DSM-5 Diagnostic Criteria for Bulimia Nervosa

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes the following diagnostic criteria for bulimia nervosa:

• Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
  • Eating, in a discrete period of time (e.g., within a two hour period), an amount of food that is definitely larger than what most people would eat during a similar period of time and under similar circumstances.
  • Lack of control over eating during the episode (e.g., a feeling that you cannot stop eating, or control what or how much you are eating).
• Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
• The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
• Self-evaluation is unduly influenced by body shape and weight.
• Binging or purging does not occur exclusively during episodes of behavior that would be common in those with anorexia nervosa.

Diagnostic Tests for Bulimia Nervosa

If your doctor suspects that you have bulimia, they will typically conduct several tests to help narrow down the diagnosis, eliminate other medical causes for weight loss or gain and check for any related complications.

• Physical Exam. This may include measuring your height and weight; checking your vital signs, such as heart rate, blood pressure and temperature; checking your skin and nails; listening to your heart and lungs, and examining your abdomen.
• Lab Tests. These may include a complete blood count and more specialized tests to check electrolytes and protein, as well as liver, kidney and thyroid functions. A urinalysis may also be performed.
• Psychological Evaluation. A therapist or mental health provider will likely inquire about your thoughts, feelings and eating habits. You may also be asked to complete a psychological self-assessment questionnaire.
• Other Studies. X-rays may be taken to measure your bone density, check for stress fractures or broken bones, or evaluate you for pneumonia or heart problems. Electrocardiograms may be used to identify heart irregularities. Tests may also be used to determine how much energy your body uses, which can help in planning nutritional requirements.

Based on the results of these tests, an appropriate treatment program will be recommended for you or your family member/loved one.

Read our blog posts about bulimia to learn more about bulimia symptoms, treatment and more.

Regain Your Life. Walden Can Help.

If you are concerned that you – or a loved one – may have an eating disorder, we are here to help. Please call 781-647-6727 to speak with a Walden eating disorders intake specialist, or complete the form on this page, to start on the road to recovery.