Harm Reduction & The Middle Place of Eating Disorder Recovery With "Slip" Author Mallary Tenore Tarpley, MFA

How can harm reduction support eating disorder recovery when full recovery feels complicated, nonlinear, or far away?

Dr. Marianne welcomes back journalist, professor, and author Mallary Tenore Tarpley, MFA, for a conversation about eating disorder harm reduction, anorexia recovery, long-term eating disorder recovery, and the pressure to achieve full recovery. Mallary is the author of Slip: Life in the Middle of Eating Disorder Recovery, a memoir that combines her lived experience with extensive research on how people actually experience eating disorder recovery.

Eating Disorder Harm Reduction and Full Recovery

Eating disorder recovery often gets framed in black-and-white terms: you are either sick or fully recovered. Mallary challenges that binary without dismissing the possibility of full recovery.

For Slip, Mallary surveyed more than 700 people with lived experience of eating disorders and interviewed approximately 175 survey respondents, clinicians, and researchers. Of those surveyed, 85% identified with what she calls the “middle place,” the gray area between acute illness and full recovery.

Dr. Marianne and Mallary discuss why rigid definitions of recovery can create shame for people navigating long-term anorexia recovery, lingering eating disorder thoughts, slips, relapse, and ongoing recovery work.

What Does Eating Disorder Recovery Actually Mean?

Recovery involves more than weight, food intake, or eliminating visible eating disorder behaviors. Mallary describes recovery through changes in identity, cognitive freedom, mental bandwidth, and physical well-being.

She shares how her eating disorder once consumed her thoughts and identity. Now, eating disorder thoughts may still appear, but they no longer dictate her life in the same way. Dr. Marianne connects this with her own lived experience and discusses how reducing food and body preoccupation can create more capacity for relationships, work, interests, and life outside the eating disorder.

Harm Reduction, Slips, and All-or-Nothing Recovery

Mallary explains how harm reduction in eating disorder recovery can help someone move forward without demanding immediate perfection. Instead of treating an eating disorder thought or behavior as proof of failure, harm reduction creates room to notice what happened, reduce risk, and make another choice.

Mallary shares a vulnerable example involving making grilled cheese for herself and her children. When a lingering eating disorder impulse influenced how she prepared her own sandwich, she noticed it, changed course, and moved forward without shaming herself.

Dr. Marianne and Mallary also discuss neurodivergent eating disorder recovery, including how autism, ADHD, perfectionism, certainty-seeking, trauma, and nervous system needs can make rigid treatment expectations especially difficult.

Slip: Life in the Middle of Eating Disorder Recovery

Mallary’s book, Slip: Life in the Middle of Eating Disorder Recovery, combines memoir, journalism, and research to challenge simplistic narratives about eating disorders and recovery. Drawing from her own history with anorexia and changing eating disorder symptoms alongside the experiences of hundreds of others, Mallary asks what recovery can look like when it does not follow a clean before-and-after story.

Mallary also shares what she is researching next, including optimization culture, the thin ideal, healthmaxxing, anti-aging pressures, body image, and cultural messages that encourage us to treat our bodies as endless projects requiring improvement.

If you have ever wondered whether your eating disorder recovery “counts” because you still struggle, this conversation offers a more flexible way to understand healing, progress, and recovery.

Follow Mallary on Instagram: @mallarytenoretarpley Go to her Substack: https://mallary.substack.com

Related Episodes

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

Listen to “'Slips'” in Eating Disorder Recovery in 2026: Why Setbacks Are Part of Progress, Not Failure (With Mallary Tenore Tarpley, MFA)" on Dr. Marianne-Land Podcast on Apple or Spotify.

Work With Dr. Marianne

Looking for eating disorder therapy, ARFID treatment, or neurodivergent-affirming eating disorder support? Dr. Marianne works with people navigating ARFID, anorexia, bulimia, binge eating, long-term eating disorders, autism, ADHD, and complex relationships with food and body image.

Visit DrMarianneMiller.com to learn more about working with Dr. Marianne through therapy or coaching, explore her ARFID & Selective Eating Course for individuals, parents, and providers, and find additional eating disorder and neurodivergent-affirming resources.

You can also listen to more episodes of Dr. Marianne-Land for conversations about eating disorder recovery, ARFID, autism, ADHD, body image, and creating a more sustainable relationship with food.