Rachel Millner, Psy.D.

Rachel Millner, Psy.D. Dr. Millner is a licensed psychologist and Certified Eating Disorder Specialist who works with people struggling with food and body issues.

04/23/2026

Just needing to vent. The lack of representation of weight inclusive providers in the media is so frustrating. Especially when having conversations about intentional weight loss.
If you are a media outlet, who wants to have a nuanced conversation and include weight inclusive providers, I’m available.

Let’s talk about “food noise…”Image description: each image has a light green outline with text that says:Let’s talk abo...
04/22/2026

Let’s talk about “food noise…”

Image description: each image has a light green outline with text that says:
Let’s talk about
“food noise...”
You have likely heard the term food noise connected to conversations about GLP-1s for weight loss
That’s because the weight loss industry popularized the term to describe what they refer to as evidence of a pathological relationship with food. They then sell their product as a way to stop “food noise.”
But what is “food noise?”
Many of us think that “food noise” is just hunger being pathologized by the weight loss industry.
It gets described as thinking about food, obsessing about food, feeling a constant pull to eat
All things that happen when we are hungry.
So “food noise” might mean hungry
But “food noise” could also be:
Evidence of deprivation/restriction-
It could be depriving yourself of certain foods, or of enough food
Being deprived due to lack of access to food
Eating enough/eating all foods while believing that you shouldn’t be or planning not to in the future (ie “l’ll start my diet on monday” or “i shouldn’t be eating these xyz food,” while eating the xyz food)
But “food noise” could also be:
A result of dieting or an eat!ng d!sorder-even if you haven’t dieted in years, there can be long-term effects of dieting that mean thinking or obsessing about food even long after you stopped dieting. The same thing with an ed. Even if you haven’t struggled in years, you may still think/obsess about food as a result of all the years of struggling.
And if you are currently dieting or dealing with an eat!ng d’sorder, your thoughts or obsessions about food, are probably turned way up.
But “food noise” could also be:
Cravings- it is normal to crave food. We crave food for all kinds of reasons; we’re in the mood for it, it reminds of a certain mood or season, we remember something associated with that food, our body needs something that’s in that food, it tastes good, etc. When we are craving something we think about it a lot. When we are craving something and don’t have access to it (for whatever reason), we think about it more.
Continued in comments.

04/22/2026

Acting as if weight stigma has no impact on anything is one of the weight loss industry’s favorite tricks.
When they talk about correlation between higher weight and certain health conditions, they love to leave out the fact that weight stigma in and of itself could be creating the correlation.
And now they are starting to talk about GLP-1s “improving” mental health, while leaving out how experiencing less weight stigma when losing weight may be creating the improvement in mood.
Of course they don’t mention weight stigma, let alone control for it. They just put out headlines that GLP1s may improve mood. They don’t bother mentioning that there are studies that show the opposite- GLP1s worsening mental health.
If experiencing less weight stigma improves mental health, what happens when someone inevitably gains weight back and experiences more weight stigma?
I would love to know if GLP-1s improve mental health. There’s a lot I would love to know about GLP-1s, but it’s information we won’t get if weight stigma is left out of the conversation.
As always, it’s important to differentiate between GLP-1s being used for intentional weight loss and for type 2 diabetes. This post is referring to GLP-1s being prescribed and used for intentional weight loss.

I’ve been sitting with this one for a while Debating the pros and cons of sharing it. I want to be clear that this is no...
04/16/2026

