According to the DSM-5, Bulimia is categorized as mild, moderate, severe or extreme based on:

A. The number of episodes of purges, or inappropriate compensatory behaviors, per week: Compensatory behaviors like vomiting, laxative use, or excessive exercise are important for clinical assessment but do not determine DSM-5 severity specifiers for bulimia nervosa. B. Both the number of binge-eating episodes and purge behaviors per week: Severity in bulimia nervosa is based on binge-eating frequency alone; compensatory behaviors are monitored separately and do not factor into DSM-5 severity classification. C. The number of binge-eating episodes per week: DSM-5 categorizes bulimia nervosa severity (mild, moderate, severe, extreme) according to the average number of binge-eating episodes per week. This standardization helps guide treatment planning and track disorder progression. D. The client’s BMI: Body mass index is used to assess severity in anorexia nervosa, not bulimia nervosa, because individuals with bulimia may have normal or fluctuating weight despite engaging in binge-purge behaviors.