At first i was going to make a remark like - so basically you were raised as an italian girl. Cuz humor is my go-to in an untenable situation, and boy i am full of it.

I literally spent a lifetime in therapy. But nobody ever heard me on the coercive stuff. They like to say, whats in it for you? You must be getting a reward or you wouldnt do it. Fear of death isnt exactly a reward - its not love. Its literally the wolf in sheeps clothing. Pleasing that wolf becomes the negative introject - the part of you that hurts yourself before they do, and thats the only love you know. Its not self sabotage - its self maiming. Mostly psychologically - any physical damage is just a byproduct.

Welbutrin is used in smoking cessation. Topamax was found to help in alcohol abuse as well as in weight control. From my personal experience, GLP1's will be found to help in these areas also because of what they are calling "food noise", but what is really the punishing (parental) voice of eating disorders as demonstrated in Jenny Shafer's books.