In order to establish whether someone has bulimia nervosa, a mental health professional needs to investigate whether the following criteria are present:
- Recurrent episodes of binge eating. An episode of binge eating is characterised by both of the following:
- Eating, in a discrete period of time (for example, within any two-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 (for instance, a feeling that one cannot stop eating or control what or how much one is eating).
- Recurrent inappropriate compensatory behaviour 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 behaviours both occur, on average, at least twice a week for three months.
- Self-evaluation is unduly influenced by body shape and weight.
- The disturbance doesn't occur exclusively during episodes of anorexia nervosa.
- Source: Diagnostic and Statistical Manual of Mental Disorders
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