Materiały źródłowe

• #1 Bulimia Nervosa – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562178/

  Bulimia nervosa is a disorder that is characterized by binge eating and inappropriate compensatory behavior to control weight with potentially dangerous sequelae. It is essential to identify and diagnose this condition promptly and to treat the patient effectively while monitoring progress and potential medical complications. This activity describes the evaluation and management of bulimia nervosa and highlights the role of the interprofessional team in the care of patients with this condition. […] The Diagnostic and Statistical Manual of Mental Disorders- 5th edition (DSM-V) defines the following diagnostic criteria for bulimia nervosa: Episodes of binge eating: Patients are eating portions more significant than what most people would consume in a similar period (usually less than 2 hours) and under comparable conditions. During eating episodes, the patient loses control and is unable to curb the servings he consumes.

• #1 Bulimia Nervosa: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/286485-overview

  DSM-5-TR diagnostic criteria require that the binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months. […] Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DMS-5-TR) diagnostic criteria for bulimia nervosa (BN) are as follows: Recurrent episodes of binge eating: An episode of binge eating is characterized by both (1) eating, in a discrete period of time (eg, within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances and (2) a sense of lack of control over eating during the episode. […] Specify current severity. The minimum level of severity is based on the frequency of inappropriate compensatory behaviors. The level of severity may be increased to reflect other symptoms and the degree of functional disability. Specify current severity as follows: Mild: An average of 1-3 episodes of inappropriate compensatory behaviors per week, Moderate: An average of 4-7 episodes of inappropriate compensatory behaviors per week, Severe: An average of 8-13 episodes of inappropriate compensatory behaviors per week, Extreme: An average of 14 or more episodes of inappropriate compensatory behaviors per week.

• #1 Anorexia vs. Bulimia: The Key Differences | The Bulimia Project

  https://bulimia.com/eating-disorders/anorexia-vs-bulimia/

  The Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5) is a comprehensive manual that provides diagnostic criteria for mental health conditions. According to the DSM-5, bulimia nervosa has the following diagnostic criteria. […] A person with bulimia has recurrent episodes of binge eating. Binge eating is a pattern of behavior where a person eats significantly more food in two hours than the average person would in similar circumstances and during that same period. […] Binging is also characterized by a loss of a sense of control over how much or what is eaten. Eating when not feeling physically hungry, eating past the point of feeling full, or experiencing a sense of guilt or embarrassment following an episode are also part of the diagnosis. […] Compensatory behaviors are behaviors a person engages in to make up for specific actions. In the case of bulimia nervosa, these behaviors are used to compensate for binge eating.

• #1 Bulimia: Symptoms, diagnosis and treatments – Harvard Health

  https://www.health.harvard.edu/mind-and-mood/bulimia-symptoms-diagnosis-and-treatments

  An important element for diagnosing bulimia is the individual’s story of how she or he is feeling. […] A health care professional will also do a physical exam and may recommend blood tests to check for problems associated with vomiting or laxative use. […] The exam will also explore whether there are any other areas of mental distress, such as obsessive-compulsive disorder, an anxiety or mood disorder, or problems with substance use.

• #1 Bulimia Nervosa – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562178/

  The episodes should occur at least once a week for three months to establish a diagnosis. […] A thorough evaluation of a patient with bulimia nervosa should include the following: A comprehensive metabolic panel, including electrolytes, liver function tests, blood urea nitrogen, serum creatinine, and calcium. […] The primary objective of treatment is a cessation of the binging and purging behavior. […] The clinician should make a diagnosis of bulimia nervosa after excluding all other medical causes of vomiting and excessive bowel activity, particularly if the patient states that binging or purging behavior is involuntary. […] Most patients who have bulimia nervosa will recover from the condition. The five-year remission rate for bulimia nervosa using DSM-IV criteria has an estimate of 74%, and among those, 47% also had a relapse within those five years. Another study based on DSM-V criteria listed a 55% five-year recovery rate for bulimia nervosa in the community. […] Bulimia nervosa is proven to be associated with an increase in all-cause mortality.

• #1 Bulimia Nervosa: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/286485-overview

  Bulimia nervosa (BN) is an eating disorder with 5 key characteristics as noted by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). […] The diagnosis is usually made by assessment of reported behavior, but laboratory studies are helpful to support the diagnosis and, importantly, assess severity of the condition and determine level of care. […] Lab studies that may be used for diagnosis include: Serum electrolytes, Lipid panel, Serum glucose, Liver function and associated tests, Renal function tests, Urinalysis, Serum gonadotropins and sex hormones, Thyroid hormone testing, Bone densitometry (DXA scan), Dental radiography (if indicated), Urine toxicology (if indicated). […] Because of the potential for arrhythmias and cardiomyopathy as possible complications of BN, an electrocardiogram (ECG) should be performed in patients who are very thin, complaining of palpitations, or have other signs or symptoms of cardiovascular concern.

• #1 Assessment and Treatment of Bulimia Nervosa | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0601/p2743.html

  To ensure that the treatment approach is properly designed and effective, the physician must look carefully for symptoms of comorbid psychiatric illness in patients with bulimia nervosa. […] A comprehensive evaluation provides the rationale for this judgment and includes the following: Standardized testing to document the patient’s general personality features, characterologic disturbance and attitudes about eating, body size and weight. […] Considerable research has been devoted to identifying the most effective pharmacologic and psychologic treatments for bulimia nervosa, including the effects of different medications and the benefits of different psychotherapy approaches. […] Despite differences in the application of techniques, the skill level of clinicians and the duration of the illness, controlled studies have clearly established the superiority of cognitive-behavioral therapy for the treatment of bulimia nervosa.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Bulimia-Nervosa-Diagnosis.aspx

  The evaluation may include a doctor-patient interview or a self-reported questionnaire, both of which assess the characteristics that are indicative of the disorder. The Eating Disorders Examination (EDE) is commonly used for this purpose, although there are also other valid tests that may be used. […] The SCOFF questionnaire is helpful to identify patients that meet the diagnostic criteria for anorexia or bulimia nervosa. […] There are also several other tests that may be used to rule out other conditions that may be causing the symptoms, or to investigate the severity of the condition and possible complications. […] It can often be very difficult for patients to accept the diagnosis of bulimia, particularly if they do not believe there is anything inherently wrong with the eating habits.

