Which of the following can trigger a binge purge episode?

The correct choice is C, as anxiety or negative emotions are well-documented triggers for binge-purge episodes, particularly in individuals struggling with eating disorders such as bulimia nervosa. When someone experiences intense feelings of anxiety, stress, or sadness, they may seek relief through food as a way to cope with those overwhelming emotions. This can lead to a cycle where negative feelings prompt excessive eating, which is then followed by purging as a way to regain control or alleviate guilt.

In contrast to this, feelings of excitement or joy (what would correspond to choice A) typically do not foster the same compulsive behaviors associated with binge eating. Instead, neutral feelings or stability (related to choice B) can provide a sense of calm that is less likely to lead to extreme eating behaviors. A balanced diet (choice D) corresponds to a healthier relationship with food and can help stabilize emotions, making it less likely to trigger a binge-purge cycle. Thus, anxiety or negative emotions serve as significant catalysts in the development of these disordered eating patterns.