Differential Diagnosis
The following differential diagnosis is based on the provided symptoms:
- Single most likely diagnosis:
- Other Specified Feeding or Eating Disorder (OSFED): This diagnosis is likely because the individual restricts food intake during the day and has a tendency to binge eat when emotional, but does not meet the full criteria for binge eating disorder or other eating disorders.
- Other Likely diagnoses:
- Anorexia Nervosa (Restricting Type): Although the individual does not identify with having binge eating disorder, they may still meet the criteria for anorexia nervosa if their restrictive eating patterns and emotional binge eating are severe enough.
- Avoidant/Restrictive Food Intake Disorder (ARFID): This diagnosis is possible if the individual's restrictive eating patterns are due to a lack of interest in food or avoidance of certain foods, rather than a fear of gaining weight or body image concerns.
- Bulimia Nervosa: Although the individual does not identify with having binge eating disorder, they may still meet the criteria for bulimia nervosa if their binge eating episodes are followed by compensatory behaviors, such as self-induced vomiting or excessive exercise.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Diabetes: Restrictive eating patterns and binge eating can lead to unstable blood sugar levels, which can be life-threatening if not properly managed.
- Electrolyte Imbalance: Purging behaviors, such as self-induced vomiting, can lead to electrolyte imbalances, which can be life-threatening if not properly treated.
- Cardiac Complications: Severe restrictive eating and binge eating can lead to cardiac complications, such as bradycardia or cardiac arrhythmias, which can be life-threatening if not properly managed.
- Rare diagnoses:
- Pica: This diagnosis is possible if the individual's restrictive eating patterns are accompanied by cravings for non-food substances, such as dirt or chalk.
- Rumination Disorder: This diagnosis is possible if the individual's binge eating episodes are accompanied by regurgitation and re-chewing of food, which can lead to digestive problems and other complications.