• #1 Bulimia Nervosa Differential Diagnoses

  https://emedicine.medscape.com/article/286485-differential

  Some of the differential diagnoses for bulimia nervosa (BN) are discusses in the sections that follow. […] Patients meet universal, medically accepted criteria for malnutrition based on body weight. […] The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months. […] The disturbance does not occur exclusively during episodes of AN. […] Differential Diagnosis of Bulimia Nervosa.

• #1 Bulimia nervosa | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/bulimia-nervosa

  Diagnosing bulimia nervosa can be difficult, because people with this condition: […] For these reasons, bulimia nervosa can go undiagnosed for a long time. […] If you think you (or someone you know) might have bulimia nervosa, it is important that you see your doctor as soon as possible. The sooner you seek help, the sooner you can start to recover, and the more effective treatment can be. […] To diagnose bulimia nervosa, a doctor: […] will need to do a full physical check-up […] may complete blood tests […] may ask questions about your health including questions about your emotional health and wellbeing, medical history and lifestyle.

• #1 Mental health providers may have trouble detecting bulimia in patients, study finds – UF Health

  https://ufhealth.org/news/2025/mental-health-providers-may-have-trouble-detecting-bulimia-in-patients-study-finds

  A new University of Florida study finds that mental health providers may not be accurately diagnosing bulimia in patients. […] When presented with a vignette describing the behaviors and characteristics of a patient with disordered eating, only a quarter of mental health providers who participated in a new study were able to correctly diagnose bulimia nervosa. […] The study findings also suggest that providers may not associate excessive exercise with bulimia, despite the fact that it is listed in the Diagnostic and Statistical Manual of Mental Disorders as one of multiple compensatory strategies used by people with bulimia. […] Only 27% of providers correctly diagnosed the patient as having bulimia nervosa, and 38% of providers incorrectly diagnosed the patient with binge eating disorder.

• #1 Bulimia Treatment in New Jersey

  https://www.rwjbh.org/treatment-care/mental-health-and-behavioral-health/conditions/eating-disorders/bulimia-nervosa/

  Although there are no specific tests to diagnose bulimia, a comprehensive evaluation, including medical history, physical exam, various diagnostic tests, and a mental health assessment can help pinpoint a diagnosis. […] Health care providers will explore a diagnosis of bulimia from many angles including: […] In addition, certain medical conditions may be possible signs of bulimia. Health care providers may look for: […] Early diagnosis is important to achieve the best recovery outcome. If you or someone you know is experiencing signs and symptoms of bulimia, be sure to talk to a health care provider as soon as possible.

• #1 Bulimia Nervosa: Diagnostic Clarification and Determining Levels of Care

  https://www.psychiatrictimes.com/view/bulimia-nervosa-diagnostic-clarification-and-determining-levels-of-care

  BN diagnoses in general have trended upward over the past decade, contributing to an estimated 6.3 million Americans currently meeting criteria. […] However, it is known that BN (similar to other EDs) is underdiagnosed in the community. […] Identification of BN begins with utilization of active listening and observation of cues that may indicate underlying symptoms. […] If any of these signs are observed, it is recommended to utilize screening tools to assist in diagnosis. […] It is also encouraged to directly follow the diagnostic criteria accepted by the American Psychiatric Association. […] Hospitalization should be considered if any of the items in Table 2 are observed with confirmation of diagnosis. […] Moreover, residential treatment is an appropriate option for those who simply do not have the capacity to fulfill day-to-day functions due to the presence of ED behaviors and persistent intrusive thoughts related to compensatory behaviors.

• #1 Bulimia Nervosa: Diagnosing a Stigmatized Eating Disorder

  https://www.ebsco.com/blogs/health-notes/bulimia-nervosa-diagnosing-stigmatized-psychiatric-disorder

  Bulimia nervosa is an eating disorder characterized by frequent uncontrolled binge eating followed by compensatory behaviors to prevent weight gain, such as vomiting, use of laxatives or diuretics, fasting, and/or excessive exercise. […] To establish a diagnosis of bulimia nervosa, the DSM-5 criteria require recurrent episodes of binge eating and compensatory behaviors that occur at least once weekly for at least three months. […] The 2023 American Psychiatric Association recommends screening for the presence of eating disorders as part of an initial psychiatric evaluation. […] Physical signs of bulimia nervosa may be more obvious. Recurrent vomiting can cause poor oral health, including tooth erosion, gum disease, dental caries, palatal scratches, salivary gland enlargement, and other signs. […] Once diagnosis is confirmed, most patients can be treated in an outpatient setting with individual or family psychotherapy, nutrition counseling and support, and treatment of sequalae and overall health.

• #2 Bulimia Nervosa – National Eating Disorders Association

  https://www.nationaleatingdisorders.org/bulimia-nervosa/

  Bulimia nervosa (BN) is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating. […] According to the DSM-5 TR, the official diagnostic criteria for bulimia nervosa is: Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating). […] Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise. […] The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months. […] Self-evaluation is unduly influenced by body shape and weight. […] The disturbance does not occur exclusively during episodes of anorexia nervosa.

• #2 Testing & Assessments for Eating Disorders

  https://www.eatingdisorderhope.com/information/eating-disorder/testing-assessments

  Eating disorders are more commonly discussed in our culture, however, much of what people believe they understand about eating disorders is false. Identifying, diagnosing, and treating these disorders is much more complicated than many assume. […] To diagnose eating disorders, doctors, therapists, and psychiatrists must consider specific criteria that are identified and can be measured using psychological assessments as well as physical examinations. […] The DSM-5 specifies that the following criteria must be met for a full Bulimia Nervosa diagnosis: Recurrent episodes of binge eating, which are characterized by BOTH of the following: “Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating). Recurrent, inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months. Self-evaluation is unduly influenced by body shape and weight. The disturbance does not occur exclusively during episodes of anorexia nervosa. […] Severity of Bulimia Nervosa is determined by the average episodes of inappropriate compensatory behaviors an individual engages in per week.

