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Tests and diagnosis
By Mayo Clinic staffWhen doctors suspect you have bulimia, they typically perform a battery of tests and exams. These can help pinpoint a diagnosis and assess any related complications you may have.
These exams and tests generally include:
- A physical exam. This may include such things as measuring height and weight; assessing body mass index; checking vital signs, such as heart rate, blood pressure and temperature; checking your skin for dryness or other problems; listening to your heart and lungs; examining your abdomen; and checking your glands for swelling.
- Laboratory tests. These may include a complete blood count (CBC), as well as more-specialized blood tests to check electrolytes and protein, and liver, kidney and thyroid function. A urinalysis also may be done.
- A psychological evaluation. A doctor or mental health professional will discuss your thoughts, feelings and eating habits with you. You may be asked about bulimia symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar issues in the past. You may also be asked to complete psychological self-assessments and questionnaires.
- Other studies. X-rays may be taken to check for broken bones, pneumonia or heart problems that severe bulimia may cause. Electrocardiograms may be done to look for heart irregularities. You may also have other tests to check for health complications.
Diagnostic criteria for bulimia
All these evaluations 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 and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.
DSM diagnostic 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 make up for your bingeing, such as self-induced vomiting, excessive exercise, fasting, or misuse of laxatives, diuretics, enemas, or other medications.
- These behaviors occur at least twice a week for at least three months.
- Your evaluation of yourself is overly influenced by body shape and weight.
- Your eating disorder behavior doesn't occur during periods of anorexia.
Some people may not meet all of these criteria but still have an eating disorder. As researchers learn more about eating disorders, the diagnostic criteria may evolve and change. Don't try to diagnose yourself — get professional help if you have any eating disorder symptoms.
