In the later stages of anorexia, your voice can literally become very small, like a whisper. The words you speak are often tentative, your sentences terse, with confusion and ambivalence peppering the things you say.
Since sex is a form of communication, and since anorexia alters how you communicate all aspects of your "self," physically intimate experiences are often transformed from occasionally awkward to frightening. Many anorexics report completely losing their sexual feelings and sex drive. This may be a result of hormonal deficiencies but also may be due to a psychological walling-off of emotions, a profound lack of trust in interpersonal relationships, a fear of being naked, a literal fear of being touched and of touching someone else. Sexual dysfunction is a complicated and serious side-effect of this disorder.
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