• #2 Browse Resources

  https://nedc.com.au/eating-disorder-resources/find-resources/show/issue-13-dsm-5-overview-of-changes

  The DSM-5 approach to eating disorders has ultimately been relatively conservative: to retain anorexia nervosa and bulimia nervosa with more inclusive criteria and to introduce binge-eating disorder as a distinct diagnosis. […] DSM-5 criteria have reduced the frequency of binge eating and compensatory behaviours that people with bulimia nervosa must exhibit from twice a week to once a week. In addition, the purging and non-purging subtypes have been removed. […] Frequency of inappropriate compensatory behaviours has been used to specify the level of severity for BN. Severity is indicated by: Mild; An average of 1-3 episodes per week, Moderate; An average of 4 – 7 episodes per week, Severe; An average of 8-13 episodes per week, Extreme; An average of 14 or more episodes per week.

• #2 Bulimia nervosa | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/bulimia-nervosa

  Diagnosing bulimia nervosa can be difficult, because people with this condition: […] For these reasons, bulimia nervosa can go undiagnosed for a long time. […] If you think you (or someone you know) might have bulimia nervosa, it is important that you see your doctor as soon as possible. The sooner you seek help, the sooner you can start to recover, and the more effective treatment can be. […] To diagnose bulimia nervosa, a doctor: […] will need to do a full physical check-up […] may complete blood tests […] may ask questions about your health including questions about your emotional health and wellbeing, medical history and lifestyle.

• #2 Bulimia – NHS

  https://www.nhs.uk/mental-health/conditions/bulimia/

  If you see a GP about symptoms of bulimia, they’ll ask you about your eating habits, how you’re feeling and your physical symptoms. […] If they think you have bulimia or another eating disorder, they will refer you to an eating disorder specialist or team of specialists.

• #2 Bulimia nervosa – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/441

  Other diagnostic factors: age 20-35 years, menstrual irregularity, drug-seeking behavior, deliberate misuse of insulin, self-injurious behavior, gastrointestinal symptoms, history of dieting, marked fluctuations in weight, shoplifting behavior, use of ipecac, needle marks on skin, vomiting in pregnancy. […] Diagnostic tests: 1st tests to order: serum electrolytes, serum creatinine, serum magnesium, urine pregnancy test, serum LFTs, serum creatine kinase (CK), CBC, urinalysis.

• #2 Bulimia nervosa | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/mental-health/eating-disorders/bulimia-nervosa/

  When making a diagnosis, your GP will probably ask questions about your eating habits. […] Its important to answer these questions honestly. Your GP isnt trying to judge you or catch you out. They just need to accurately assess your symptoms. […] Your GP may also check your weight and other physical measurements. If this feels frightening, you can request that you are not told your weight. […] Your GP might check your pulse and blood pressure. […] Sometimes an electrocardiogram (ECG) may be needed to check how well your heart is working. […] Blood tests look for the complications of bulimia nervosa. Even if they come back as normal, your GP may still refer you to an eating disorder specialist if youre experiencing bulimia nervosa symptoms.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Bulimia-Nervosa-Diagnosis.aspx

  The evaluation may include a doctor-patient interview or a self-reported questionnaire, both of which assess the characteristics that are indicative of the disorder. The Eating Disorders Examination (EDE) is commonly used for this purpose, although there are also other valid tests that may be used. […] The SCOFF questionnaire is helpful to identify patients that meet the diagnostic criteria for anorexia or bulimia nervosa. […] There are also several other tests that may be used to rule out other conditions that may be causing the symptoms, or to investigate the severity of the condition and possible complications. […] It can often be very difficult for patients to accept the diagnosis of bulimia, particularly if they do not believe there is anything inherently wrong with the eating habits.

• #2 Assessment and Treatment of Bulimia Nervosa | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0601/p2743.html

  To ensure that the treatment approach is properly designed and effective, the physician must look carefully for symptoms of comorbid psychiatric illness in patients with bulimia nervosa. […] A comprehensive evaluation provides the rationale for this judgment and includes the following: Standardized testing to document the patient’s general personality features, characterologic disturbance and attitudes about eating, body size and weight. […] Considerable research has been devoted to identifying the most effective pharmacologic and psychologic treatments for bulimia nervosa, including the effects of different medications and the benefits of different psychotherapy approaches. […] Despite differences in the application of techniques, the skill level of clinicians and the duration of the illness, controlled studies have clearly established the superiority of cognitive-behavioral therapy for the treatment of bulimia nervosa.

• #2 Bulimia nervosa differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Bulimia_nervosa_differential_diagnosis

  Bulimia nervosa should also be differentiated from other diseases that cause chronic nausea and vomiting. […] Bulimics feel more shame and out of control with their behaviors, as the anorexic meticulously controls their intake, a symptom that calms their anxiety around food as s/he feels s/he has control of it, nave to the notion that it, in fact, controls him/her. […] The bulimic is more likely to admit to having a problem, as they do not feel they are in control of their behavior. […] Bulimics feel that they are a failure because s/he cannot achieve a low weight, and this outlook infiltrates into all aspects of their lives. […] Bulimia nervosa Diagnostics, Diagnosis.

