If your doctor suspects you have bulimia, he or she will 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 additional tests to help pinpoint a diagnosis, rule out medical causes for weight changes and check for any related complications.

Criteria for diagnosis

For a diagnosis of bulimia, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points:

  • You recurrently have episodes of eating an abnormally large amount of food ― more than most people would eat in a similar amount of time and under similar circumstances, for example, in a two-hour time period
  • You feel a lack of control during bingeing, such as how much you're eating and whether you can stop eating
  • You get rid of the extra calories from bingeing to avoid weight gain by vomiting, excessive exercise, fasting, or misuse of laxatives, diuretics or other medications
  • You binge and purge at least once 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

The severity of bulimia is determined by the number of times a week that you purge.

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.

Jan. 29, 2016
  1. Bulimia nervosa. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed March 6, 2015.
  2. Bulimia nervosa. National Alliance on Mental Illness. http://www2.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=7638. Accessed March 6, 2015.
  3. Harrington BC, et al. Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa. American Family Physician. 2015;91:46.
  4. Lock J. An update on evidence-based psychosocial treatments for eating disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology. 2015;12:1.
  5. Foreman SF. Eating disorders: Overview of treatment. http://www.uptodate.com/home. Accessed March 6, 2015.
  6. Breuner CC. Complementary, holistic, and integrative medicine: Eating disorders. Pediatrics in Review. 2010;31:e75.
  7. Rohren CH (expert opinion). Mayo Clinic, Rochester, Minn. March 16, 2015.
  8. Cook, AJ. Decision Support System. Mayo Clinic, Rochester, Minn. Jan. 23, 2015.
  9. Bulimia — Information prescription. NHS Choices. http://www.nhs.uk/conditions/bulimia/pages/introduction.aspx. Accessed March 6, 2015.
  10. Sim LA, et al. Identification and treatment of eating disorders in the primary care setting. Mayo Clinic Proceedings. 2010;85:746.
  11. Grothe K (expert opinion). Mayo Clinic, Rochester, Minn. April 15, 2015.
  12. Couturier J, et al. Efficacy of family-based treatment for adolescents with eating disorders: A systematic review and meta-analysis. International Journal of Eating Disorders. 2013;46:3.
  13. Campbell K, et al. Eating disorders in children and adolescents: State of the art review. Pediatrics 2014;134:582.