Table 4.

Diagnostic criteria for anorexia nervosa and bulimia nervosa^*

Anorexia nervosa	Bulimia nervosa
• Body weight is maintained at least 15% below that expected or body mass index is 17.5 or lower†	• Persistent preoccupation with eating; overeating episodes in which large amounts of food are eaten in short periods of time
• Weight loss is self induced by avoidance of “fattening foods” plus one or more of: self induced vomiting; self induced purging; excessive exercise; use of appetite suppressants or diuretics	• The patient tries to counteract the “fattening” effects of food by one or more of: self induced vomiting or purgative abuse; alternating starvation and eating; use of appetite suppressants, thyroid preparations, or diuretics
• Body image distortion in which dread of fatness persists as an intrusive, overvalued idea	• The psychopathology consists of a morbid dread of fatness, and the patient sets herself or himself a precise weight threshold, well below the premorbid weight that constitutes the optimum or healthy weight in the opinion of the physician
• Widespread endocrine disorder involving the hypothalamic-pituitary-gonadal and manifesting as amenorrhoea in women and loss of sexual interest and potency in men	• Often a history of previous anorexia nervosa, with the interval ranging from a few months to several years
• If onset is prepubertal, puberty is delayed or arrested. With recovery, puberty is often normal, but the menarche is late

^*Based on ICD-10 (international classification of diseases, 10th revision); †Body mass index criterion does not apply for young people aged under 17