• #2 Bulimia nervosa – Wikipedia

  https://en.wikipedia.org/wiki/Bulimia_nervosa

  Diagnosis is based on a person’s medical history; however, this is difficult, as people are usually secretive about their binge eating and purging habits. […] Bulimia Nervosa is diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The diagnostic criteria include the following: Recurrent episodes of binge eating, Recurrent inappropriate compensatory behavior to prevent weight gain, like self-induced vomiting, misuse of laxatives or other medications, fasting, or excessive exercise. […] Other methods are also used to narrow down the diagnosis, such as physical exams (measuring height, weight, and vitals, or checking skin, nails, heart and lungs), or lab tests (for blood count, electrolytes, protein, or urinalysis).

• #2 Mental health providers may have trouble detecting bulimia in patients, study finds – UF Health

  https://ufhealth.org/news/2025/mental-health-providers-may-have-trouble-detecting-bulimia-in-patients-study-finds

  Correctly distinguishing between bulimia, binge eating or any other eating disorder is critical, the authors say, not only to ensure patients receive the right treatment, but also to appropriately monitor for other health effects, such as dangerously low sodium levels caused by excessive exercise. […] The findings also point to the need for more continuing education on eating disorders for mental health providers who may not have specialized training.

• #2 Early detection of eating disorders in general practice

  https://www.racgp.org.au/afp/2017/november/early-detection-of-eating-disorders

  Physical examination and investigation are the next steps in assessment, but there may not be any abnormal physical findings and, often, laboratory results are normal. […] The first priority in the management of a patient with an eating disorder is securing medical and psychiatric safety. […] The criteria for admission to hospital are listed in Table 4. […] For most patients who will not need immediate hospitalisation, treatment should be individualised and take place initially in an outpatient community setting, if possible. […] The role of the GP includes assessment and initial diagnosis (including urgent referral to the emergency department, if indicated). […] The more detailed aspects of management are beyond the scope of this article, but are provided in the list of resources supplied. […] Eating disorders are serious, lifethreatening conditions with significant physical, psychiatric, psychosocial and financial outcomes. […] The impact of these consequences can be minimised or avoided by early identification and management in the general practice setting.

• #2 Bulimia Nervosa: Diagnostic Clarification and Determining Levels of Care

  https://www.psychiatrictimes.com/view/bulimia-nervosa-diagnostic-clarification-and-determining-levels-of-care

  When the discussion of treatment initiation occurs, it is imperative to provide a sense of validation and support to the patient, as treatment for EDs can elicit feelings of fear or failure, which have been shown to intensify comorbid symptoms. […] Research demonstrates that prognosis improves greatly when practitioners can diagnose and treat promptly at the first signs of BN. […] Longitudinal outcome data indicate 45% to 50% of patients show full recovery from BN, with patients diagnosed during the first 4 years of their symptomatology achieving better results.

• #2 What Does a Bulimia Diagnosis Mean? – Eating Disorder Recovery Specialists

  https://eatingdisorderspecialists.com/what-does-a-bulimia-diagnosis-mean/

  When someone is diagnosed with bulimia, it indicates that their eating behaviors, habits and relationship with food have reached a critical level that is dangerous to both their physical and mental health. […] When you receive a bulimia nervosa diagnosis it means that you, or someone you love, is struggling to manage what they eat, how they eat, how they purge the food eaten and how they take care of their body. […] This concern has led to talking with a mental health provider or doctor which is what leads to a formal bulimia diagnosis. […] Its important to note that Dr. Google isnt enough to get a diagnosis. […] If you confide in a friend or loved one and its suggested that you speak to a medical doctor or therapist, its wise to share the extent of your bulimia symptoms. […] The American Psychiatric Association says that the first step in treating an individual with bulimia nervosa is to disrupt his or her harmful cycle of binging and purging. […] Healing from bulimia is a life long process for many people.

• #2 Early Diagnosis and Management of Bulimia Nervosa in Type 1 Diabetes

  https://www.psychiatrist.com/pcc/bulimia-nervosa-in-type-1-diabetes/

  Treatment outcomes for bulimia nervosa in type 1 diabetes are worse than those for conventional bulimia nervosa. […] These outcomes may be a consequence of late detection and subsequent management. […] Early intervention is required to prevent short- and longer-term complications, with intensive treatment approaches having the best current evidence. […] Collaboration is required between specialist services for patients to receive optimal care. […] This narrative review summarizes the latest published evidence in the formulation, detection, and subsequent management of bulimia nervosa in type 1 diabetes, while highlighting the need for higher-quality research in the assessment and treatment of these comorbidities. […] Early recognition and treatment of bulimia nervosa in type 1 diabetes results in better outcomes.

• #2 Screening, assessment and diagnosis in the eating disorders: findings from a rapid review | Journal of Eating Disorders | Full Text

  https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00597-8

  Clinicians report greater awareness of diagnostic criteria for Anorexia Nervosa (AN) and Bulimia Nervosa (BN), compared to other ED diagnoses; in particular Binge Eating Disorder (BED) and Other Specified Feeding or Eating Disorders (OSFED) (including Atypical AN (A-AN)). […] Improving clinical knowledge of diverse ED behaviors and symptoms will be important for ensuring accurate diagnosis and assessment of EDs in primary care settings and enabling early intervention in the form of timely referral and access to appropriate care per diagnostic type. […] Limited screening practices and tools within both healthcare and more diverse settings is an additional barrier to early intervention for individuals impacted by EDs, and means even high-risk groups such as dieting adolescents, women seeking reproductive healthcare, and individuals with diabetes and other comorbidities are not screened, and early symptomatology undetected.

• #3 Table 20, DSM-IV to DSM-5 Bulimia Nervosa Comparison – DSM-5 Changes – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t16/

  A. Recurrent episodes of binge eating, as characterized by both: […] B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting or excessive exercise. […] C. The binge eating and inappropriate compensatory behaviors occur, on average, at least once a week for 3 months. […] D. Self-evaluation is unjustifiability influenced by body shape and weight. […] E. The disturbance does not occur exclusively during episodes of anorexia nervosa. […] Specify type: […] Not a criterion. […] Specify if: […] Not a criterion. Current severity1: […] The level of severity may be increased to reflect other symptoms and the degree of functional disability.

