A 42-year-old woman presents with a 2-year history of chronic nausea, postprandial fullness, and early satiety. These symptoms occur daily. She reports non-bilious vomiting of undigested food around three times a week. The symptoms are exacerbated by large, fatty, or high-fiber meals. She notes an unintentional 15-pound weight loss over the past two years. Her medical history is significant for hypothyroidism. She takes levothyroxine daily. She has no history of diabetes mellitus, prior abdominal surgeries, or eating disorders. She denies using opioid analgesics, anticholinergic medications, cannabis, or nonsteroidal anti-inflammatory drugs. She does not smoke cigarettes and drinks alcohol only on rare social occasions. A review of systems is otherwise unremarkable.