Calculators & Tools

Bulimia Nervosa

DSM-5 criteria - recurrent binge eating with compensatory behaviours.

1 What is the Bulimia Nervosa?

The Bulimia Nervosa is a psychosocial scoring tool used in paediatric practice. DSM-5 criteria - recurrent binge eating with compensatory behaviours. It scores 5 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in psychosocial
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 5 criteria: Recurrent episodes of binge eating (large amount in a discrete period + sense of lack of control); Recurrent inappropriate compensatory behaviour (vomiting, laxatives, fasting, excessive exercise); Binges and compensatory behaviours both occur ≥1×/week for 3 months; Self-evaluation unduly influenced by body shape and weight; Does not occur exclusively during episodes of anorexia nervosa. Totals are then banded: any score - Below threshold: not all criteria met; 5 criteria met or more - Threshold met: all criteria met - consistent with bulimia nervosa. Check electrolytes, dental erosion and cardiac status.
  • DSM-5 threshold: 5 or more of the 5 criteria listed.
  • A diagnosis also requires clinically significant distress or impairment, the required duration, and exclusion of substance use or another condition. Screening aid only - not a diagnosis.

4 Frequently asked questions

How many criteria does the Bulimia Nervosa use?

5. They are Recurrent episodes of binge eating (large amount in a discrete period + sense of lack of control); Recurrent inappropriate compensatory behaviour (vomiting, laxatives, fasting, excessive exercise); Binges and compensatory behaviours both occur ≥1×/week for 3 months; Self-evaluation unduly influenced by body shape and weight; Does not occur exclusively during episodes of anorexia nervosa.

What do the bands of the Bulimia Nervosa mean?

The total is interpreted as: any score - Below threshold: not all criteria met; 5 criteria met or more - Threshold met: all criteria met - consistent with bulimia nervosa. Check electrolytes, dental erosion and cardiac status.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

DSM-5 threshold: 5 or more of the 5 criteria listed.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.