• #3 Testing & Assessments for Eating Disorders

  https://www.eatingdisorderhope.com/information/eating-disorder/testing-assessments

  Eating disorders are more commonly discussed in our culture, however, much of what people believe they understand about eating disorders is false. Identifying, diagnosing, and treating these disorders is much more complicated than many assume. […] To diagnose eating disorders, doctors, therapists, and psychiatrists must consider specific criteria that are identified and can be measured using psychological assessments as well as physical examinations. […] The DSM-5 specifies that the following criteria must be met for a full Bulimia Nervosa diagnosis: Recurrent episodes of binge eating, which are characterized by BOTH of the following: “Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating). Recurrent, inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months. Self-evaluation is unduly influenced by body shape and weight. The disturbance does not occur exclusively during episodes of anorexia nervosa. […] Severity of Bulimia Nervosa is determined by the average episodes of inappropriate compensatory behaviors an individual engages in per week.

• #3 Bulimia nervosa | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/mental-health/eating-disorders/bulimia-nervosa/

  When making a diagnosis, your GP will probably ask questions about your eating habits. […] Its important to answer these questions honestly. Your GP isnt trying to judge you or catch you out. They just need to accurately assess your symptoms. […] Your GP may also check your weight and other physical measurements. If this feels frightening, you can request that you are not told your weight. […] Your GP might check your pulse and blood pressure. […] Sometimes an electrocardiogram (ECG) may be needed to check how well your heart is working. […] Blood tests look for the complications of bulimia nervosa. Even if they come back as normal, your GP may still refer you to an eating disorder specialist if youre experiencing bulimia nervosa symptoms.

• #3 Bulimia Nervosa – Mental Health Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/mental-health-disorders/eating-disorders/bulimia-nervosa

  Doctors suspect the diagnosis when people are overly concerned about their weight and their weight fluctuates a lot. […] Doctors diagnose bulimia nervosa when people, particularly young women, do the following: Report binge eating at least once a week for 3 months or more. […] Doctors also check for other clues that support the diagnosis of bulimia nervosa: Wide fluctuations in weight, especially if there are clues suggesting excessive laxative use (such as diarrhea and abdominal cramps). […] A low level of potassium detected by a blood test.

• #3 Bulimia Nervosa: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/286485-overview

  Bulimia nervosa (BN) is an eating disorder with 5 key characteristics as noted by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). […] The diagnosis is usually made by assessment of reported behavior, but laboratory studies are helpful to support the diagnosis and, importantly, assess severity of the condition and determine level of care. […] Lab studies that may be used for diagnosis include: Serum electrolytes, Lipid panel, Serum glucose, Liver function and associated tests, Renal function tests, Urinalysis, Serum gonadotropins and sex hormones, Thyroid hormone testing, Bone densitometry (DXA scan), Dental radiography (if indicated), Urine toxicology (if indicated). […] Because of the potential for arrhythmias and cardiomyopathy as possible complications of BN, an electrocardiogram (ECG) should be performed in patients who are very thin, complaining of palpitations, or have other signs or symptoms of cardiovascular concern.

• #3 Bulimia Nervosa | Diagnosis and treatment | CUN

  https://www.cun.es/en/diseases-treatments/diseases/bulimia-nervosa

  The diagnosis is clinical. Medical causes of loss of control with food and vomiting must be ruled out in bulimia. […] Diagnostic interview. […] Rule out organic disease by means of: magnetic resonance, general and specific analysis and evaluation by other specialists (endocrinologists). […] Psycho diagnostic tests. […] Carrying out the diagnosis following the criteria of the ICD-10 and the DSM-IV-TR.

• #3 Bulimia nervosa – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bulimia/symptoms-causes/syc-20353615

  Conditions that often occur along with bulimia include anxiety, depression, personality disorders or bipolar disorder, and misuse of alcohol or drugs. […] If you notice a loved one or friend who seems to have food issues that could lead to or suggest an eating disorder, think about talking to the person about these issues and ask how you can help.

• #3 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Eating-Disorders-Diagnosis.aspx

  For bulimia diagnosis there has to be at least two bulimic episodes per week for 3 months. […] Another test is called the SCOFF questionnaire, which can help identify both very young and adult patients who meet the full criteria for anorexia or bulimia nervosa. […] One point for every yes answer; a score 2 indicates a likely case of anorexia nervosa or bulimia nervosa.

• #3 McCallum Place | DSM 5 Diagnostic Criteria for Eating Disorders

  https://www.mccallumplace.com/admissions/dsm-5-diagnostic-criteria/

  Recurring binge eating episodes characterized by the following: […] Binge eating and compensatory behaviors occur, on average, at least once a week for three months […] Bulimia nervosa (of low frequency and/or limited duration) The individual meets the criteria for bulimia, with the exception that they engage in bingeing and compensatory behaviors less than one time per week or for a duration of fewer than three months.

• #3 Bulimia Nervosa: Diagnosing a Stigmatized Eating Disorder

  https://www.ebsco.com/blogs/health-notes/bulimia-nervosa-diagnosing-stigmatized-psychiatric-disorder

  Bulimia nervosa is an eating disorder characterized by frequent uncontrolled binge eating followed by compensatory behaviors to prevent weight gain, such as vomiting, use of laxatives or diuretics, fasting, and/or excessive exercise. […] To establish a diagnosis of bulimia nervosa, the DSM-5 criteria require recurrent episodes of binge eating and compensatory behaviors that occur at least once weekly for at least three months. […] The 2023 American Psychiatric Association recommends screening for the presence of eating disorders as part of an initial psychiatric evaluation. […] Physical signs of bulimia nervosa may be more obvious. Recurrent vomiting can cause poor oral health, including tooth erosion, gum disease, dental caries, palatal scratches, salivary gland enlargement, and other signs. […] Once diagnosis is confirmed, most patients can be treated in an outpatient setting with individual or family psychotherapy, nutrition counseling and support, and treatment of sequalae and overall health.

