Eating Disorders - Diagnosis

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For example, a woman who is 5'5" and weighs 125 pounds has a healthy BMI of 21. A woman at the same height who weighs 90 pounds would have a dangerously low BMI of 15.

Diagnosing Bulimia Nervosa

A doctor generally makes a diagnosis of bulimia if there are at least two bulimic episodes per week for 3 months. Because people with bulimia tend to have complications with their teeth and gums, dentists can play a crucial role in identifying and diagnosing bulimia.

Diagnosing Anorexia Nervosa

Generally, an observation of physical symptoms and a personal history will confirm the diagnosis of anorexia. The standard criteria for diagnosing anorexia nervosa are:

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• The patient's refusal to maintain a body weight normal for age and height
• Intense fear of becoming fat even though underweight
• A distorted self-image that results in diminished self-confidence
• Denial of the seriousness of emaciation and starvation
• The loss of menstrual function for at least 3 months

The doctor then categorizes the anorexia further:

• Restricting (severe dieting only)
• Anorexia bulimia (binge-purge behavior)

Diagnosing Complications of Eating Disorders

Once a diagnosis is made, a doctor will check for any serious complications of starvation and also rule out other medical disorders that might be causing the anorexia. Tests should include:

• A complete blood count
• Tests for electrolyte imbalances
• Test for protein levels
• An electrocardiogram and a chest x-ray
• Tests for liver, kidney, and thyroid problems
• A bone density test

Review Date: 02/18/2011
Reviewed By: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital; and David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).