Individuals whose binge-eating behavior occurs only during Anorexia Nervosa are given the diagnosis Anorexia Nervosa, Binge-Eating/Purging Type, and should not be given the additional diagnosis of Bulimia Nervosa. For an individual who binges and purges but whose presentation no longer meets the full criteria for Anorexia Nervosa, Binge-Eating/Purging Type (e.g., when weight is normal or menses have become regular), it is a matter of clinical judgment whether the most appropriate current diagnosis is Anorexia Nervosa, Binge-Eating/Purging Type, In Partial Remission, or Bulimia Nervosa.
In certain neurological or other general medical conditions, such as Kleine-Levin syndrome, there is disturbed eating behavior, but the characteristic psychological features of Bulimia Nervosa, such as overconcern with body shape and weight, are not present. Overeating is common in Major Depressive Disorder, With Atypical Features, but such individuals do not engage in inappropriate compensatory behavior and do not exhibit the characteristic overconcern with body shape and weight. If criteria for both disorders are met, both diagnoses should be given. Binge-eating behavior is included in the impulsive behavior criterion that is part of the definition of Borderline Personality Disorder. If the full criteria for both disorders are met, both diagnoses can be given.