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The first step in diagnosis is admitting that you have symptoms of an eating disorder. You may need support and encouragement from others before seeking help.

  • Initial evaluation—During the initial evaluation, your doctor will ask about your symptoms and medical history, the amount of food you eat, and how you try to control your weight.
  • Physical exam and tests—Your doctor will give you a physical exam and check your height and weight. If you have symptoms of bulimia , your teeth may be checked for erosion, which is a sign of frequent vomiting. You will also have routine blood, urine, and other tests to check your overall health status.
  • Psychiatric evaluation—A mental health professional may perform a series of tests and evaluate you for other psychiatric conditions, such as depression and anxiety disorders , which are common in people with eating disorders. Diagnosis of a particular type of eating disorder is based on an evaluation of your symptoms using the criteria of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Screening tests such as the Eating Attitudes Test (EAT-26) can be used to screen for symptoms of eating disorders.

Diagnosis of Anorexia Nervosa

Anorexia nervosa is characterized by:

  • An intense fear of gaining weight
  • A refusal to maintain adequate nutrition, often associated with an erroneous image of the self as fat
  • Loss of original body weight to 85% or less of what is expected for normal height and weight
  • Disturbance of body image and negative self-evaluation
  • Absence of at least three consecutive menstrual periods in females who have started menstruating

Diagnosis of Bulimia Nervosa

Bulimia nervosa is characterized by:

  • Frequent occurrence of binge eating episodes accompanied by a sense of loss of control
  • Recurrent inappropriate behavior such as vomiting, use of laxatives, fasting, or excessive exercise, intended to prevent weight gain
  • Both of the above behaviors occur at least twice a week, on average, for three months
  • Negative self-evaluation influenced by body shape and weight

Diagnosis of Binge Eating Disorder

Binge eating disorder is characterized by:

  • Binge eating episodes accompanied by a sense of loss of control
  • No inappropriate behavior to prevent weight gain
  • The behavior occurs at least twice a week, on average, for three months

Revision Information

  • American Psychiatric Association. Diagnosis and Statistical Manual of Mental Disorders. 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000.

  • About eating disorders. National Association of Anorexia Nervosa and Associated Disorders website. Available at: http://www.anad.org/get-information/about-eating-disorders . Accessed July 11, 2013.

  • Yager J, Devlin MJ, et al. Practice Guideline for the Treatment of Patients with Eating Disorders. 3rd ed. American Psychiatric Association; 2006. Available at: http://www.guideline.gov/content.aspx?id=9318 . Accessed July 11, 2013.