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Tests and diagnosis
By Mayo Clinic staffWhen doctors suspect you have bulimia, they typically perform:
- A complete physical exam
- Blood and urine tests
- A psychological evaluation, including a discussion of your eating habits and attitude toward food
Your doctor may also request an X-ray to check for broken bones, pneumonia or heart problems and an electrocardiogram (EKG) to look for heart irregularities.
These tests help doctors determine if you have bulimia or another eating disorder, such as anorexia or binge-eating disorder.
Diagnostic criteria for bulimia
To be diagnosed with bulimia, you must meet these criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association:
- You repeatedly binge, eating an abnormally large amount of food, and feel that you can't control your eating.
- You get rid of the extra calories from bingeing by vomiting, excessive exercise, fasting, or misuse of laxatives, diuretics, enemas or other medications.
- You binge and purge at least twice a week for at least three months.
- Your body shape and weight influence your feelings of self-worth too much.
- You don't have anorexia, an eating disorder with extremely restrictive eating behaviors.
Even if you don't meet all of these criteria, you could still have an eating disorder. Don't try to diagnose yourself — get professional help if you have any eating disorder symptoms.
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- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4.. Accessed Jan. 17, 2012.
- Forman SF. Eating disorders: Epidemiology, pathogenesis and clinical features. http://www.uptodate.com/index. Accessed Jan 26, 2012.
- Ebert MH, et al. Current Diagnosis & Treatment: Psychiatry. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=10. Accessed Jan. 17, 2012.
- Forman SF. Eating disorders: Treatment and outcome. http://www.uptodate.com/index. Accessed Jan. 26, 2012.
- Breuner CC. Complementary, holistic, and integrative medicine: Eating disorders. Pediatrics in Review. 2010;31:c75.
- Carei TR, et al. Randomized controlled clinical trial of yoga in the treatment of eating disorders. Journal of Adolescent Health. 2010;46:346.
- Binge eating disorder. National Institute of Diabetes and Digestive and Kidney Diseases. http://win.niddk.nih.gov/publications/binge.htm. Accessed Jan. 31, 2012.
- LeGrange D, et al. Calculation of expected body weight in adolescents with eating disorders. Pediatrics. 2012;129:1.
- Sim LA, et al. Identification and treatment of eating disorders in the primary care setting. Mayo Clinic Proceedings. 2010;85:746.
- Interpersonal psychotherapy for depressed adolescents (IPT-A). National Registry of Evidence-based Programs and Practices (NREPP) Substance Abuse and Mental Health Services (SAMHS). http://nrepp.samhsa.gov/ViewIntervention.aspx?id=198. Accessed Jan. 26, 2012.
- Loeb KL, et al. Transdiagnostic theory and application of family-based treatment for youth with eating disorders. Cognitive and Behavioral Practice. 2012;1:17
- Hall-Flavin DK (expert opinion). Mayo Clinic Rochester, Minn. Feb. 22, 2012.
- Sim LA (expert opinion). Mayo Clinic Rochester, Minn. Mar. 14, 2012.
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