Eating Disorders - Diagnosis

A doctor will evaluate a patient’s body mass index (BMI). The BMI is a measurement of body fat. It is derived by multiplying a person's weight in pounds by 703 and then dividing it twice by the height in inches. (BMI calculators are available online.)

  • A healthy BMI for women over age 20 is 19 - 25.
  • Those over 25 are considered overweight; those over 30 are considered obese.
  • Those under 17.5 are considered to be at risk for health problems related to anorexia. (However, young teenagers can have lower BMIs without necessarily being anorexic.)

For example, a woman who is 5'5" and weighs 125 pounds has a healthy BMI of 21. A woman at the same height who weighs 90 pounds would have a dangerously low BMI of 15.

Diagnosing Bulimia Nervosa

A doctor generally makes a diagnosis of bulimia if there are at least two bulimic episodes per week for 3 months. Because people with bulimia tend to have complications with their teeth and gums, dentists can play a crucial role in identifying and diagnosing bulimia.

Diagnosing Anorexia Nervosa

Generally, an observation of physical symptoms and a personal history will confirm the diagnosis of anorexia. The standard criteria for diagnosing anorexia nervosa are:

  • The patient's refusal to maintain a body weight normal for age and height
  • Intense fear of becoming fat even though underweight
  • A distorted self-image that results in diminished self-confidence
  • Denial of the seriousness of emaciation and starvation
  • The loss of menstrual function for at least 3 months

The doctor then categorizes the anorexia further:

  • Restricting (severe dieting only)
  • Anorexia bulimia (binge-purge behavior)

Diagnosing Complications of Eating Disorders

Once a diagnosis is made, a doctor will check for any serious complications of starvation and also rule out other medical disorders that might be causing the anorexia. Tests should include:

  • A complete blood count
  • Tests for electrolyte imbalances
  • Test for protein levels
  • An electrocardiogram and a chest x-ray
  • Tests for liver, kidney, and thyroid problems
  • A bone density test

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Review Date: 02/18/2011
Reviewed By: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital; and David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)