ED-NOS-A REAL Eating Disorder?

Anorexia nervosa and Bulimia nervosa are the two most common diagnoses given for someone who is suffering from an eating disorder. If a person is struggling with eating disorder thoughts, feelings or behaviors, but does not have all the symptoms of anorexia or bulimia, that person may be diagnosed with eating disorder not otherwise specified (EDNOS).

Some known examples of EDNOS include:

1. Despite having regular menses, all of the criteria for anorexia nervosa are met.
2. Despite substantial weight loss, the individual’s current weight is in the normal range.
3. Binging may occur, but at a frequency of less than twice a week or for a duration of less than 3 months.
4. A normal body weight is maintained, but inappropriate compensatory behavior after eating small amounts of food (such as purging after the consumption of two cookies) is seen.
5. Repeatedly chewing and spitting, but not swallowing, large amounts of food.
6. Recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa.
The “not otherwise specified” label often suggests to people that these disorders are not as important, as serious, or as common as anorexia or bulimia nervosa. This is not true. Far more individuals suffer from EDNOS than from bulimia and anorexia combined, and the risks associated with having EDNOS are often just as profound as with anorexia or bulimia because many people with EDNOS engage in the same risky, damaging behaviors seen in other eating disorders.

Often, people categorized as having ED-NOS are basically anorexic or bulimic, but cannot be classified as such because of a technicality. Obviously, ED-NOS can very easily lead to a diagnosis of one of the two other clinical eating disorders. Some sources point to as many as 50% of eating disorder cases being diagnosed as ED-NOS.
In the meantime, if you mention “ED-NOS” to most laypeople, they will not have a clue what you are talking about. While anorexia and bulimia get all the publicity, people diagnosed as NOS are often left in the shadows. They may look at the criteria for anorexia and bulimia and feel puzzled. They know something is “off” about their eating habits, but feel invalidated because nothing out there tells them that what they have is in fact an eating disorder. Invalidation, usually unintentional, may also come from family or friends. (The person who has lost fifty pounds by starving themselves but is still overweight will more likely get praise from loved ones rather than concern, for example.)
Even though ED-NOS may not get quite as much publicity as its more infamous “cousins,” it is important to remember that ANY eating disorder has the potential to be lethal. In the long term, it’s not the label that matters; it’s the PERSON. And a person diagnosed with ED-NOS deserves just as much care, consideration, and support as any other eating disordered patient.