National Eating Disorders Association

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don't know if I should get help

I'm a freshman in college and pretty far from home and far from my brother and Dad so I've been doing a lot worse lately due to lack of accountability. No one knows I'm struggling, so my behaviors are overlooked. Prior to college, I hadn't purged in a long time, and now I'm doing so X times a week. I'm not sure if that's something that warrants help—in the past, I used behaviors with a much higher frequency and went to treatment, and now I feel like I'm not sick enough to need help but stuck in some kind of quasi-recovery where I'm oscillating between nourishing myself and trying to love myself but also hating my body and wanting to change it. I know getting support can't hurt me recovery-wise, but I'm not sure if I'm justified in getting it because therapy is just so expensive, and my student insurance doesn't cover much. Also I know most of you are probably not medical professionals, but does anyone know if it's an issue if I'm purging and there's a little blood? It's very little so I don't know if I need to be concerned or not. Thanks!

Hello serena2019 and welcome

Hello serena2019 and welcome to the forums! Please visit: for helpful information and for insurance resourcesWe encourage you to call the NEDA Helpline at 1(800) 931-2237 (Monday-Thursday from 9am-9pm EST, Friday from 9am-5pm EST) for more help and assistance.Since there was mention of blood when purging ,we wanted to post up the signs and symptoms of a medical emergency. The following are just some of the signs of a serious problem that demands immediate medical attention:• accidentally or deliberately caused themselves a physical injury• become suicidal• confused thinking and is not making any sense• delusions (false beliefs) or hallucinations (experiencing things that aren’t there)• disoriented; doesn’t know what day it is, where they are or who they are• vomiting several times a day or has uncontrollable vomiting or diarrhea• experiencing dizziness or fainting spells• too weak to walk or collapses• painful muscle spasms• complaining of chest pain or having trouble breathing• blood in their bowel movements, urine or vomit• a body mass index (BMI) of less than 16• an irregular heartbeat, and fast heartbeat, or very low heart beat (less than 50 beats per minute)• cold or clammy skin indicating a low body temperature or has a body temperature of less than 35 degrees Celsius/95 degrees FahrenheitOr any other serious medical concernsIf you experience anything above, we highly recommend seeking medical attention as soon as possible. Another option is 911.

Yes. Please go see a doctor.

Yes. Please go see a doctor. Your stomach/throat are protected from your stomach acid by a mucus lining. If you've abraded something in that location, there might be a spot of exposure there now. Just a wild guess,

Visiting a doctor should prove to you that yes, it's something serious, and that might be shocking enough to help motivate you. Let your family know if it helps. Your roommate and/or friends might also help.

Hope you're doing alright this week.


Thanks, I'll try to make an appointment with my doctor soon


Hi Serena-

I'm glad you found us and reached out. I'm so sorry that you have been struggling. I know college and being away from home was the most difficult time for me in terms of my ED. I just want you to know that you are deserving of help- you're worth it. ED loves to tell us that we're "not sick enough" and that's a lie that keeps us from getting the support we need for full recovery. Regardless of how often behaviors are happening now vs. the past, it is still important to seek support- especially being in a new, stressful environment. Is there a counseling center at your college? And though I'm not a medical professional, the blood does sound alarming and a sign that this is serious and dangerous.

Keep us posted on how you are doing, we are here for you!


I really appreciate the support, thank you. There's a counseling center, but it takes weeks to get an appointment and they cap sessions so it's hard to get in more than a few. I think that I really do want to recover, but it's just hard without the accountability.


Of course! How have you been doing since your original post?

That's unfortunate that there are so many barriers to getting support from the counseling center. Do you feel comfortable sharing what's going on with a friend or family member? I know for me, I have one of my best friends text me every day and ask if I'm eating lunch- and just that source of accountability is helpful. Either that or maybe if you're feeling the urge to engage in behaviors, coming on here and posting. I know it is a lot more difficult not having people physically there and it's easier to go under the radar. Just know that we are here for you to support in whatever way we can & we care about you!


Hi- I just wanted to say that I am sorry you are dealing with ED while trying to also manage the responsibilities of college classes, that's a lot. I think the blood in the vomit is not a good sign and that maybe you should see a doctor. ED are deadly and dangerous for our bodies. Of all the mental illnesses, eating disorders have the highest death rate, which was alarming to me when I read that. Can you talk with anyone so that you are not isolated and all alone in your thoughts and frustration over ED? Maybe you can call your family and see if they can support therapy for you or even see the school counselor a few times as she might have a referral or resource to offer. There might be a support group 12-step meeting in your area, which helped me immensely, I can't say enough good things about a 12-step approach to recovery. Everyone at the meetings struggles with disordered eating and most have found a way out of that cycle through the step-work. I use several steps daily for stress or irritation, or days I feel shame, or grief and sadness, and it helps every time. Plus, I know people now who I can call now on days that are harder for me. Having a solid support network saved me many times in my recovery process. Also, for me a simple approach was to take it an hour at a time to start, because I could go an hour and not binge. Slowly add time and reset your goal until you can make it an entire day without a binge. Always remind yourself that the food will be there if you really want it and need to binge, but for that hour or that 24 hours, you don't have to give in. That strategy worked for my drug addiction and my restricting/anorexia disorder that I am 6 months free from. It is not an easy journey so just be patient and never beat yourself up with shame and guilt, or you will only be feeding the ED, because the ED loves the negativity. I retrained my brain with daily positive self-talk, which was very foreign to me and took some getting use to but really helped. A gratitude list at the end of everyday kept me focused on the good things in my life. Instead of laying in my bed trying to sleep and thinking about all the things I should do, should have done, did wrong or won't do ever again, I focused on my list of 5 or 10 things I was grateful for and that included my body. All these little things helped along with weekly therapy targeting the underlying issues and trauma that made me restrict. I wish you well and hope you will keep posting on here because it helps. Take care:)