Diagnosis of bulimia nervosa

According to the American Psychiatric Association, a person diagnosed as bulimic must have all of the disorder's specific symptoms:

• recurrent episodes of binge eating (minimum average of two binge-eating episodes a week for at least three months)
• a feeling of lack of control over eating during the binges
• regular use of one or more of the following to prevent weight gain: self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise
• persistent over-concern with body shape and weight.

When a problem is identified, medical attention should be sought immediately.  The doctor will take a complete medical history and conduct a physical exam.  Laboratory blood studies, including measurement of electrolyte levels, will be ordered as well.   The doctor will ask about eating patterns, looking for such behavior as:

• repeated short episodes of binge eating followed by self- induced vomiting or use of laxatives
• alternate fasting and binging
• secret eating and binging
• exercising excessively to prevent weight gain.

Once the diagnosis is made, early treatment is vital.