A 38-year-old woman with no prior psychiatric or medical history presents with a craving for toothpaste for the past four months. She admits that this has gotten out of control recently, and she now ingests approximately five tubes of toothpaste each week. She also complains of experiencing fatigue easily over the last year but attributed this to her busy life as a working mother of three, with her youngest child, who is 3 years old, still being breastfed. Upon further questioning, she reveals that she follows a vegetarian diet and is often very selective when it comes to food. She also confesses to a habit of biting and consuming her nails, which was first noticed during the latter half of her second pregnancy. Her gynecological and family histories are unremarkable. She drinks alcohol only socially and does not smoke. A urine pregnancy test is negative.