Diagnostic criteria of Bulimia

Men and women who live with Bulimia seek out binge and purge episodes — they will eat a large quantity of food in a relatively short period of time and then use behaviors such as taking laxatives or self-induced vomiting — because they feel overwhelmed in coping with their emotions, or in order to punish themselves for something they feel they should unrealistically blame themselves for. This can be in direct relation to how they feel about themselves, or how they feel over a particular event or series of events in their lives. Those suffering with Bulimia may seek episodes of binging and purging to avoid and let out feelings of anger, depression, stress or anxiety. New research indicates that for a percentage of sufferers, a genetic predisposition may play a role in a sensitivity to develop Bulimia, with environmental factors being the trigger.

Men and women suffering Bulimia are usually aware they have an eating disorder. Fascinated by food they sometimes buy magazines and cook-books to read recipes, and enjoy discussing dieting issues. Some of the behavioral signs can be: Recurring episodes of rapid food consumption followed by tremendous guilt and purging (laxatives or self-induced vomiting), a feeling of lacking control over his or her eating behaviors, regularly engaging in stringent diet plans and exercise, the misuse of laxatives, diuretics, and/or diet pills and a persistent concern with body image can all be warning signs someone is suffering with Bulimia.

It is important to realize that what makes a person Bulimic — as opposed to Anorexic — is not the purging, but the cycle of binging and purging. Purging may be using laxatives or self-induced vomiting, but there are Bulimics who use other inappropriate compensatory behaviors such as compulsive exercise (ie., excessive jogging or aerobics), to attempt to burn off the calories of a binge, or fasting the day following a binge. It is not uncommon for a man or woman suffering with Bulimia to take diet pills in an attempt to keep from binging, or to use diuretics to try to lose weight. A sufferer will often hide or “store” food for later binges, will often eat secretly and can have large fluctuations in their weight.

In other words, if you think you have Bulimia, it’s dangerous to read the diagnostic criteria and think “I don’t have one of the symptoms, so I must not be Bulimic”.

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, enemas, or other medications; fasting; or excessive exercise.
  • The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice 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.

Purging Type:

During the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

Nonpurging Type:

During the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas