a. How tall are you?
b. What was your lowest weight in the past 3 months?
c. Is patient's weight lower than the threshold corresponding to his/her height (see table)? YES/NO
in the past 3 months
(if weight is lower than threshold, answer)
M2 In spite of this low weight have you tried not to gain weight? YES/NO
M3 Have you feared gaining weight or becomming fat, even though you were underweight? YES/NO
a. Have you considered yourself fat or that part of your body was too fat? YES/NO
b. Has your body weight or shape greatly influenced how you felt about yourself? YES/NO
c. Have you thought that your current low body weight was normal or excessive? YES/NO
M5 Are 1 or more items from M4 coded YES?
M6 For women only: During the last 3 months, did you miss all your mentstrual periods when they were expected to occur (when you were not pregnant)?
for women: Are M5 and M6 coded yes? = Anorexia Nervousa current
for men: Is M5 coded yes? = Anorexia Nervousa current
N1 In the past three months, did you have eating binges or times when you ate a very large amount of food within a 2-hour period? YES/NO
N2 In the last 3 months, did you have eating binges as often as twice a week? YES/NO
only answer the following questions, if N2 was yes
N3 During these binges, did you feel that our eating was out of control? YES/NO
N4 Did you do anything to compensate for, or to prevent a weight gain from these binges, like vomiting, fasting, exercising or taking laxatives, ennemas, diuretics, or other medications? YES/NO
N5 Does your body weight or shape greatly influence how you feel about yourself? YES/NO
N6 Do the patient's symptons meet criteria for Anorexia Nervousa? (if not skip to N8)YES/NO
N7 Do these binges occur when you are under (threshold weight)? YES/NO
N8 Is N5 coded yes and N7 coded No or skipped? = Buliminia Nervousa Current
Is N7 coded yes? = Anorexia Nervosa Binger Eating/Purging Type
This was done as an interview. A neuropsychologist asks you the questions in order (though there are a couple other sections). I wouldn't recommend taking this yourself for self diagnosis but to get a physician to give something similar to you.