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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
Additionally, your doctor may also request an X-ray to check for broken bones, pneumonia or heart problems, and an electrocardiogram may be done to look for heart irregularities.
Diagnostic criteria for bulimia
These tests help doctors determine if you meet the criteria for bulimia or if you may have another eating disorder, such as anorexia or binge-eating disorder. To be diagnosed with bulimia, you must meet these criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association.
DSM criteria for bulimia include:
- Repeated episodes of binge eating, including eating an abnormally large amount of food and feeling that you lack control over your eating.
- Repeated efforts to counteract your bingeing, such as self-induced vomiting, excessive exercise, fasting, or misuse of laxatives, diuretics, enemas or other medications.
- These behaviors generally occur at least twice a week for at least three months.
- Your feelings of self-worth are overly influenced by body shape and weight.
- You don't have anorexia nervosa, another eating disorder characterized by extremely restrictive eating behaviors.
Some people may not meet all of these criteria but still have an eating disorder. Don't try to diagnose yourself — get professional help if you have any eating disorder symptoms.
- Eating disorders. In: Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://psychiatryonline.com/content.aspx?aID=3610. Accessed Nov. 2, 2009.
- Walsh BT. Eating disorders. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2865564. Accessed Nov. 1, 2009.
- Steffen KJ, et al. A survey of herbal and alternative medication use among participants with eating disorder symptoms. International Journal of Eating Disorders. 2006:39;741.
- Forman SF. Eating disorders: Epidemiology, pathogenesis and clinical features. http://www.uptodate.com/home/index.html. Accessed Nov. 2, 2009.
- Gwirtsman HE, et al. Eating disorders. In: Ebert MH, et al. Current Diagnosis & Treatment: Psychiatry. 2nd ed. New York, N.Y.: McGraw-Hill Co.; 2008. http://www.accessmedicine.com/content.aspx?aID=3288493. Accessed Nov. 1, 2009.
- Forman SF. Eating disorders: Treatment and outcome. http://www.uptodate.com/home/index.html. Accessed Nov. 2, 2009.
- Sim LA, et al. Family-based therapy for adolescents with anorexia nervosa. Mayo Clinic Proceedings. 2004;79:1305.
- Douglass L. Yoga as an intervention in the treatment of eating disorders: Does it help? Eating Disorders. 2009;17:126.
- Sim LA (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 18, 2009.
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