A 22-year-old woman presents to the clinic complaining of severe fatigue, palpitations, and near-syncope for the past week. She reports feeling “completely drained” and has experienced intermittent muscle cramping in her legs. She denies any recent illnesses, diarrhea, or significant changes in her daily routine, though she expresses intense dissatisfaction with her body weight and shape, and exercises vigorously for 2 hours daily. She has a past medical history of generalized anxiety disorder but denies any substance use. Upon further questioning, she admits to feeling out of control with her eating at times, which is followed by immense guilt and self-induced vomiting multiple times a day. She appears anxious and fatigued but is in no acute respiratory distress. She is afebrile. Her blood pressure is 100/60 mmHg with a heart rate of 110 bpm, a respiratory rate of 14 breaths per minute, and a body mass index of 23 kg/m².