I’ve been sitting with this one for a while Debating the pros and cons of sharing it. I want to be clear that this is not about comparing oppressions. Oppressions can’t be compared and also all intersect.
The reason I decided to share this is because there are parallels between these two aspects of my identity and how the culture responds to them.
I am guessing that most providers who support or profit off of intentional weight loss, would say they are opposed to conversion therapy.
And they would probably be telling the truth. But then completely miss the parallel to body size.
I know this might be a leap for a lot of people. It requires an understanding that just like q***rness is not changeable, body size is not changeable.
And that even if either of these were changeable, there would be no reason to change them. It is only in the context of stigma that attempting to change these is even a thought.
And people who support intentional weight loss and people who support conversion therapy are trying to use stigma to change a stigmatized part of someone’s identity. There’s no way to address stigma with stigma.
They are both a form of eugenics. Conversion therapy is an attempt to rid the world of q***r people. Intentional weight loss is an attempt to rid the world of fat people.
If I know that someone provides/profits from intentional weight loss, I know they aren’t a safe person for me or any fat person.
If I know that someone provides/profits from conversion therapy, I know they aren’t a safe person for me or any q***r person.
If you are a fat person pursuing intentional weight loss or a q***r person pursuing conversion therapy, This post has nothing to do with you. This is about people providing or profiting from these things. Not people who are oppressed trying to decrease the amount of stigma they encounter.
There’s way more to say than what I can fit here, but if you support intentional weight loss and are opposed to conversion therapy, take time to reflect on the parallels and consider if your ethics and morals are really aligned with encouraging intentional weight loss.
And if you support conversion therapy, unfollow me now.

04/14/2026

I am about half way through new book, Adult Braces. I also came across this substack by processing her feelings about what Lindy talks about in the book.
As I was reading about Jennifer’s feelings about Lindy talking more openly in her book about the complicated relationship she has with her body, I remembered when Jennifer talked about getting bariatric surgery years ago.
Jennifer talked about her decision and recognized she was going to be letting people down by pursuing intentional weight loss.
And even with her own complicated relationship with her body and knowing what it’s like to be put on a pedestal as one of very few well known plus size people, she still put Lindy on a pedestal.
And I can understand why. There are so few fat people who are well known and have big followings who talk about their fatness and don’t pursue intentional weight loss. It feels like we have to cling so tightly to what we have.
But it sets up a standard that is never expected of thin people. But with public figures who are fat we expect them to love their body all of the time and not be vulnerable because
if they admit to the complexity of being in a fat body, we fear that we may lose another fat person to intentional weight loss or it will somehow prove diet culture and everyone who upholds it, “right.”
I want all of the plus size and fat representation we can get. I want every well known fat person or every fat person with a following to talk about fat liberation and not to pursue intentional weight loss.
But I also want truth. If the expectation of being a well known fat person is never feeling bad about your body or never grappling with the pull to weight loss, then we will never have the fat representation we so desperately need.

04/11/2026

I was at the grocery store earlier and found these two products on the shelf next to each other 😤
It’s only in a culture seeped in anti-fat bias that products called “skinny pop” and “like air” exist.
Seriously. WTAF is going on? There are so many terrible things happening in the world and this is what’s going on in the grocery store.
Talk about trying to keep us all distracted and small.
And for everyone in the grocery store struggling with an ed or disordered eating or who’s dieting or thinks their body is a problem, these products are reinforcing all of it.
It’s easy to just roll our eyes at products like this because they are so absurd, and they are absolutely absurd. But their existence isn’t neutral. The names of these products is intentional. The message is clear and it’s BS.

04/09/2026

has been talking about her eat!ng d!sorder history and shares about it in her upcoming book.
I am glad she’s talking about it because I’m sure it will be helpful for a lot of people, and it also challenges the narrative around thin equals happy and that being in an idealized body means feeling good or not impacted by anti-fat bias.
Christina is a reminder of how weight stigma and anti-fat bias impact all of us and how the system is designed to keep all women- no matter what their body size- distracted and controllable and working on the “project” of our body instead of on our liberation.
If you are thin and think you aren’t impacted by anti-fat bias, think again. Fat people are impacted differently than thin people, but none of us escape it when it’s so insidious.
Anti-fat bias took Christina out of her life. It meant she was hungry and distracted and under constant surveillance when she was thin and struggling with her ed.
It meant she couldn’t be present and enjoy getting the star on the Hollywood Walk of Fame because she was worried about what people were thinking about her weight gain.
This is why fat liberation needs to be for all of us. Thin people aren’t free until fat people are free.

