Diagnosis of Eating Disorders

Woman looking down ashamedly with her elbows on a dinner table

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Eating disorders can be diagnosed by a number of professionals. This includes medical physicians or mental health professionals such as psychiatrists, psychologists, dietitians, or social workers.

Sometimes a pediatrician or family practice doctor will diagnose an eating disorder after noticing symptoms within the course of a regular check-up or having questions brought up by the patient or his or her parent. On other occasions, a patient or his or her family will have concerns and schedule an assessment with a mental health professional.

Is There a Test for Eating Disorders?

While eating disorders are serious illnesses with physical complications, there is no laboratory test to screen for eating disorders. However, there are multiple questionnaires and assessment tools that may be used to assess a person's symptoms. These may include self-report instruments, such as the Eating Disorder Inventory, the SCOFF Questionnaire, the Eating Attitudes Test, or the Eating Disorder Examination Questionnaire (EDE-Q).

An eating disorder professional will also usually interview the person about his or her experience. Questions will typically include topics such as:

  • Current eating and exercise habits
  • How much a person weighs
  • Whether they have recently lost weight
  • The person's thoughts on weight, food, and body image

A professional may also ask about physical symptoms, such as being cold much of the time or bruising easily.

It is not uncommon for patients with eating disorders, especially patients with anorexia nervosa, to not believe that they are ill. This is a symptom called anosognosia. So, if you are concerned about a friend or loved one and he or she denies having a problem, it does not necessarily mean there is not a problem.

Within the course of a physical examination, a physician may also use a number of diagnostic tools, including–but not limited to–blood work, a bone density exam, and/or an electrocardiogram (EKG), to assess whether there are any medical complications from the eating disorder.

What Criteria Are Used to Diagnose Eating Disorders?

Physicians and mental health professionals use diagnostic criteria from the Diagnostic & Statistical Manual of Mental Disorders, 5th edition (DSM-5), to diagnose eating disorders. The DSM is a manual published by the American Psychiatric Association. It is currently in its fifth edition. Each diagnostic category in the book has been created based on research and feedback from clinicians.

While the best-known eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder, there are other eating disorders as well. People who are struggling with some of the symptoms of an eating disorder but do not meet full criteria or who are struggling with issues surrounding weight and food to the point that it is an issue in their life may also be diagnosed with other specified or unspecified feeding and eating disorder (OSFED or UFED).

Criteria for anorexia nervosa include symptoms related to significantly low body weight, a fear of weight gain, and body image issues.

Criteria for bulimia nervosa include recurrent binge eating and purging behaviors occurring at least once per week for at least three months, as well as a self-evaluation that is based on weight and/or body shape.

Criteria for binge eating disorder include recurrent episodes of eating unusually large amounts of food at least once a week for three months. A sense of lack of control over eating during the episode needs to be present. At least 3 of these other features also have to be present. 

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty afterward

It is also important to note that just because you do not meet the specific criteria for an eating disorder, it does not mean that you have a healthy relationship with food and weight.

Many people have disordered eating behaviors and/or disordered thoughts about food, weight, and body image. Atypical anorexia falls under the OSFED category but is more common than people realize.

What Happens After an Eating Disorder Diagnosis

A treatment team and treatment plan will be formulated based on the needs of the patient. This may include referral to other professionals and/or more in-depth assessment of symptoms. A treatment team may include a therapist, a dietician, a medical physician, and a psychiatrist. Typically, the professional who diagnoses the eating disorder can help refer a person to other eating disorder professionals within the community.

A treatment plan may include outpatient treatment, inpatient treatment, or residential treatment. Often, treatment includes both the patient and their family.

Free Online Screening Tool

If you are concerned about having an eating disorder, you may also want to take a screening test offered through the National Eating Disorders Association.

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  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.

  • Costin, C. (2007). The Eating Disorder Sourcebook (3rd Ed.). New York, NY: McGraw Hill.

  • Rosen, D.S. and the Committee on Adolescence (2010). Clinical Report: Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics, 126(6), 1240-1253.

By Susan Cowden, MS
Susan Cowden is a licensed marriage and family therapist and a member of the Academy for Eating Disorders.