---
title: "DC 9521 - Bulimia nervosa"
diagnostic_code: "9521"
body_system: "Mental Disorders"
cfr_section: "§ 4.130"
canonical: "https://veteranai.co/va-rating-schedule/mental-health/9521-bulimia-nervosa"
source: "https://www.ecfr.gov/current/title-38/section-4.130"
updated: "2026-07-21T05:52:27.178849Z"
---

# DC 9521 - Bulimia nervosa

Rated under § 4.130. Body system: Mental Disorders.

Rating Formula for Eating Disorders

## Rating criteria

| Rating | Criteria |
| --- | --- |
| 100% | Self-induced weight loss to less than 80 percent of expected minimum weight, with incapacitating episodes of at least six weeks total duration per year, and requiring hospitalization more than twice a year for parenteral nutrition or tube feeding. |
| 60% | Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of six or more weeks total duration per year. |
| 30% | Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of more than two but less than six weeks total duration per year. |
| 10% | Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder and incapacitating episodes of up to two weeks total duration per year. |
| 0% | Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder but without incapacitating episodes. |

## Notes

- Note 1: An incapacitating episode is a period during which bed rest and treatment by a physician are required.
- Note 2: Ratings under diagnostic codes 9201 to 9440 will be evaluated using the General Rating Formula for Mental Disorders. Ratings under diagnostic codes 9520 and 9521 will be evaluated using the General Rating Formula for Eating Disorders.

# VA Disability Ratings for Bulimia Nervosa (Diagnostic Code 9521)

**Body System:** Mental Disorders · **Regulation:** § 4.130 · **Rated Under:** General Rating Formula for Eating Disorders

## Understanding Bulimia Nervosa and How the VA Rates It

Bulimia nervosa is an eating disorder listed under Diagnostic Code 9521 in the VA's mental disorders rating schedule. Rather than being evaluated under the General Rating Formula for Mental Disorders, bulimia nervosa (along with diagnostic code 9520) is evaluated using the **General Rating Formula for Eating Disorders**.

Under this formula, the VA assigns a disability rating based on factors such as self-induced weight loss relative to expected minimum weight, the presence of binge eating followed by measures to prevent weight gain, and the frequency and duration of incapacitating episodes.

**What counts as an "incapacitating episode"?** According to Note 1 in the regulation, an incapacitating episode is a period during which bed rest and treatment by a physician are required.

## Available Rating Levels

The following rating levels are defined for bulimia nervosa:

### 100%
Self-induced weight loss to less than 80 percent of expected minimum weight, with incapacitating episodes of at least six weeks total duration per year, and requiring hospitalization more than twice a year for parenteral nutrition or tube feeding.

### 60%
Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of six or more weeks total duration per year.

### 30%
Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of more than two but less than six weeks total duration per year.

### 10%
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder and incapacitating episodes of up to two weeks total duration per year.

### 0%
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder but without incapacitating episodes.

## What the VA Looks For

When rating bulimia nervosa under Diagnostic Code 9521, the VA considers:

- **Self-induced weight loss** measured against a percentage of expected minimum weight (for example, less than 80 percent or less than 85 percent).
- **Binge eating patterns** followed by self-induced vomiting or other measures to prevent weight gain.
- **Resistance to weight gain**, even when the individual is below expected minimum weight.
- **A diagnosis of an eating disorder.**
- **The frequency and total duration of incapacitating episodes** per year — periods requiring bed rest and treatment by a physician.
- **Hospitalization needs**, including hospitalization for parenteral nutrition or tube feeding, at the highest rating level.

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*This information is drawn directly from the VA rating schedule under § 4.130 for Diagnostic Code 9521. It is provided for general educational purposes only.*

Source: https://www.ecfr.gov/current/title-38/section-4.130