bail the boat or repair the crack first?
First of all, a boat taking on water isn't going anywhere. You have to get the water out, or you sink.
Does it matter how the water got in there? Well, yes, especially if the water is coming in as fast as you're bailing. If the reason you're filling with water is because of an unusual big wave then get into harbor and concentrate on bailing. If the reason is a big hole in the bottom you may need to pull the whole boat out of the water for a while. If it's a slow leak and you caught it early then bail as fast as you can and then get to work on patching.
My point is that you can't keep moving forward as if you're not taking on water. Refeeding is necessary, if insufficient. All the frantic rowing - or in this case, trying to go on with normal life and talking the issue to pieces - is just wearing you out and missing the point. Stop rowing. Bail the boat. Find the leak and patch it stronger even than the rest of the boat. Rest a bit. Then figure out which way you want to go, and start rowing - slowly at first.
Not every boat is going down for the same reason, but every eating disorder patient needs normalization of eating behaviors and nourishment and activity levels.