You don't have to hit rock bottom to deserve support. For college students and young women struggling with food and body image.
By Danielle Gofman, LPC
"Other people have it so much worse."
"I'm still eating, so it can't be that serious."
"I'm functioning fine—I don't really need help."
If you've ever had thoughts like these, you're not alone. As a therapist who works with college students and young adult women struggling with eating and body image, I hear some version of this nearly every week. Smart, self-aware, high-achieving women who are clearly suffering—but who've convinced themselves they don't deserve support.
This belief often comes from a good place. You don't want to be dramatic. You don't want to take up space or resources that could go to someone who "really" needs it. You've always handled things on your own, and asking for help feels like admitting defeat.
But here's what I want you to know: the belief that you're not "sick enough" is often the eating disorder talking. It's one of the most common things that keeps people stuck—and one of the biggest barriers to getting support that could genuinely help.
Why "Sick Enough" Is a Myth
When most people picture an eating disorder, they imagine someone who is visibly emaciated, hospitalized, unable to function. That image represents the most severe end of a very wide spectrum—and it leaves out the vast majority of people who are struggling.
The truth is that eating disorders affect people in all body sizes. You cannot tell by looking at someone whether they have a problematic relationship with food. Many people with eating disorders are at a "normal" weight or even in larger bodies. Many are high-functioning on the outside—excelling at school, crushing it at work, holding their lives together—while quietly suffering on the inside.
Research consistently shows that early intervention leads to better outcomes in eating disorder recovery. The longer disordered patterns continue, the more entrenched they become. Waiting until things are "bad enough" doesn't make you more deserving of help—it often just makes recovery harder.
And here's something important to understand: the eating disorder itself wants you to believe you don't need help. Minimizing, dismissing, and convincing you that your struggles aren't "real" enough—that's part of how it maintains its grip. When you hear that voice telling you you're fine, that you're overreacting, that you should just try harder on your own—consider that it might not be a voice worth trusting.
What Disordered Eating Actually Looks Like
Part of the reason so many people don't recognize their struggles as "real" is that our culture normalizes—and even celebrates—a lot of disordered behaviors. Restriction gets praised as discipline. Obsessive exercise gets called dedication. Rigid food rules get framed as "clean eating" or "wellness."
So what does disordered eating actually look like? It's not one thing. It exists on a spectrum, and it shows up differently for different people. But if you recognize yourself in several of these experiences, it may be worth paying attention:
You're constantly doing mental math around food. Calories, macros, "good" foods versus "bad" foods—there's a running calculator in your head that never turns off.
You feel anxious or guilty after eating. Especially after eating something "unplanned" or outside your rules. A single meal can shift your entire mood.
You cycle between restriction and overeating. You control your food tightly, then feel out of control and eat past fullness, then feel ashamed and restrict again. The cycle repeats.
Exercise is primarily about earning or burning food. Movement isn't about enjoyment or health—it's about compensating for what you ate or creating "permission" to eat later.
You avoid social situations because of food anxiety. Dinner with friends, holidays with family, vacations—anything involving food you can't control feels overwhelming.
Your mood and self-worth are tied to your body. How you feel about yourself on any given day depends heavily on what you ate, what the scale said, or how your clothes fit.
You spend significant mental energy thinking about food and your body. Even when you're doing other things, part of your brain is planning meals, worrying about weight, or critiquing your appearance.
Your food rules keep getting stricter. What started as "cutting back on sugar" has become an ever-growing list of foods you won't eat, times you won't eat, and rigid rituals you have to follow.
You feel out of control around food, then ashamed afterward. Bingeing or overeating is followed by intense self-criticism, secrecy, and promises to "do better tomorrow."
If several of these resonate, it doesn't mean something is fundamentally wrong with you. It means your relationship with food is causing you distress. And that's worth addressing—not because you've hit some arbitrary threshold of "sick enough," but because you deserve to feel better.
Why High-Achievers Often Fly Under the Radar
Here's a pattern I see often: the young women who are struggling the most are also the ones least likely to seek help. They're the high-achievers, the perfectionists, the ones who have always held it together.
If that sounds like you, it makes sense that you'd minimize your struggles. The same traits that make you successful—discipline, self-control, high standards—are often the same traits that fuel disordered eating. And because those traits are praised in our culture, it's hard to recognize when they've crossed a line.
