Frisiangal, thanks for your feedback.
I don't have your medical astrology background, but just go by the old system of "the man of the signs," where Aries rules the head, Cancer the stomach, on down to Pisces and the feet. Then medical astrology is one of the few traditional systems where we can also go "by the numbers" for the houses.
I think I got that principle off an old Julia and Derek Parker introductory textbook on astrology.
No, I don't do Vedic astrology. I can't say how a Vedic astrologer would answer the question.
I don't dispute what you write about Pluto. Very well stated. But each planet, sign, and house has multiple interpretations consistent with its core meanings. Pluto is one of the rulers of vomiting.
We already know the querent suffers from bulimia. To me, Pluto in the 4th house is entirely consistent with her medical problem, especially with Pluto in hard aspect to her first house sun (identity.)
It's hard to "prove" anything in astrology. No astrological signature works 100%, probably because a horoscope has hundreds of data bytes.
But we do use "cookbook" signatures when learning astrology and delineating charts. What I did with Ceres in hard aspect to Pluto was a cookbook example. I wish I remember where I found it.
Diana, Princess of Wales suffered from both bulimia and anorexia, but with onsets in adulthood.
Natally her 4th house (stomach) is ruled by Mars, which conjuncts her natal Pluto.
She told an interviewer ca. 1990 that her bulimia started the week after her engagement to Prince Charles, which was on February 24, 1981. It's hard to put an exact date on it, but I tried March 1, 1981.
https://www.vogue.com/article/princess-diana-real-life-battle-with-bulimia
Natally Diana's Ceres-Pluto midpoint conjuncted her Cancer sun. On March 1, 1981, Ceres had recently transited over her natal sun and Pluto-Ceres midpoint; and Chiron had recently passed her natal Ceres. She was also just past a sun-Chiron double-whammy. Sometime during that week the transiting moon hit Diana's natal Saturn.
So I think there is a Pluto-Ceres connection with bulimia, although it isn't always so straightforward as a highly visible opposition.
Diana was known to have mother troubles. But I think it's a bit much to blame bulimia on Mum. In Diana's case, it was apparently trigged by Prince Charle's behavior: kidding her for being "chubby" and continuing to phone Camilla Parker-Bowles.
Incidentally, pears and apples are closely botanically related.