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"And it's sad because it's like, when you guys tell me, 'Oh, you used to look like a healthy weight,' like when you have an eating disorder, the word 'healthy' triggers me." "When people tell me that I look tiny, and I'm starting to look sick, for some reason, in my twisted brain, that gives me an endorphin rush."

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Graphical abstract Access this article Similar content being viewed by others Data availability The data generated during the current study are available from the corresponding author upon reasonable request

doi: 10.1016/j.jasms.2007.08.002