The DSM IV diagnoses individuals with Bulimia Nervosa by identifying with the following:
Recurrent episodes of binge eating. An episode of binge eating is characterised by both of the following:
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eating, in a discrete period of time (e.g. within any 2 hour period), and amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
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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)
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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 3 months.
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Self-evaluation is unduly influenced by body shape and weight.
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The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
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Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics or enemas.
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Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviours, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics or enemas.