What are the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-V-TR) criteria for bulimia nervosa?

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From the Guidelines

The DSM-V-TR criteria for bulimia nervosa include recurrent episodes of binge eating characterized by consuming a larger amount of food within a 2-hour period compared with peers, with a perceived lack of control during the binge, followed by repeated use of unhealthy behaviors to prevent weight gain, such as vomiting, abuse of laxatives, diuretics, or other medications, food restriction, or excessive exercise, occurring at least once a week for 3 months, with self-worth overly based on body shape and weight, and behaviors occurring distinctly apart from anorexia nervosa. The key features of bulimia nervosa, as outlined in the DSM-5 criteria 1, include binge eating and inappropriate compensatory behaviors, such as self-induced vomiting or laxative misuse, which must occur at least once a week for three months. Some of the key characteristics of bulimia nervosa include:

  • Binge eating in which a larger amount of food is eaten within a 2-hour period compared with peers, and there is a perceived lack of control during the time of the binge
  • Repeated use of unhealthy behaviors after a binge to prevent weight gain, such as vomiting, abuse of laxatives, diuretics, or other medications, food restriction, or excessive exercise
  • Behaviors occur at least once a week for 3 months
  • Self-worth is overly based on body shape and weight
  • Behaviors occur distinctly apart from anorexia nervosa, as noted in the DSM-5 criteria 1. It is essential to note that bulimia nervosa can lead to serious medical complications, including electrolyte imbalances, dental erosion, gastrointestinal problems, and cardiac arrhythmias, highlighting the importance of early identification and treatment, which may involve a combination of psychotherapy, nutritional counseling, and medications, as supported by the DSM-5 criteria 1.

From the Research

DSM-V-TR Criteria for Bulimia Nervosa

The provided studies do not directly address the DSM-V-TR criteria for bulimia nervosa. However, they discuss the efficacy of cognitive-behavioral therapy (CBT) for eating disorders, including bulimia nervosa and binge eating disorder.

Key Findings

  • CBT is efficacious for eating disorders, including bulimia nervosa and binge eating disorder 2, 3, 4.
  • CBT is more effective than other treatments for bulimia nervosa, although interpersonal psychotherapy appears to be equally effective for binge eating disorder 3.
  • The core features of bulimia nervosa, including binge eating and purging, predict weight change during treatment 5.

Limitations

  • The studies do not provide direct information on the DSM-V-TR criteria for bulimia nervosa.
  • The findings are based on studies that evaluated the efficacy of CBT for eating disorders, rather than specifically examining the diagnostic criteria for bulimia nervosa.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Cognitive Behavioral Therapy for the Eating Disorders.

Annual review of clinical psychology, 2021

Research

Weight Suppression, Binge Eating, and Purging as Predictors of Weight Gain During Inpatient Treatment in Persons With Bulimia Nervosa.

European eating disorders review : the journal of the Eating Disorders Association, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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