You Don't Have to Be 'Sick Enough' to Deserve Eating Disorder Support

You don't have to hit rock bottom to deserve support. For college students and young women struggling with food and body image.

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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.

Do I have an eating disorder or disordered eating? How to tell

It’s not unusual to question your relationship with food at some point in life. Maybe you’ve noticed your eating habits changing. Maybe food feels more stressful than it used to. Or maybe someone close to you has expressed concern, and you’re not sure whether it’s something to take seriously.

For teens, young adults, and parents, the line between “disordered eating” and an eating disorder can feel blurry. Many people wonder if what they’re experiencing is a phase, a response to stress, or something that deserves professional support.

This post explores the difference between eating disorder vs disordered eating, common warning signs, and when therapy, including DBT-based support, can help.

If you’re reading this and wondering, “Do I have an eating disorder?” you’re not alone. That question itself is often a meaningful place to start.

What Is Disordered Eating?

Disordered eating is a broad term that describes unhealthy or unhelpful patterns around food, eating, or body image. These behaviors may not meet the criteria for a formal eating disorder, but they can still have a real impact on physical and emotional wellbeing.

Examples of disordered eating can include:

• Skipping meals regularly

• Rigid “food rules” or labeling foods as strictly good or bad

• Eating in response to stress, guilt, or anxiety rather than hunger

• Feeling a strong sense of control or relief through restricting or overeating

• Preoccupation with weight, calories, or body shape

• Avoiding social situations that involve food

Disordered eating often exists on a spectrum. Some people move in and out of these patterns depending on stress, life transitions, or emotional challenges. For others, these habits become more entrenched over time.

What Is an Eating Disorder?

An eating disorder is a diagnosable mental health condition that involves persistent disturbances in eating behavior, body image, and emotional regulation. These patterns typically cause significant distress and interfere with daily functioning, relationships, school, or work.

Common eating disorders include:

• Anorexia nervosa

• Bulimia nervosa

• Binge eating disorder

• Avoidant/restrictive food intake disorder (ARFID)

• Other specified feeding or eating disorders (OSFED)

While the behaviors may look different, many eating disorders share common emotional and psychological roots, such as perfectionism, anxiety, difficulty tolerating strong emotions, or a deep need for control or certainty.

Eating Disorder vs Disordered Eating: What’s the Difference?

This is one of the most common questions people search for, and the answer isn’t always straightforward.

A helpful way to think about it is this:

Disordered eating refers to patterns that are concerning but may be more flexible or situational. An eating disorder tends to involve more rigid, persistent, and consuming behaviors that significantly affect daily life.

Some key differences include:

• How much time and mental energy food and body concerns take up

• Whether eating behaviors feel optional or feel driven and hard to stop

• The level of distress, secrecy, or shame involved

• The impact on physical health, relationships, or responsibilities

It’s also important to know that many people move along this spectrum over time. What starts as disordered eating can develop into something more serious, especially during periods of stress, transition, or emotional strain.

Common Eating Disorder Symptoms in Teens and Young Adults

Eating disorder symptoms don’t always look the same from person to person. In teens, college students, and young adults, some warning signs can include:

• Skipping meals or eating very small portions

• Frequent trips to the bathroom after eating

• Cycles of binge eating followed by guilt or attempts to “make up for it”

• Avoiding eating around others

• Increased secrecy around food or body habits

• Strong emotional reactions tied to weight, shape, or appearance

• Feeling out of control around food

• Physical symptoms like dizziness, fatigue, or changes in sleep

Parents often search for signs of an eating disorder in teens because these patterns can be subtle at first. Changes in mood, isolation, or withdrawal can sometimes appear before eating behaviors become obvious.

When Does Dieting or Stress Become a Concern?

Many people ask, “Is this just stress eating, or is it something more?”

Stress, anxiety, and major life transitions can all influence how someone eats. Starting college, entering the workforce, navigating identity changes, or dealing with pressure to perform can all shape eating patterns.

It may be time to seek support if:

• Food feels like a primary way of coping with emotions

• Eating habits feel increasingly rigid or out of control

• Thoughts about food or body image dominate your day

• You feel shame, secrecy, or fear around eating

• Your health, focus, or relationships are being affected

These are not signs of weakness. They are signals that something in your system may be overwhelmed and looking for support.

How Emotional Regulation Connects to Eating Behaviors

Many people are surprised to learn how closely eating patterns are tied to emotional regulation. For some, food becomes a way to manage feelings that feel too intense, confusing, or uncomfortable.

This is one reason DBT for eating disorders and disordered eating can be so helpful. Dialectical Behavior Therapy focuses on building skills for:

• Tolerating distress without harmful coping strategies

• Regulating intense emotions

• Increasing awareness of internal experiences

• Building healthier ways to respond to stress and urges

When emotional tools are limited, behaviors around food often fill that gap. Therapy helps expand the range of ways someone can care for themselves during difficult moments.

How Therapy Can Help With Eating Concerns

Therapy for disordered eating and eating disorders is not just about changing food behaviors. It’s about understanding what those behaviors are doing for you emotionally and building safer, more sustainable ways to meet those needs.

In our work with teens and young adults, therapy often focuses on:

• Exploring the emotional role food and body image play

• Building emotional awareness and regulation skills

• Addressing anxiety, perfectionism, or identity stress

• Strengthening self-trust and self-compassion

• Improving communication with family or support systems

For some clients, DBT-based therapy provides a practical, structured way to work with urges, intense emotions, and all-or-nothing thinking that often show up alongside eating issues.

Eating Disorder Therapy in Westport, CT and Virtual Support

At Gofman Therapy & Consulting, we offer eating disorder therapy in Westport, CT, and virtual therapy across Connecticut and Virginia. We work with teens, young adults, and families who are navigating concerns about food, body image, and emotional wellbeing.

Whether you’re noticing early warning signs or dealing with long-standing patterns, support can make a meaningful difference.

You Don’t Have to Figure This Out Alone

If you’re wondering whether what you’re experiencing is disordered eating or an eating disorder, that curiosity itself is a sign of care. You don’t need a diagnosis to reach out for support. You just need a sense that something doesn’t feel quite right.

If you’re a parent concerned about your teen or young adult, it’s okay to ask questions and explore options. You don’t have to wait for things to become a crisis before seeking guidance.

We’re here to talk through what’s been coming up and help you decide what next steps might make sense.

FAQ: Eating Disorders and Disordered Eating

What’s the difference between disordered eating and an eating disorder?

Disordered eating refers to unhealthy patterns around food that may be more flexible or situational. An eating disorder is a diagnosable condition involving more persistent, rigid behaviors that significantly impact daily life, health, or emotional wellbeing.

How do I know if I have an eating disorder?

If food, body image, or eating behaviors are causing distress, interfering with relationships or responsibilities, or feel hard to control, it may be helpful to talk with a mental health professional for an assessment.

Can DBT help with eating disorder symptoms?

Yes. DBT focuses on emotional regulation, distress tolerance, and coping skills, which can be especially helpful for people who use food-related behaviors to manage intense emotions or stress.

What are early warning signs of an eating disorder in teens?

Early signs can include skipping meals, avoiding eating around others, changes in mood or energy, secrecy around food, and increased preoccupation with weight or appearance.

Do you offer virtual eating disorder therapy?

Yes. We offer virtual therapy across Connecticut and Virginia.