People with eating disorders often have greater sexual dysfunction (more problems), less sexual satisfaction (less pleasure), and lower sexual self-esteem (less self-confidence).

The symptoms of eating disorders are an attempt to cope with psychological difficulties. In other words, when it's difficult to put words to what you feel, the body speaks. And sexuality is also a form of body language . The low self-esteem these individuals have towards their bodies extends to sex, where they self-harm, either by abstaining from the activity or by using their bodies as objects, thus giving them a harmful use.

Furthermore, sex in people with eating disorders involves great difficulty.   The difficulty in establishing closeness with others (i.e., in relating to others) reactivates feelings of guilt and shame , as one feels their body is being used as an object . Eating disorders themselves can lead to isolation, and since much of sexual activity requires a partner, these relational difficulties come into play again.