04/08/2026

I was away for spring break for a week and obviously couldn’t ride my while I was away.
I am so grateful for my current relationship with movement that allows me to go away for a week without anxiety about not doing movement or finding ways to do movement while I’m away.
When I got back, I was looking forward to riding my peloton again, but otherwise wasn’t thinking too much about it.
But I noticed right away how good my body felt. I felt stronger and well rested and it was a great ride.
It made me think about my ed days when I couldn’t take a day off let alone a week off. It was a good reminder of how important rest is.
It also made me think about all the messages we get about movement and fitness. Messages like if we take time off we are going to “lose fitness,” or things like that.
And there would be nothing wrong with that. Taking time off and then coming back and needing to build strength or endurance back up happens and makes total sense.
And, a week off had absolutely no impact on my endurance or strength. The fear mongering in the fitness industry makes it seem like the second we take time away everything will fall apart.
I took a week away and nothing fell apart. In fact, my body felt stronger and more rested.
Our bodies need rest. They need breaks. And nothing terrible will happen when we take them.

The next round of the provider group that and I co-facilitate starts THIS Monday, April 6th and we have a spot availabl...
04/03/2026

The next round of the provider group that and I co-facilitate starts THIS Monday, April 6th and we have a spot available and would love for you to join us.
The group is open to providers of any kind who want a place to talk openly about their own eating disorder, disordered eating, or their relationship with food and body.
We know how hard it can be to join a group like this and are happy to answer any questions or share more about the group. DM either of us with questions or to register.
Image description: there is a background that looks like old paper with a boarder that has flowers and other designs with text that says:

NOW ENROLLING
PROVIDER SUPPORT GROUP

FOR ANY PROVIDER NAVIGATING EATING DISORDER
RECOVERY OR BODY IMAGE STRUGGLES
STARTS MONDAY,4/6/26
MONDAYS, 11 AM -12:30 PM PST
$450 FOR 6 SESSIONS
EQUITY PRICING AVAILABLE
FACILITATED BY:
AARON FLORES, RDN & RACHEL MILLNER, Psy.D.
DM TO ENROLL OR LEARN MORE!

The latest terminology I’ve seen used to talk about GLP-1s for weight loss, is calling them “anti-obesity medications.” ...
04/01/2026

The latest terminology I’ve seen used to talk about GLP-1s for weight loss, is calling them “anti-obesity medications.”
It’s infuriating and not surprising. They will go to any length to profit without any accountability for the harm they cause.
Image description: there are 4 slides that each have a blue background with stars in two of the corners. The text says:
We don’t need an “anti-obesity medication” any more than we need a “weight loss medication”
The entire concept of an “anti-obesity” medication is rooted in eugenics. It’s not about health.
It’s not about well-being. It’s about the belief that fat bodies shouldn’t exist. It’s about anti-fat bias. It also doesn’t surprise me that this is the latest tactic of the weight loss industry.
We know that the weight loss industry is predatory. They are selling something and will use whatever tactic they can to sell more of it. The public knows diets don’t work, so they call it a “lifestyle change.” They know stigma is bad so they claim to fight stigma by stigmatizing people. They can sell a lot of GLP-1s marketing them as weight loss medications, but imagine how many more they can sell marketing them as
“anti-obesity medications?”
By calling them “anti-obesity”
medications, they can prey on fat people and on people afraid of becoming fat, and call it all “health.” These are systems that cannot be trusted. They do not care who they harm. They are banking on the pervasive and insidious amount of anti-fat bias to sell their product without too many questions asked. Without the truth of what they are selling, being told. And it works just as it’s designed to.
To be clear, the fact that it works is not because of the people taking them whether for weight loss or for “anti-obesity.” The people taking them for these reasons have also been preyed upon by the weight loss industry. They have also been harmed. I am not here to judge anyone’s decisions about whether to take these medications or not. I am here to call out the tactics being used to profit, manipulate, and harm people, especially when the tactics are rooted in eugenics and anti-fatness and anti-Blackness and are being sold as health.

