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Sarah, a 20-year-old female, presents to the psychiatric office after her roommates became concerned with her behavior and asked her to get help. Sarah admits that for the past year she has had recurrent episodes of binge eating followed by self-induced vomiting. She reports feeling out of control during these episodes and feels ashamed and guilty afterward. She shared that sometimes she will order an extra-large pizza and eat the entire thing by herself before making herself throw up. Sarah admits these behaviors started when her longtime boyfriend broke up with her. Since that time, Sarah reports a preoccupation with her weight and body shape and has a fear of gaining weight. She has noticed a significant impact on her social life and academic performance due to her preoccupation with food and her weight. She denies substance use, suicidal/homicidal ideation. Denies hallucinations/paranoia. Physical exam shows a young woman who is 5' 7" and 140 lbs.
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