Diagnostic criteria for bulimia nervosa: It is an eating disorder characterized by recurrent and irresistible desire to eat, and binge eating behavior, and the patient has a fear of gaining weight, and often takes extreme measures such as inducing vomiting, inducing diarrhea, and fasting to eliminate binge eating that causes gaining weight. It may alternate with anorexia nervosa, and both have similar pathological and psychological mechanisms, as well as gender and age distribution. Most patients are continuers of anorexia nervosa, with a later age of onset than anorexia nervosa. This disorder is not bulimia caused by organic lesions of the nervous system, nor is it binge eating secondary to epilepsy, schizophrenia, and other psychiatric disorders. Li Chunbo, Psychiatry Department, Shanghai Mental Health Center
[Diagnostic criteria] (1) There is a persistent dominant notion of uncontrollable eating and craving for food, and the patient succumbs to bulimic episodes of ingesting large amounts of food in a short period of time; (2) The fattening effect of food is counteracted by at least one of the following methods: (1) self-induced vomiting; (2) laxative abuse; (3) intermittent fasting; (4) use of anorexics, thyroxine-like agents, or diuretics. In the case of diabetic patients, insulin therapy may be abandoned; (3) there is often a pathological fear of gaining weight; (4) there is often a past history of anorexia nervosa, with an interval of several months to several years between the two; (5) episodes of binge eating at least twice a week for 3 months; (6) binge eating due to organic lesions of the nervous system and binge eating secondary to epilepsy, schizophrenia, and other psychiatric disorders are excluded.
[Note] Sometimes the disorder can be secondary to depression, leading to diagnostic difficulties or requiring concurrent diagnosis when necessary.