Do I have an eating disorder?

Dear Alice,

I'm hoping you could answer my question.

I am a freshman at a university, and I think I have an eating disorder. I starve myself, but sometimes I just have to binge. I have to do this until I feel better about myself, but I have an additional problem. I feel so depressed after I binge because I sit for over an hour trying self-induced vomiting, but it doesn't work for me. I feel it would be better to just purge and feel better than be left feeling hopeless because I couldn't undo my mistake. I was hoping you could tell me why I can't even vomit right? It doesn't seem fair. I just want to lose some weight, then I'll handle the eating problems, but for now I fear what this depression will lead to if I continue to occasionally lose the will-power to not eat but can't vomit. I'm sure you don't want to answer my question because you will feel you are contributing to my problem, but I'll take a chance and ask anyway. How can I make myself throw up or what can I take or do to get rid of my food. I just feel like I'm missing something, that so many girls have this problem, but I can't even do it the right way. Even this won't work for me to lose weight.

I hope you receive this, and I apologize for the length. Thank you for your time.


Dear a.n.,

It’s good that you’ve reached out — it takes a lot of courage to acknowledge that you’re struggling with eating concerns and by asking for help, in any form, you've taken a huge step. Although you may feel that a cycle of starving, bingeing, and purging is the only way to lose weight, these behaviors could be dangerous and have long-term consequences for your physical and mental health. With that in mind, it may be helpful to refocus your energies on establishing a healthier relationship with food and your body — and break the cycle once and for all.

First, it could help to break down why this cycle may be occurring. From a physiological perspective, your body craves nutrients after going long periods of time without eating. Meaning that, when the body is deprived of necessary fuel and nutrients, it may be increasing your hunger level until you feel ravenous; this could result in you no longer feeling in control of how much you eat. Eating balanced meals throughout the day can actually help to reduce the likelihood of bingeing for physiological reasons. Binging can also happen in response to feeling intense emotions, so becoming more aware of those feelings when you choose to skip a meal or overeat can also be helpful in changing the pattern. Cycles like the one you described can be very hard to break and these behaviors could potentially result in both short- and long-term consequences, some of which can be quite dangerous and irreversible.

A.n., you also mention that you think you might have an eating disorder. In addition to your concerns about bingeing and desire to purge, using self-starvation as a way to lose weight could also be a cause for concern. Eating disorders, and disordered eating patterns, in general, are very complex. You might benefit from talking with a health care or mental health provider, first, to determine that you’re not putting your physical health in danger, and second, to see what factors might have led you to start engaging in these behaviors in the first place. Health care providers use specific criteria to diagnose an eating disorder and they can also provide additional support and resources tailored to your needs. If you aren’t feeling ready to talk with a professional, there are other options and actions you can take to explore your feelings around your eating patterns. The National Eating Disorders Association (NEDA) has an anonymous screening tool that can walk you through a set of questions to determine your risk for an eating disorder and link you to helpful information and resources. You may also consider checking out Go Ask Alice! Nutrition & Physical Activity and Emotional Health archives for more information on body image and eating concerns.

Hopefully you can find the information and support you need.

Last updated Jul 22, 2016
Originally published Apr 25, 1997

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