• #3 Bulimia Nervosa – Child and Adolescent Eating Disorder Program – Adolescent Medicine – Golisano Children’s Hospital – University of Rochester Medical Center

  https://www.urmc.rochester.edu/childrens-hospital/adolescent/eating-disorders/teens/bulimia-nervosa

  Family members who note symptoms of bulimia nervosa in a loved one can help by seeking an evaluation and treatment early. […] Bulimia nervosa, and the malnutrition that results, can adversely affect nearly every organ system in the body, increasing the importance of early diagnosis and treatment. […] Consult a physician for more information.

• #3 Bulimia Nervosa: Diagnosis, Impacts, Causes and Treatments

  https://www.linkedin.com/pulse/bulimia-nervosa-diagnosis-impacts-causes-treatments-

  In the International Classification for Diseases (ICD-10) diagnostic manual, bulimia nervosa is classified under the section eating disorders, along with other disorders such as anorexia nervosa. According to the manual, there are two different classifications for bulimia nervosa according to which symptoms are present. These are: […] A syndrome characterized by repeated bouts of overeating and an excessive preoccupation with the control of body weight, leading to a pattern of overeating followed by vomiting or use of purgatives. This disorder shares many psychological features with anorexia nervosa, including an overconcern with body shape and weight. […] Disorders that fulfil some of the features of bulimia nervosa, but in which the overall clinical picture does not justify that diagnosis. For instance, there may be recurrent bouts of overeating and overuse of purgatives without significant weight change, or the typical overconcern about body shape and weight may be absent.

• #3 How Are Eating Disorders Diagnosed?

  https://www.healthline.com/health/eating-disorders-diagnosis

  Doctors use physical and psychological evaluations to diagnose eating disorders. […] To be diagnosed with an eating disorder, you must meet the criteria for a specific type of disorder. […] Bulimia nervosa: fear of gaining weight, extreme use of weight loss supplements, forced vomiting, extreme exercising, regularly using laxatives, diuretics, or enemas.

• #3 Screening, assessment and diagnosis in the eating disorders: findings from a rapid review | Journal of Eating Disorders | Full Text

  https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00597-8

  Primary health providers play a pivotal role in the early identification and diagnosis of EDs in the community, providing affected individuals with timely access to care and ideally early intervention. […] A high degree of overlap in the symptomatology of different ED subtypes adds to the challenge of accurately assessing and diagnosing different EDs. […] Issues relating to accurate assessment and diagnosis are particularly apparent in children and adolescents. […] The impact of ARFID on children and adolescents appears to be significant. […] Research suggests clinicians and parents have difficulty identifying EDs in children. […] The RR identified key gaps in the evidence base for screening, assessment, and diagnosis in the EDs, laying the groundwork for further research and possible health system remedies. […] Despite increased advocacy in recent years, a majority of individuals with eating disorders remain undiagnosed and untreated, particularly males and those from diverse or minority populations. […] Research into improving detection and clinician diagnostic skill is extremely limited.

• #4 Bulimia Nervosa – National Eating Disorders Association

  https://www.nationaleatingdisorders.org/bulimia-nervosa/

  Bulimia nervosa (BN) is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating. […] According to the DSM-5 TR, the official diagnostic criteria for bulimia nervosa is: Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating). […] Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise. […] The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months. […] Self-evaluation is unduly influenced by body shape and weight. […] The disturbance does not occur exclusively during episodes of anorexia nervosa.

• #4 DSM 5 Diagnostic Criteria for Eating Disorders – Mentalyc

  https://www.mentalyc.com/blog/dsm-5-eating-disorders

  Individuals suffering from Bulimia Nervosa tend to engage in a cycle of binge eating. This cycle of binge eating is successively followed by unhealthy compensatory actions to avoid weight gain. […] For an individual to be diagnosed with Bulimia Nervosa, they have to meet the following criteria: Recurrent episodes of binge eating which includes: Eating large amounts of food in a discrete period (e.g., within any 2-hour period). This food quantity is usually larger than what most individuals consume within that time in such a situation. […] The severity of Bulimia Nervosa is measured by the frequency of inappropriate compensatory behaviors. A mild and moderate situation is when a client has 1-3 or 4-7 inappropriate compensatory behaviors respectively in a week. When a client begins to have the episodes 8-13 times, its a severe case. An extreme case is seen in an individual who has these inappropriate compensatory behaviors with an average of episodes 14 or more times a week.

• #4 Assessment and Treatment of Bulimia Nervosa | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0601/p2743.html

  To ensure that the treatment approach is properly designed and effective, the physician must look carefully for symptoms of comorbid psychiatric illness in patients with bulimia nervosa. […] A comprehensive evaluation provides the rationale for this judgment and includes the following: Standardized testing to document the patient’s general personality features, characterologic disturbance and attitudes about eating, body size and weight. […] Considerable research has been devoted to identifying the most effective pharmacologic and psychologic treatments for bulimia nervosa, including the effects of different medications and the benefits of different psychotherapy approaches. […] Despite differences in the application of techniques, the skill level of clinicians and the duration of the illness, controlled studies have clearly established the superiority of cognitive-behavioral therapy for the treatment of bulimia nervosa.

• #4 Bulimia nervosa – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/441

  Bulimia nervosa is an eating disorder, characterized by severe preoccupation about weight and body shape. Includes recurrent episodes of binge eating with compensatory mechanisms, such as self-induced vomiting to prevent weight gain. […] Parotid hypertrophy and erosion of the teeth are the most common physical signs and may prompt diagnosis. […] Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating, followed by behaviors aimed at compensating for the binge. […] Recurrent inappropriate compensatory behaviors occur in order to prevent weight gain. […] Key diagnostic factors: recurrent episodes of binge eating, recurrent inappropriate compensatory behavior, eating disturbance not exclusively during periods of anorexia nervosa, depression and low self-esteem, concern about weight and body shape, dental erosion, parotid hypertrophy, Russell sign, arrhythmia.

