What are the key diagnostic criteria for bulimia nervosa according to the DSM-5?

Key diagnostic criteria for bulimia nervosa according to the DSM-5 include:

• Recurrent episodes of binge eating, characterized by eating an amount of food that is definitely larger than most people would eat in a similar period under similar circumstances, accompanied by a sense of lack of control over eating during the episode.
• Recurrent inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting, or excessive exercise.
• These binge eating and compensatory behaviors both occur, on average, at least once a week for three months.
• Self-evaluation is unduly influenced by body shape and weight.
• The disturbance does not occur exclusively during episodes of anorexia nervosa.

These criteria reflect the DSM-5 classification and are consistent with the clinical understanding underpinning UK NICE guidelines, which emphasize the presence of binge eating episodes and compensatory behaviors as core features of bulimia nervosa ¹. The NICE guideline on eating disorders also highlights the importance of assessing the frequency and pattern of these behaviors and the psychological impact related to body image concerns ¹. The transition from DSM-IV to DSM-5 maintained these core diagnostic features but clarified frequency and duration criteria to improve diagnostic accuracy (Call et al., 2013).