| Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: |
| Eating, in a discrete period of time (eg, within any two-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. |
| A sense of lack of control over eating during the episode (eg, a feeling that one cannot stop eating or control what or how much one is eating). |
| Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. |
| The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice 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. |
| Specify type: |
| Purging type: during the current episode of bulimia nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. |
| Nonpurging type: during the current episode of bulimia nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. |
