Bulimia Nervosa

Detailed Diagnostic Criteria

Detailed diagnostic criteria are taken from the Diagnostic Statistical Manual, 5th edition (DSM-V).

  1. 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 a large amount of food (2) A sense of lack of control over eating during the episode
  2. Recurrent inappropriate compensatory behavior (sometimes called "purging") in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas or other medications; fasting or excessive exercise.
  3. The binge eating and inappropriate compensatory behaviors occur, on average, at least once a week for 3 months.
  4. Self-evaluation is unduly influenced by body shape and weight.
  5. The disturbance does not occur exclusively during episodes of anorexia nervosa.

Prevalence of Bulimia Nervosa

 According to Keel (2005) and Wilson, Grilo & Vitousek (2007), the prevalence of eating disorders is as follows:

  • The lifetime prevalence for women is between 1-3%
  • The lifetime prevalence for men is between 0.1-0.3%

Typical Course of Bulimia Nervosa

Keel (2005), Steinhausen (2002) and Wilson, Grilo & Vitousek (2007) describe the typical onset and course of eating disorders :

  • Onset: late adolescence to early adulthood
  • 50% of individuals recover and maintain recovery
  • 30% improve but remain symptomatic
  • 10% of individuals continue to meet full criteria for bulimia (Cowden, 2020).
  • The rate of relapse is 31-44% (Wilkerson, 2019), 
  • Cross-over rates to either anorexia or binge-eating are very low, because those with bulimia are more likely to continue to suffer from bulimia

Last update:  18 March 2021

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