Editing Bulimia nervosa (section)

==Diagnosis==
The onset of bulimia nervosa is often during adolescence, between 13 and 20 years of age, and many cases have previously experienced obesity, with many relapsing in adulthood into episodic bingeing and purging even after initially successful treatment and remission.<ref>{{Cite book|last=Shader |first=Richard I. | name-list-style = vanc |title=Manual of Psychiatric Therapeutics |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2004 |isbn=978-0-7817-4459-1}}{{Page needed|date=September 2010}}</ref> A lifetime [[prevalence]] of 0.5 percent and 0.9 percent for adults and adolescents, respectively, is estimated among the United States population.<ref>[Nolen-Hoeksema, S. (2013)."(Ab)normal Psychology"(6th edition). McGraw-Hill. p.344]</ref> Bulimia nervosa may affect up to 1% of young women and, after 10 years of diagnosis, half will recover fully, a third will recover partially, and 10–20% will still have symptoms.<ref name=Hay2010/>

Adolescents with bulimia nervosa are more likely to have self-imposed [[Perfectionism (psychology)|perfectionism]] and compulsivity issues in eating compared to their peers. This means that the high expectations and unrealistic goals that these individuals set for themselves are internally motivated rather than by social views or expectations.<ref>{{cite journal | vauthors = Castro-Fornieles J, Gual P, Lahortiga F, Gila A, Casulà V, Fuhrmann C, Imirizaldu M, Saura B, Martínez E, Toro J | display-authors = 6 | title = Self-oriented perfectionism in eating disorders | journal = The International Journal of Eating Disorders | volume = 40 | issue = 6 | pages = 562–8 | date = September 2007 | pmid = 17510925 | doi = 10.1002/eat.20393 }}</ref>

===Criteria===

Bulimia Nervosa is diagnosed using the ''Diagnostic and Statistical Manual of Mental Disorders (DSM-5).'' The diagnostic criteria include the following:<ref name=":1" /><ref>{{Cite journal |last1=Harrington |first1=Brian C. |last2=Jimerson |first2=Michelle |last3=Haxton |first3=Christina |last4=Jimerson |first4=David C. |date=2015-01-01 |title=Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa |url=https://www.aafp.org/pubs/afp/issues/2015/0101/p46.html |journal=American Family Physician |language=en-US |volume=91 |issue=1 |pages=46–52|pmid=25591200 }}</ref>

* Recurrent episodes of binge eating 
* Recurrent inappropriate compensatory behavior to prevent weight gain, like self-induced vomiting, misuse of laxatives or other medications, fasting, or excessive exercise.
* The binge eating and compensatory behaviors both occur at least once a week for three months
* Self-evaluation is influenced by body shape and weight.

Other methods are also used to narrow down the diagnosis, such as physical exams (measuring height, weight, and vitals, or checking skin, nails, heart and lungs), or lab tests (for blood count, electrolytes, protein, or urinalysis).