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This tool is designed to help evaluate whether an individual meets the DSM-5 diagnostic criteria for bulimia nervosa and, if so, determine the severity and remission status of the condition. It gathers inputs from the user regarding three key aspects: the fulfillment of diagnostic criteria, the frequency of inappropriate compensatory behaviors, and the current remission status.

The evaluation process involves several steps:

1. **Diagnostic Criteria:** The tool examines six main diagnostic criteria to establish a bulimia nervosa diagnosis:
   - Recurrent episodes of binge eating within discrete time periods, featuring consumption of significantly more food than most individuals under similar conditions.
   - A sense of lack of control over food intake during these binge episodes.
   - Recurrent engagement in inappropriate compensatory behaviors to avoid weight gain, such as vomiting, misuse of medications, fasting, or excessive exercise.
   - Occurrence of binge eating and compensatory behaviors at least once a week for three months on average.
   - Self-evaluation that is excessively dependent on body shape and weight.
   - Absence of these behaviors exclusively during episodes of anorexia nervosa.

   Each of these criteria is treated as a true or false statement. All criteria must be affirmed for a definitive diagnosis of bulimia nervosa.

2. **Frequency of Inappropriate Compensatory Behaviors:** When all diagnostic criteria are met, the tool assesses the frequency of compensatory behaviors to determine the severity of the condition:
   - 1-3 episodes per week are considered mild.
   - 4-7 episodes per week are moderate.
   - 8-13 episodes per week are severe.
   - 14 or more episodes per week constitute an extreme severity.

3. **Remission Status:** The tool also considers the remission condition of the disorder:
   - Partial remission is indicated when some, but not all, of the initial criteria are met over a sustained period.
   - Full remission signifies that none of the criteria are met for an extended timeframe.

Using these inputs, the tool will classify the condition comprehensively. If the individual meets all diagnostic criteria and presents variations in compensatory behavior frequency or remission status, the diagnosis is specified according to the combination of these factors, like "Bulimia nervosa, moderate" or "Bulimia nervosa, extreme, in full remission."

This structured approach ensures an accurate understanding of the condition, guiding towards appropriate diagnosis and subsequent treatment planning.

The calculator in question is the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) diagnostic criteria for bulimia nervosa. This calculator is used by mental health professionals to diagnose bulimia nervosa in individuals of any age, although it is most commonly diagnosed in adolescents and young adults. 

The DSM-5 criteria for bulimia nervosa include recurrent episodes of binge eating, recurrent inappropriate compensatory behaviors to prevent weight gain, and self-evaluation that is unduly influenced by body shape and weight. These behaviors must occur, on average, at least once a week for three months. 

The clinical utility of this calculator is to provide a standardized method for diagnosing bulimia nervosa, which can guide appropriate treatment strategies. It is important to note that the DSM-5 criteria should be used in conjunction with a comprehensive clinical assessment, as they do not account for all individual variations in symptoms and experiences.

There are no specific exclusion criteria for the use of the DSM-5 diagnostic criteria for bulimia nervosa. However, the diagnosis should not be made if the binge eating and compensatory behaviors are exclusively during episodes of anorexia nervosa, or if the symptoms are better explained by another mental disorder or medical condition.

Bulimia nervosa

Background

Overview

Guidelines

Key sources