A 46-year-old woman with a BMI of 35 reports episodes of feeling "out of control" with eating. She says that during these episodes, she eats an extremely large quantity of food in a short period of time. She eats quickly and past the point of being full, which leaves her feeling physically uncomfortable. After these episodes, she feels ashamed. She has been hiding this behavior from her friends and family for about 4 months. What is the most appropriate diagnosis?

Choice A reason: Bulimia nervosa involves binge eating followed by compensatory behaviors (e.g., vomiting, laxatives, excessive exercise). This patient does not engage in compensatory behaviors, ruling out bulimia. Choice B reason: Atypical eating disorder is a vague term not defined in DSM-5. This diagnosis is not specific enough to describe her behavior. Choice C reason: This is the correct answer. Binge eating disorder is characterized by recurrent binge episodes with a sense of loss of control, eating rapidly, and feelings of shame, without compensatory behaviors. Her BMI and 4-month history fit these criteria. Choice D reason: Avoidant-restrictive food intake disorder involves avoidance or restriction of food intake leading to nutritional deficiency or weight loss. The patient’s issue is overeating, not restriction.