the criteria have been met for a sustained period of time.
Specify current severity:
The minimum level of severity is based on the frequency of inappropriate compensatory
behaviors (see below). The level of severity may be increased to reflect other symptoms
and the degree of functional disability.
Mild:  An average of 1–3 episodes of inappropriate compensatory behaviors per week.
Moderate: An average of 4–7 episodes of inappropriate compensatory behaviors per
week.
Severe:  An average of 8–13 episodes of inappropriate compensatory behaviors per
week.
Extreme:  An average of 14 or more episodes of inappropriate compensatory behav-
iors per week.
Diagnostic Features
There are three essential features of bulimia nervosa: recurrent episodes of binge eating
(Criterion A), recurrent inappropriate comp ensatory behaviors to prevent weight gain
(Criterion B), and self-evaluat ion that is unduly influenced by body shape and weight
(Criterion D). To qualify for the diagnosis, the binge eating and inappropriate compensa-
tory behaviors must occur, on average, at least once per week for 3 months (Criterion C).
An “episode of binge eating” is defined as  eating, in a discrete period of time, an
amount of food that is definitely larger than  most individuals would eat in a similar period
of time under similar circumstances (Criterion  A1). The context in which the eating occurs