214 Bulimia Nervosa (307.51)
DSM-IV-TR criteria
A. 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 any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances; it is common for more than 10,000 calories to be consumed per binge
- an abnormal constant craving for food; a sense of a lack of control of eating during an episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
- eating is usually done in secret
B. Recurrent inappropriate, compensatory behavior in order to prevent weight gain. Such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting, or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors both occur on average at least twice a week for three months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
Specify type:
- Purging Type: during a current episode of Bulimia Nervosa, the person regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, enemas or ipecac, as means of rapidly extricating the contents consumed.
- Non-purging Type: during a current episode of Bulimia Nervosa, the person uses other inappropriate compensatory behaviors, such as fasting or excessive exercise, but does not regularly engage in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
- The following six criteria should be met for a patient to be diagnosed with bulimia
- 1.The patient feels incapable of controlling the urge to binge, even during the binge itself, and consumes a larger amount of food than an average healthy person would normally consume at one sitting.
- 2.The patient purges him or herself of the recent intake, resorting to vomiting, laxatives, diuretics, exercising, etc.
- 3. The patient engages in such secretive behavior at least twice per week for three months.
- 4. The patient is focused upon body image and possesses a desperate desire to appear thin.
- 5. The patient does not meet the diagnostic criteria for anorexia nervosa
- 6.The patient is of normal weight or overweight, contrasting with characteristics of anorexia nervosa.
Associated features/ effects
A person with Bulimia Nervosa suffers from “body image disturbance”, which makes them unable to perceive their body size accurately. By having these distorted thoughts about their body, they avoid looking into a mirror. People suffering from bulimia nervosa are usually not noticed right away. They seem normal in appearance and are not noticed as easily as anorexics are in public settings. This is because they engage in binge eating activities privately as a solitary activity. People with bulimia nervosa consume their food at a rapid pace, and