• Diagnosis of Eating Disorders

    The first step in being diagnosed 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

    As part of the overall evaluation, your doctor will:
    • Give you a physical exam and check your height and weight.
    • Check the back of your teeth for erosion if you have symptoms of bulimia. Erosion indicates frequent vomiting.
    • Have your blood, urine, and other fluids tested to evaluate your overall health.
    • Get x-rays to check for bone thinning.

    Psychiatric Evaluation

    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-5). In addition:
    • 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.
    • 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:
    • Calorie restrictions below nutritional requirements for age, gender, and overall physical health. This result in significantly low body weight, which is defined as less than minimally normal.
    • An intense fear of gaining weight or persistent behaviors that prevent weight gain, even when body weight is significantly low.
    • Negative body image and self-evaluation about weight. This continues despite having a body weight that is significantly low.

    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 on average at least once a week for 3 months.
    • Negative self-evaluation influenced by body shape and weight.

    Diagnosis of Binge Eating Disorder

    Binge eating disorder is characterized by: bnge eating episodes accompanied by a sense of loss of control.
    • Episodes are defined by eating more food than what an average person would eat under similar circumstances in a 2-hour period.
    • Episodes are associated with 3 or more of the following:
      • Eating faster than normal.
      • Eating until you feel overly full.
      • Eating large amounts without feeling hungry.
      • Eating alone because of embarrassment.
      • Feelings of depression, guilt, or disgust after eating.
      • No inappropriate behavior to prevent weight gain.
    • The behavior occurs at least once a week, on average, for 3 months.
    • There is persistent distress about binge eating habits.


    About eating disorders. National Association of Anorexia Nervosa and Associated Disorders website. Available at: http://www.anad.org/get-information/about-eating-disorders. Accessed May 18, 2016.

    American Psychiatric Association. Practice guideline for the treatment of patients with eating disorders. National Guideline Clearinghouse website. Available at: http://www.guideline.gov/content.aspx?id=9318. Updated 2011. Accessed May 18, 2016.

    Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013.

    Eating disorders: About more than food. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml. Updated 2014. Accessed May 18, 2016.

    Revision Information

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