Do You Have Bulimia?

I think most people with bulimia are pretty aware that they have it. If you’re reading this and  you think someone else may have bulimia, here are the DSM-V guidelines. (The DSM is the psychology/psychiatry diagnostic manual) If anyone else who binges or purges reads this, it may change the way you view your condition, because the limitations on a diagnosis of bulimia are different in this DSM versus the last one.

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 most people would eat during 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 per 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.

B is really where the change was made, because in the old diagnostic manual, one with bulimia would purge at least twice a week. With the change made to once a week, more people with eating problems can be diagnosed and treated appropriately. However, there’s also the fact that some people who binge and purge, once they receive a more a seemingly more serious diagnosis (although in reality EDNOS is just as serious as bulimia), will face more serious stigma and other consequences.