Lovato revealed she was also assaulted as a teenager. Lovato explained that her decision to have sex with her drug dealer after her assault was not the first time she's tried to take control back. "When I was a teenager, I was in a very similar situation. I lost my virginity in rape," she alleged. "I called that person back a month later and tried to make it right by being in control. All it did was make me feel worse." She realised those reactions were "textbook trauma reenactments," noting that her first experience with sexual violence is what caused her to have trouble coming to terms with her second. "I internalized it and I told myself it was my fault because I still went in the room with him, I still hooked up with him," she recalled, citing pressure from the picture-perfect public image of the Disney crowd as what kept her silent. "F*ck it, my #MeToo story is me telling somebody that someone did this to me and they never got in trouble for it," she alleged. "They never got taken out of the movie they were in. But I've just kept it quiet because I've always had something to say, and I don't know, I'm tired of opening my mouth. So there's the tea." Lovato also revealed that when she did share what happened with adults, her alleged attacker never faced consequences and "never got taken out of the movie they were in."
Lovato also began relapsing with her eating disorder in 2018. Lovato revealed that she began over-exercising and extreme dieting, as her former management team policed her food intake to the point of demanding her friends and family guard her meals. Lovato shared that it took three years to feel as if she has "found balance" when it comes to her eating disorder, although she knows she will never be cured of it. "The voice has gotten so quiet that it no longer rules my life and I no longer feel like I'm in a prison," she said. In August 2020, she celebrated both her 28th birthday and a major milestone in her recovery with three cakes after having watermelon "cakes" for eight consecutive years.