It’s very critical that the intimacy anorexic has a severe consequence if sex is not initiated or they say no without medical reasons. If you want more information on the sexual agreement, you can read the chapter on this in the book Intimacy: A 100 Day Guide to Lasting Relationships.

My sexual agreement with my spouse is:

Write down the following:

1. Sex ________ times a week.
2. The type of sex system
3. What your consequence is for not initiating or for saying “no” to your spouse is.
4. The person you will be accountable to maintain this agreement outside of your spouse.