• #4 Medical complications of bulimia nervosa | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/88/6/333

  Covert purging should be strongly suspected in otherwise healthy young women presenting with hypokalemia without an alternative medical cause. […] If the patient is not forthcoming about their behavior when confronted, a spot urine potassium, creatinine, sodium, and chloride measurement can be obtained to further assess the source of potassium loss. […] Standard mental health treatments for BN include nutritional stabilization and behavior interruption, monitoring for and appropriate management of associated medical complications, prescribing medications as clinically indicated, and psychotherapeutic interventions. […] Cognitive behavioral therapy is the recommended initial intervention for the treatment of BN. […] Fluoxetine, with a target dose of 60 mg daily independent of the presence of comorbidities, is the only medication approved by the US Food and Drug Administration for BN.

• #4 Early detection of eating disorders in general practice

  https://www.racgp.org.au/afp/2017/november/early-detection-of-eating-disorders

  To limit the impact of these disorders in terms of physical, psychiatric and economic outcomes, it is essential that general practitioners (GPs) are able to identify and initiate management in such patients, as primary care is the context of most presentations. […] Given that early intervention may limit the progression and improve outcomes of eating disorders, early recognition is imperative. […] There are a number of screening tools that can be used in the primary care setting to assist in the detection and diagnosis of eating disorders. […] Each yes answer scores one point and a score of 2 indicates a likely diagnosis of anorexia nervosa or bulimia nervosa. […] A thorough history will also eliminate many of the other potential differential diagnoses of weight loss or symptoms. […] GPs failure to identify that certain symptoms and signs may represent an eating disorder may preclude early detection.

• #4 Diagnosis and Assessment Issues in Eating Disorders

  https://www.psychiatrictimes.com/view/diagnosis-and-assessment-issues-eating-disorders

  Bulimia nervosa first appeared in DSM-III-R and ICD-9 and is characterized by recurrent episodes of binge eating followed by compensatory behaviors. […] DSM specifies the presence of a feeling of loss of control of ones eating in addition to the large amount consumed. Both criteria include the presence of compensatory behaviors (eg, self-induced vomiting, laxatives, diuretics, excessive exercise, or fasting) and recognize similar concern about shape and weight as found in anorexia nervosa. DSM-5 specifies a frequency threshold of binge eating and compensatory behaviors as an average of once per week, over the past 3 months. […] The frequency threshold of binges and compensatory behavior for bulimia nervosa and binge eating disorder was reduced from DSM-IV-TR, because DSM-IV criteria were criticized for being arbitrary. […] The presence of regular compensatory behaviors distinguishes bulimia nervosa from binge eating disorder.

• #4 Mental health providers may have trouble detecting bulimia in patients, study finds – UF Health

  https://ufhealth.org/news/2025/mental-health-providers-may-have-trouble-detecting-bulimia-in-patients-study-finds

  A new University of Florida study finds that mental health providers may not be accurately diagnosing bulimia in patients. […] When presented with a vignette describing the behaviors and characteristics of a patient with disordered eating, only a quarter of mental health providers who participated in a new study were able to correctly diagnose bulimia nervosa. […] The study findings also suggest that providers may not associate excessive exercise with bulimia, despite the fact that it is listed in the Diagnostic and Statistical Manual of Mental Disorders as one of multiple compensatory strategies used by people with bulimia. […] Only 27% of providers correctly diagnosed the patient as having bulimia nervosa, and 38% of providers incorrectly diagnosed the patient with binge eating disorder.

• #4 Early Diagnosis and Management of Bulimia Nervosa in Type 1 Diabetes

  https://www.psychiatrist.com/pcc/bulimia-nervosa-in-type-1-diabetes/

  Treatment outcomes for bulimia nervosa in type 1 diabetes are worse than those for conventional bulimia nervosa. […] These outcomes may be a consequence of late detection and subsequent management. […] Early intervention is required to prevent short- and longer-term complications, with intensive treatment approaches having the best current evidence. […] Collaboration is required between specialist services for patients to receive optimal care. […] This narrative review summarizes the latest published evidence in the formulation, detection, and subsequent management of bulimia nervosa in type 1 diabetes, while highlighting the need for higher-quality research in the assessment and treatment of these comorbidities. […] Early recognition and treatment of bulimia nervosa in type 1 diabetes results in better outcomes.

• #4 Bulimia nervosa | Mental Health Foundation

  https://mentalhealth.org.nz/conditions/condition/bulimia-nervosa

  In addition to specialist psychological treatment, you may be prescribed the antidepressant fluoxetine, as higher doses have been shown to reduce the frequency of binge-purge behaviours in bulimia. […] Cognitive Behavioural Therapy (CBT-E) is the first line of treatment for bulimia. It focuses on patterns of thought and behaviour that are happening in the present day, rather than experiences in your past. […] Family Based Treatment (FBT) was originally designed to treat adolescents and young adults with anorexia but has been shown to be effective in a modified form for adolescents with bulimia too. […] Integrative Cognitive Affective Therapy (ICAT) is a structured short-term treatment for bulimia, over 20 sessions. It focuses on the emotions that lead to a binge/purge episode, so you can increase your awareness and learn new techniques to manage these emotions.

• #5 Bulimia nervosa – WikEM

  https://wikem.org/wiki/Bulimia_nervosa

  A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: 1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances. 2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating). […] B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. […] C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months. […] D. Self-evaluation is unduly influenced by body shape and weight. […] E. The disturbance does not occur exclusively during episodes of anorexia nervosa.

