Drawing from trauma-related theory (e.g., M. F. Schwartz & P. Gay, 1996), this article presents a model of associations among child sexual abuse (CSA), psychological distress, alexithymia, and disordered eating (DE). Structural equation modeling was used to test this conceptual model with a sample of female college students (N = 589). Results indicate that CSA is not directly associated with DE. Instead, CSA is associated with psychological distress, which is further related to alexithymia. Additionally, bootstrapping analyses were used to show that distress and alexithymia mediate the relationship between CSA and DE. Finally, restrictive eating behaviors and attitudes mediate between alexithymia and bulimic behaviors. This latter pathway was shown to be important to the model by the analysis of a 2nd, nested model. Although this model is only one of many possible, these results point to a weak but significant complex relation between CSA and DE.