If she is constantly working out and eating less than she needs, then may I humbly suggest she is eating the wrong kinds of foods. Eating ālessā of junk food may not lead to weight gain, but it will cause cravings and feeling miserable⦠possibly manifesting as a belief that she is still fat and needs to do more.
Subs for improving self image are a great part of it, but I definitely suggest she take a good look at what sheās eating, and make some changes. Iām partial to (clean!) keto, but even a standard low carb approach works well, with lots of healthy fats (avocado, nuts, oily fish like salmon) and piles of fresh veggies.
Iād also suggest having her minerals checked, as certain imbalances (Iām not a doctor so I wonāt even attempt specifics here) can lead to body perception issues, especially when coupled with a history of emotional trauma from bullying and the resulting self abuse (both mental and physical, ie binging and purging).
2 great resources for the nutrition aspect Iāll suggest are the recent books by Dr. Mark Hyman on the āpegan dietā, as well as every book by Dr. Jason Fung. His work with insulin and other hormones has all but redefined how I view obesity. Brilliant.
And⦠the book Nutrient Power, by Dr. William Walsh. This looks at how nutrient (minerals, mostly) imbalances shape so much of what happens in our body. Too much copper, or zinc? Or. not enough? Potential for major shifts in brain functioning.
No ābro scienceā here, these are all well-respected accomplished doctors with peer review, published studies, etc.
Itās very rare that you can build something with a single tool⦠hereās a few more you can add to your toolbox for helping your friend.