Bulimia: Diagnosis

The key to diagnosing bulimia nervosa is whether a child is a binge eater, meaning that she consumes much more in a given period than average, and has a “sense of lack of control” during the binge episode, which is often described as a sort of “out-of-body” experience. The diagnosis also requires that she compensate for the binge episode inappropriately—self-induced vomiting, off-label use of laxatives or diuretics, fasting, or excessive exercise—and her self-image be dominated by her body weight and appearance. The biinging and compensating behavior must occur on average once a week for 3 months.