Eating Disorders

A 16-year-old girl has intense cravings for food. She eats large amounts of food, which is followed by self-induced vomiting. What is the probable diagnosis?

A 22-year-old female college student presents with a 2-year history of severe food restriction, excessive exercise (3–4 hours daily), and intense fear of weight gain despite weighing 38 kg at a height of 162 cm (BMI 14.5 kg/m²). She denies binge eating or purging. On examination, she appears cachectic with fine body hair, cold extremities, and a heart rate of 48 bpm. Laboratory findings show serum potassium 3.2 mEq/L, magnesium 1.6 mg/dL, and albumin 2.8 g/dL. What is the most appropriate initial management priority?

A 19-year-old female presents with a 1-year history of recurrent episodes of uncontrolled eating (consuming 3000–4000 kcal in 1–2 hours) followed by self-induced vomiting 2–3 times daily. She reports using laxatives (20–30 tablets daily) and diuretics to prevent weight gain. Her weight is stable at 58 kg (BMI 21.8 kg/m²). Examination reveals dental erosion, parotid gland enlargement, and calluses on her knuckles. Serum electrolytes: sodium 132 mEq/L, potassium 2.8 mEq/L, chloride 88 mEq/L, bicarbonate 32 mEq/L. What is the primary acid–base disturbance?

A 22-year-old woman presents to the psychiatry clinic with her mother, who reports that her daughter has lost 18 kg over the past 8 months. On examination, the patient weighs 38 kg at a height of 162 cm (BMI 14.5). She denies hunger and states she feels "fat" despite appearing visibly emaciated. Laboratory investigations reveal: serum potassium 3.2 mEq/L, magnesium 1.6 mg/dL, phosphate 2.1 mg/dL, and albumin 2.8 g/dL. ECG shows prolonged QT interval. The patient admits to strict caloric restriction and excessive exercise. What is the most likely diagnosis?

A 19-year-old female college student presents with a 2-year history of recurrent episodes of eating large quantities of food in a short time, followed by self-induced vomiting 3–4 times per week. She reports using laxatives daily and occasionally diuretics to prevent weight gain. Her weight fluctuates between 52–58 kg (BMI 20–22, within normal range). She expresses concern about her eating behavior but feels unable to control it. Physical examination reveals dental erosion, parotid gland enlargement, and calluses on her knuckles. Serum electrolytes show sodium 138 mEq/L, potassium 3.4 mEq/L, chloride 96 mEq/L, and bicarbonate 32 mEq/L. What is the most likely diagnosis?