It’s common for people to use the web to self-diagnose illnesses. And often, people assume they have the worst problem possible. For example, one doctor says his tired clients often self-diagnose lupus.  Meanwhile, most of them do not have it.
Eating disorders are different. A bulimia test may help you realize your unhealthy eating habits. But some people take bulimia tests and walk away feeling invincible. Since they don’t get a high score, they think they can keep eating as they have.
Understanding bulimia and how people with this eating disorder act and react is worthwhile. But it’s also critical to know how bulimia is diagnosed and how you can help your doctor spot it.
Bulimia Signs to Watch For
Most bulimia tests are based on symptoms. You’re asked simple questions about habits, and your answers can indicate problems.
A bulimia test might include behavior questions like:
- Do you eat large amounts of food in one setting?
- Do you sometimes feel like you’re in a trance while eating like this?
- Do you feel guilty about how or how much you eat?
- Do you use vomiting to limit how many calories you ingest?
- Do you use laxatives to remove food from your body?
A bulimia test may also include questions about known eating disorder medical issues: 
- Do you often have a sore throat from vomiting?
- Has your dentist noticed worn tooth enamel or decaying teeth, explained best by regular vomiting?
- Do you have acid reflux often?
- Do you often have a stomachache?
Answering these questions honestly can help you understand your eating patterns and health risks. But you’ll need to do more to know if you have bulimia.
How Doctors Define Bulimia
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains detailed descriptions of mental health issues. It’s a bit like a medical dictionary. Doctors use it to understand symptoms in patients and see how they fit into known illness categories.
The DSM-5 defines bulimia through these behaviors:
- Binge eating: People eat a large amount of food in a short time (usually less than two hours). They feel unable to control the episodes or stop them.
- Purging: People feel terrible about how much they ate, and they try to curb the damage through vomiting, abusing laxatives, avoiding fluids, exercising excessively, or dieting.
People must participate in these episodes at least once per week for three months for a formal bulimia diagnosis. 
Who Can Diagnose Bulimia?
A formal diagnosis of bulimia is critical. You’ll need a treatment program; most insurance companies won’t cover the cost without a doctor’s approval. They must ensure that you need the therapies before they pay for them.
Typically, that means you need a formal diagnosis. You can’t get that from a self-test.
Doctors know that diagnosing bulimia is best. People who get an early diagnosis tend to get treatment started quickly and have fewer medical complications.
Some doctors incorporate screening questions into all of their routine exams.  They might ask you the following:
- How do you feel about your weight?
- Do you ever eat more than you should?
- Does talking about your weight make you feel anxious?
These questions don’t dig into the DSM-5 details, of course. But they can work to open up a conversation between you and your doctor. Your honest answers could prompt your doctor to stop, ask a follow-up question, and learn more about what’s really happening.
Dentists may also be the first point of contact for people with bulimia. During a routine visit, your dentist may notice that your teeth are worn or missing due to acid exposure, or you have jaw issues. After an exam, your dentist could ask you more questions about your habits, and you could be prompted to admit that you’re struggling with bulimia.
Dentists can’t formally diagnose bulimia. Most insurance companies require these diagnostic assessments from primary medical doctors. But dentists are medical professionals, and often, they can prompt their patients to make different choices about their health.
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How is Bulimia Treated?
A doctor can diagnose bulimia, but unless you’re spectacularly ill and require immediate hospitalization, a doctor can’t make you get treatment. Instead, you must decide that your future is worth fighting for. Many people with bulimia do just that.
About 43% of people with bulimia seek treatment for their eating disorder. 
They find treatment programs that seem right for them and enroll independently. Others have a more winding road to getting help, working with their doctors sporadically until they formally enroll in care.
No matter what path you take, getting treatment is critical. The longer bulimia goes untreated, the worse your problems may be.
Years ago, doctors thought it was impossible to treat bulimia.  Now we know that isn’t true. People with bulimia can and do get better, and several approaches are available.
Therapy is a frontline bulimia treatment. Two types of therapy are proven effective: 
Binges come from triggers for most people with bulimia. You’re under pressure, depressed, or anxious. You feel hopeless or powerless. You can’t address these feelings or situations, so you lean on food.
Cognitive behavioral therapy (CBT) can help you understand the thoughts—or triggers—that cause your binges. When you change them, you may lose the risk of overeating.
Bulimia is a private disease. Most people binge alone and are terrified that friends and family will find out. But the eating disorder makes clear communication hard, and relationships can fray.
Interpersonal psychotherapy helps repair the damage, and you may learn how to make friends in treatment.
The U.S. Food and Drug Administration approved one medication (Prozac) for bulimia treatment. It’s an adjunct therapy, so you can’t lean on drugs instead of counseling. The two should work together. But your medication could help you feel calm and focused enough to work well in therapy.
How Long Does Recovery Take?
Bulimia takes weeks or months to develop. You don’t wake up one morning and change how you eat and interact with the world. Similarly, your recovery may be slow and steady. For some, it takes years to recover.
Relapse is part of the healing process for people with bulimia. You may feel healthy and strong, but a trigger hits you unexpectedly, and you binge.
Each slip is an opportunity to learn more about and overcome your triggers. As long as you return to your team when you slip, you’re still on track.
You may always have an unusual relationship with food. And you may always need to lean on the lessons you picked up in therapy to keep you from responding to triggers by bingeing and purging. Some people find that working in support groups (including some that follow the 12-step model popularized by Alcoholics Anonymous) is helpful.
The Role of Support Groups
You don’t have to pay to participate in self-help groups and are not required to show progress. Instead, they’re semi-informal settings that give you access to others in recovery. You can share stories, swap tips, and help one another to get better.
As you improve, you may feel ready to mentor someone new in recovery. In addition, giving back could give you a deep sense of accomplishment.
Some people find that life in bulimia recovery is different. Of course, you will always take steps to control your eating disorder, but you can find joy in the process.
What to Do Next
If you’re struggling with bulimia and you’ve taken a few bulimia tests that alarm you, it’s time to talk with someone you trust. Schedule an appointment with your doctor, talk to a friend, or call a treatment center.
Your new life is waiting for you. But you must take the first step to make it possible.
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- Pritts SD, Susman J. (2003). Diagnosis of Eating Disorders in Primary Care. American Family Physician; 67(2):297-304.
- Eating Disorders. National Institute of Mental Health. Retrieved August 10, 2022.
- National Collaborating Centre for Mental Health (UK). (2004). Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. Leicester (UK): British Psychological Society (UK); (NICE Clinical Guidelines, No. 9.) 7, Treatment and management of bulimia nervosa.
- Treatment for Anorexia and Bulimia. (2002). American Psychological Association. Retrieved August 10, 2022.