When we are given so little, any crumb can feel like a lot. When we are told our bodies have to be so small that they ba...
03/28/2026

When we are given so little, any crumb can feel like a lot. When we are told our bodies have to be so small that they barely exist, someone trying to normalize slightly bigger bodies can feel revolutionary.
But it’s not revolutionary and it’s not liberatory. It’s not what gets us free.
Fat liberation doesn’t have a size limit or a weight limit. There’s no limits at all on our bodies when we are rooted in fat liberation.
If we want fat liberation we can’t settle for a slight widening of oppressive body standards. We need to dismantle the oppressive systems altogether.

Image description: there are two images. Each one has shades of green and grey in the background and text that says:
Living in a culture that tells us we are supposed to be the smallest size possible, it can seem radical when someone says it’s “ok” to be a slightly bigger size, or have thighs that touch, or belly rolls, or stretch marks. But as soon as
someone starts putting
conditions on what’s “ok” for a body to be, there’s nothing radical or liberatory about it.
I’m all for normalizing normal aspects of having a body, but when someone is saying what’s “Ok” for a body to be, what they typically mean is up to a certain size. As in “it’s ok to be fat, but not too fat.” Or “it’s ok to have belly rolls when you sit down, but not a fat belly with rolls all of the time.” I don’t want a culture that widens oppressive beauty standards just a little bit and calls it liberation. I want a culture that dismantles the beauty standards entirely.

The next round of and my provider support group starts Monday April 6th. We meet biweekly for 6 sessions from 11am-12:3...
03/23/2026

The next round of and my provider support group starts Monday April 6th. We meet biweekly for 6 sessions from 11am-12:30pm Pacific time.
This group is open to providers of any type (therapists, dietitians, coaches, doctors, nurses, trainers, etc.) who are struggling with an eat!ng d!sorder, d!sordered eating or want to work on their relationship with food and body.
Aaron and I have been facilitating this group since 2019 and know how scary it can be to reach out for support when you’re a provider who’s struggling.
We believe that providers can be struggling and still be excellent providers. We believe in autonomy. We trust providers.
The group is fat positive and grounded in body trust®️ principles.
Please DM with any questions or for link to register. We would love for you to join us.

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Rachel Millner, Psy.D., CEDS-S, CBTP is a psychologist in PA and NJ, Certified Eating Disorder Specialist and Supervisor, and Certified Body Trust® provider. Dr. Millner has been in practice since 2005, working with people struggling with all forms of eating disorders and disordered eating as well as those working to break free from diet culture and work toward body liberation. Since 2014, Dr. Millner has worked in the Eating Disorder Assessment and Treatment Program at the Children’s Hospital of Philadelphia, where she treats children and adolescents struggling with eating disorders using a family-based approach.

Dr. Millner is a trauma-informed, Health at Every Size®, fat-positive provider who works from a weight-inclusive lens. She works with people across the weight spectrum from a non-diet perspective. Dr. Millner believes in body autonomy and recognizes that weight stigma and diet culture impact all of us and the decisions we make about how to care for our bodies.

In addition to her clinical work, Dr. Millner serves on the board of the local International Association of Eating Disorder Professionals chapter. She is the co-chair of the Weight Stigma and Social Justice special interest group in the Academy of Eating Disorders, where she also serves as a member of the Awards and Scientific Review committee. Dr. Millner speaks nationally about weight stigma, weight-inclusive care, anorexia in higher-weight bodies, and her own eating disorder recovery. Dr. Millner has shared her expertise on popular podcasts such as the Food Psych podcast and the Eating Disorder Recovery Podcast. She has taught at the University of Pennsylvania, Mercer County Community College and Gwynedd Mercy College.

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