A 19-year-old woman is referred to a psychiatrist after her roommates become concerned about her behavior. The patient tells the psychiatrist that for the past 2 years, since beginning college, she has been making herself vomit by sticking her fingers down her throat. This behavior occurs regularly, as many as three or four times a week, and worsens when she is stressed out at school. The patient says that she regularly gorges herself with food and is worried that she will become overweight if she does not vomit it up.
She describes her gorging episodes as “eating whatever I can find” in large quantities and mentions one incident in which she ordered three large pizzas and ate them all by herself. The patient states that she feels out of control when she is gorging herself but is unable to stop. She is ashamed of this behavior and goes to great lengths to hide how much she eats. She…
