, and historical narratives about food and bodies impact how trauma and eating disorders manifest.

• Why curiosity, compassion, and shared storytelling are central to transformative healing.

“The eating disorder became a self-management tool, a self-regulating tool, a strategy to manage states of hyperarousal and anxiety, to have a sense of efficacy and control.” – Heather Ferguson

“Most of us with a psychoanalytic frame of mind think about eating disorders serving both functions, that is, they can both downregulate and soothe the nervous system, but it can also be self-harming and self-punishing.” – Heather Ferguson

“That’s part of what gets mapped around trauma – ‘I’m bad, I deserve punishment.’ It’s illogical, it’s sort of how the psyche makes sense of this – that you are the bad one, and you somehow induce the traumatic event.” – Heather Ferguson

“The eating disorder, in a way, can be a window into understanding the trauma.” – Heather Ferguson

Heather’s Website

Heather’s email: heatherfergusonlcsw@outlook.com

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