A 23 year old woman with a history of diabetes, hypertension, chronic pain, phobias, major depressive disorder, and alcohol dependence is brought in by her sister who is worried about an eating disorder. Her sister says the patient will eat unusually large amounts of food from time to time. The patient says she "just can't help it" and will eat rapidly until uncomfortably full, even when she is not hungry. The sister says the patient often eats alone because she feels ashamed and guilty. This has been happening once or twice a week for many months. Nevertheless, the patient denies purging, fasting, or excessive exercise.
Challenge: What is the most accurate diagnosis?