A dentist refers a 21-year-old woman with a BMI of 26 to the PMHNP after he discovers significant enamel erosion and decay of her front teeth. What diagnosis does the dentist suspect?

Choice A reason: Anorexia nervosa involves restriction of caloric intake and often leads to significantly low body weight. This patient’s BMI is in the overweight range, making anorexia less likely. Choice B reason: Binge eating disorder involves recurrent episodes of excessive food consumption without compensatory behaviors. While it may affect BMI, it typically does not cause enamel erosion. Choice C reason: Atypical eating disorder is a broad category used when individuals exhibit some symptoms of eating disorders but do not meet full criteria. The pattern of enamel erosion strongly suggests purging behavior, indicating a more specific diagnosis. Choice D reason: This is correct. Bulimia nervosa involves recurrent binge eating episodes followed by compensatory behaviors such as self-induced vomiting. Repeated vomiting exposes teeth to gastric acid, causing enamel erosion and dental decay, which aligns with the dentist’s findings.