Diagnosing Eating Disorders

Eating disorders can lead to serious medical consequences. These include infertility in women and osteoporosis, which is a loss of bone density that can cause bones to become brittle. Eating disorders can also lead to obesity and type 2 diabetes. Severe eating disorders can be fatal.

If you suspect that you or a loved one may have an eating disorder, contact the specialists at NYU Langone.

Psychological Assessment

After speaking with one of our intake specialists, a person with a suspected eating disorder meets in person with one of our team members—which may include a psychiatrist or psychologist—for an in-depth diagnostic evaluation. For children and adolescents with eating disorders, specialists at NYU Langone’s Child Study Center are involved in diagnosis and treatment.

The evaluation includes an assessment of the person’s eating problems, a full medical history, and a review of past treatment for an eating disorder, if applicable. A doctor may also ask about a person’s attitude toward food, eating, weight, and exercise. An assessment of other psychiatric symptoms, such as problems with mood, anxiety, or sleep, is also conducted.

Your NYU Langone specialist may recommend additional diagnostic testing—including blood tests, a physical examination, or a nutritional evaluation—depending on the severity of your symptoms.

An evaluation may also involve filling out several questionnaires to confirm the diagnosis and create a comprehensive treatment plan. Your doctor may want to interview your family and friends to gain a more complete understanding of the situation.

Diagnostic Criteria

Each eating disorder has its own set of diagnostic criteria, which means a person must experience several specific symptoms to be diagnosed with the eating disorder.

To diagnose anorexia nervosa, a person’s body weight should consistently be 15 percent below average, either due to weight loss or a failure to gain weight. A doctor determines during the evaluation if a person is extremely troubled by weight gain or the prospect of being “fat,” even though he or she is not overweight. The doctor also looks for evidence of an unrealistic body image or denial of the severity of the condition.

To diagnose bulimia nervosa, binge eating and purging must occur at least once a week for three months or more. A person must binge eat and have a lack of control during the binge episode, and then compensate for the binge by vomiting, using laxatives or diuretics, fasting, or exercising excessively.

To diagnose binge eating disorder, a person must repeatedly eat unusually large amounts of food in a relatively short period of time and think that these binges are beyond his or her control. At least three of the following factors must also be present: eating rapidly, eating to the point of uncomfortable fullness, eating when not hungry, eating in shame or in secret, and feeling disgusted, depressed, or ashamed after eating.

The behavior must occur at least once a week for a period of six months. Binge eating is not associated with inappropriate methods of compensating for overeating, such as self-induced vomiting.

Many people have some or most of the above symptoms without meeting the full criteria for an eating disorder. For example, a person may have all of the symptoms of anorexia nervosa at a normal weight if he or she was previously overweight or obese.

The medical and psychological risks of other eating-related syndromes, such as food avoidance that does not meet criteria for anorexia nervosa, or excessive exercising in the absence of anorexia or bulimia, may be significant and warrant evaluation and treatment as well.

After the evaluation, which typically takes place in a single session, you meet with a team member to review the specialist’s findings and discuss treatment recommendations.