Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Key diagnostic criteria for bulimia nervosa according to the DSM-5 include:
- Recurrent episodes of binge eating, characterized by eating an amount of food that is definitely larger than most people would eat in a similar period under similar circumstances, accompanied by a sense of lack of control over eating during the episode.
- Recurrent inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting, or excessive exercise.
- These binge eating and compensatory behaviors both occur, on average, at least once a week for three months.
- Self-evaluation is unduly influenced by body shape and weight.
- The disturbance does not occur exclusively during episodes of anorexia nervosa.
These criteria reflect the DSM-5 classification and are consistent with the clinical understanding underpinning UK NICE guidelines, which emphasize the presence of binge eating episodes and compensatory behaviors as core features of bulimia nervosa NICE NG69. The NICE guideline on eating disorders also highlights the importance of assessing the frequency and pattern of these behaviors and the psychological impact related to body image concerns NICE NG69. The transition from DSM-IV to DSM-5 maintained these core diagnostic features but clarified frequency and duration criteria to improve diagnostic accuracy Call et al. 2013.