• #5 Bulimia Diagnostic Criteria | The Bulimia Project

  https://bulimia.com/bulimia-diagnostic-criteria/

  Only licensed health care professionals can formally diagnose someone with any psychiatric disorder. […] Giving someone this diagnosis will usually require several appointments to gain a full understanding of their history, symptoms, and behaviors. […] Some providers may also contact family members to gain another viewpoint and more accurate history, as some patients tend to downplay their symptoms. […] Unfortunately, because of embarrassment or denial, some individuals may not readily disclose all of their symptoms to their provider, delaying a necessary diagnosis. […] It is important to be open, honest, and forthcoming with all symptoms, relapses, triggers, and emotions. […] Patients may be encouraged to keep a diary of symptoms to better assist their provider. […] Licensed professional counselors have either a masters or doctorate degree in counseling. They provide counseling and therapy, but cannot prescribe medication.

• #5 Bulimia Nervosa DSM-5 307.51 (F50.2)

  https://www.theravive.com/therapedia/bulimia-nervosa-dsm–5-307.51-(f50.2)

  Experiences episodes of binge eating and compensatory purging behaviors at least once a week for three months or more. […] Preoccupied with body shape and weight in self evaluation. […] For bulimia to be diagnosed, health professionals also need to ensure that the disturbance experienced by the sufferer does not occur exclusively during episodes of anorexia nervosa, that is – that the disorder can be identified as separate. […] There is no set test for diagnosing bulimia but physical and dental examinations may be carried out, which can reveal signs indicating that a person is bulimic. […] Bulimia nervosa has several levels of severity, usually specified during diagnosis. […] Bulimics may also have puffy cheeks, rashes, pimples and signs of dehydration. […] Bulimia nervosa may affect sufferers over the long term and individuals may still experience symptoms of the eating disorder even with treatment. Early intervention and treatment is advised for the best chance at overcoming the disorder.

• #5 Can You Have Anorexia and Bulimia at the Same Time? – The Emily Program

  https://emilyprogram.com/blog/can-you-have-anorexia-and-bulimia-at-the-same-time/

  Provided they meet the other criteria, a person who engages in bingeing and purging and has a low body weight would likely be diagnosed with anorexia nervosa, binge-eating/purging subtype. A person who engages in bingeing and purging and does not have a less-than-expected body weight would likely receive a diagnosis of bulimia nervosa. […] […] Many eating disorders do not fit within the narrow definition of either anorexia or bulimia. These situations may merit another diagnosis, OSFED. […] […] For those who do not meet these strict anorexia or bulimia criteria but do engage in restricting, bingeing, and/or purging, the DSM-5 offers another category: Other Specified Feeding or Eating Disorder (OSFED), formerly known as Eating Disorder Not Otherwise Specified (EDNOS). […] […] A person typically has one eating disorder diagnosis at a time, but that diagnosis can and often does change over time; the combination of symptoms fluctuates and with it the appropriate diagnosis. This movement among diagnoses or diagnostic subtypes is called diagnostic crossover, and is especially common in those with anorexia nervosa. […]

• #5 Mental health providers may have trouble detecting bulimia in patients, study finds News | University of Florida

  https://news.ufl.edu/2025/03/bulimia-diagnosis/

  When presented with a vignette describing the behaviors and characteristics of a patient with disordered eating, only a quarter of mental health providers who participated in a new study were able to correctly diagnose bulimia nervosa. […] Many patients with bulimia have average or higher body weight, yet misconceptions persist about the typical patient with bulimia, Leget said. […] Unfortunately, we have stereotypes that someone with an eating disorder will look very lean or sickly, but we know thats not the case for a lot of eating disorders, she said.

• #5 Early Diagnosis and Management of Bulimia Nervosa in Type 1 Diabetes

  https://www.psychiatrist.com/pcc/bulimia-nervosa-in-type-1-diabetes/

  Efficacy of recognized treatments for bulimia nervosa in type 1 diabetes is equivocal. […] A collaborative effort between diabetes and eating disorder services appears to be the best approach in the treatment of patients with bulimia nervosa and type 1 diabetes. […] We recommend regular screening for disordered eating to be incorporated into consultations, particularly for those considered to be at higher risk, which would assist in the earlier identification of bulimia nervosa in type 1 diabetes. […] The evidence for the efficacy of recognized treatments for bulimia nervosa in type 1 diabetes is equivocal. […] Early recognition and management of bulimia nervosa results in better outcomes. […] It is imperative to detect this disorder in time before these maladaptive beliefs and disruptive behaviors become entrenched and resistant to treatment.

• #5 Medical complications of bulimia nervosa | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/88/6/333

  Covert purging should be strongly suspected in otherwise healthy young women presenting with hypokalemia without an alternative medical cause. […] If the patient is not forthcoming about their behavior when confronted, a spot urine potassium, creatinine, sodium, and chloride measurement can be obtained to further assess the source of potassium loss. […] Standard mental health treatments for BN include nutritional stabilization and behavior interruption, monitoring for and appropriate management of associated medical complications, prescribing medications as clinically indicated, and psychotherapeutic interventions. […] Cognitive behavioral therapy is the recommended initial intervention for the treatment of BN. […] Fluoxetine, with a target dose of 60 mg daily independent of the presence of comorbidities, is the only medication approved by the US Food and Drug Administration for BN.

• #6 Bulimia Nervosa – Child and Adolescent Eating Disorder Program – Adolescent Medicine – Golisano Children’s Hospital – University of Rochester Medical Center

  https://www.urmc.rochester.edu/childrens-hospital/adolescent/eating-disorders/teens/bulimia-nervosa

  Bulimia nervosa is an eating disorder in which a person engages in uncontrollable episodes of overeating (bingeing) usually followed by intentionally vomiting (sometimes called purging), misuse of laxatives, enemas, fasting, or excessive exercise to control weight. […] The symptoms of bulimia nervosa may resemble other medical problems or psychiatric conditions. Always consult your physician for a diagnosis. […] Parents, family members, spouses, teachers, coaches, and instructors may be able to identify an individual with bulimia nervosa, although many persons with the disorder initially keep their illness very private and hidden. […] Therefore, a detailed history of the individual’s behavior from family, parents, and teachers, clinical observations of the person’s behavior contribute to the diagnosis.

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