You might be excelling in school while internally obsessing over every meal. You might be killing it at work while spending your evenings in a shame spiral over what you ate. From the outside, you look like you have it all together. From the inside, you're exhausted.
Because you're "functioning," no one—including you—recognizes there's a problem. You compare yourself to people who seem worse off and conclude that you're fine. You tell yourself you should be able to handle this on your own, because you've always handled everything on your own.
But here's the thing: the internal experience matters. Just because you're keeping it together on the outside doesn't mean you're okay on the inside. You might be the person everyone else comes to for support. That doesn't mean you don't deserve support too.
Perfectionism can also show up in how you think about getting help. You might believe that needing therapy is a sign of weakness, or that you should be able to "fix" this yourself if you just try harder. You might worry about doing recovery "wrong." These thoughts are part of the same pattern—and they're worth examining, not obeying.
Signs It Might Be Time to Seek Support
You don't need to be in crisis to benefit from eating disorder therapy. You don't need a formal diagnosis. You don't need to have "hit bottom."
Here are some signs that support could help:
You think about food, eating, or your body more than feels sustainable. It takes up mental space that you'd rather use for other things.
Your eating behaviors are affecting other areas of your life. Your mood, your energy, your relationships, your ability to be present—something is suffering.
You feel trapped in cycles you can't break on your own. Restriction, then overeating, then shame, then restriction. You've tried to stop, but the pattern keeps repeating.
You've tried to "fix" your eating yourself, but the patterns keep returning. Willpower isn't working. The rules you set for yourself aren't holding.
You're exhausted by the mental effort of managing food and your body. It's taking more energy than it should, and you're tired.
You avoid situations because of food or body anxiety. You're saying no to things you'd otherwise want to do because food is involved.
You find yourself thinking, "I'll get help when it gets worse." But it's been getting worse. Or it's been the same level of hard for a long time, and that's its own kind of worse.
If any of this resonates, I want to offer a reframe: seeking support now isn't dramatic. It's smart. Therapy is often most effective when you're not in crisis, because you have the mental and emotional capacity to build skills, try new things, and make real changes. You don't have to wait until you're falling apart to deserve help.
What Eating Disorder Therapy Can Offer
Eating disorder therapy isn't about proving you're "sick enough." It's about building a healthier relationship with food, your body, and yourself.
In therapy, you'll have a space to explore the patterns driving your eating behaviors—not just the behaviors themselves. What needs is the eating disorder trying to meet? What emotions are you avoiding, managing, or numbing through food? What would it feel like to have more flexibility and less rigidity in how you eat and how you think about your body?
You'll also learn practical skills. In my work, I use a DBT-informed approach, which means we focus on building concrete tools for managing urges, tolerating distress, regulating emotions, and responding to yourself with more compassion. These aren't abstract concepts—they're strategies you can use in daily life, in the moments when you need them most.
Therapy meets you where you are. Whether you're dealing with disordered eating that doesn't fit neatly into a diagnosis, a full eating disorder, or something in between—support can help. We'll work collaboratively to set goals that feel meaningful to you, and we'll move at a pace that feels safe and sustainable.
And if it turns out you need a higher level of care—like an intensive outpatient program, partial hospitalization, or residential treatment—that's something we can assess together. Part of my job is helping you figure out what level of support is right for you, and connecting you with resources if needed.
You Don't Have to Wait Until It's Worse
If you've read this far, something here probably resonated. Maybe you're not sure if your struggles are "real" enough. Maybe you've been telling yourself you should be able to handle this alone. Maybe you're exhausted by the mental effort of managing food and your body, but you've convinced yourself it's not that bad.
I want to leave you with this: you don't have to earn the right to feel better. You don't have to wait until things get worse to deserve support. If your relationship with food is taking up mental space and causing you distress, that's enough.
Reaching out can feel intimidating—but it can also be the beginning of real change. A consultation isn't a commitment to anything. It's just a conversation to explore whether therapy might help, and whether we'd be a good fit to work together.
If any of this resonated, I'd be glad to talk.
Ready to take the first step?
I offer a free 15-minute phone consultation for college students and young adult women navigating eating disorders, disordered eating, and body image struggles. Let's talk about what you're experiencing and whether this approach might be right for you.
Danielle Gofman, LPC, is a licensed professional counselor specializing in eating disorder therapy for college students and young adult women. She provides virtual DBT-informed treatment throughout Connecticut and Virginia. Learn more about Danielle's approach or schedule a consultation.