When I received the diagnosis of Eating Disorder Not Otherwise Specified (EDNOS) two years ago, I had mixed reactions. On the one hand, the label didn’t seem to fit. Me? With an eating disorder? I wasn’t underweight, and in fact was technically on the edge of being “overweight.” I had intentionally thrown up from time to time, but certainly was not bulimic. I had tried starving myself periodically in an attempt to get my weight under control, but I definitely wasn’t anorexic. At the most I considered myself a chronic dieter, or someone who at times could be a little obsessed with healthy eating and exercise. I could agree that my eating was very disordered but to identify myself as someone with an eating disorder made me squirm in my seat a bit. (For more on the differences between disorders and disordered eating, read Disordered Eating or Eating Disorder?).
On the other hand, after hearing my therapist tell me I had an eating disorder, I felt relief. After all, I was there to get help, and if I could label my problem, perhaps the solution would come more easily. I was ready to silence the voice in my head that made me obsess over my body and food 24 hours, a day 7 days a week, and if giving that voice the name ED (for Eating Disorder) would help, I was willing to accept it.
National Eating Disorder Awareness Week is February 20-26 in 2011, which is a good opportunity to bring attention to this lesser known sibling of anorexia and bulimia. Everyone knows about anorexia and bulimia, but EDNOS, which has only recently begun to receive recognition in the mental health community can be as equally dangerous and life consuming as its better known counterparts.
So what does eating disorder not otherwise specified mean? Well, the short answer is a “category [of] disorders of eating that do not meet the criteria of a specific eating disorder,” according to the most recently updated version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Ultimately, the definition is more anecdotal, which explains why it is often harder to identify; however, according to the publication Eating Disorders: The Journal of Treatment and Prevention, 50% of individuals who present for eating disorder treatment receive the diagnosis of EDNOS, which affects 4 to 6% of the general population.
Although many of the criteria for EDNOS may closely mimic anorexia or bulimia, some behaviors are less obvious, and in fact, within our diet- and body-obsessed culture, can appear perfectly normal. What may look to an outsider as just another diet involving close monitoring of caloric intake and exercise may in fact become — if not already — an unhealthy and unnatural way to control weight based on an intense drive to be thin combined with an unrealistic body image. On the flip side, EDNOS also includes the sub-category of Binge Eating Disorder (BED), which is often overlooked as a simple lack of willpower. Regardless of where a patient lies in the spectrum of EDNOS, it is important to realize that the emotional trauma suffered as a result of the disorder is equal to that of anorexia and bulimia, and should not be seen as anything less than a serious illness.
The introduction of EDNOS as an accepted diagnosis “gives a voice to sufferers who don’t fit into the narrow diagnostic categories of anorexia, bulimia, and binge eating disorder” said Shannon Cutts, author of ANA: How to Outsmart Your Eating Disorder and Take Your Life Back, and founder of Mentor Connect, a community of people in recovery from eating and related disorders.
Cutts, who herself suffered from anorexia, bulimia, and EDNOS feels grateful for the recognition of EDNOS, and encourages sufferers to seek help:
“If you know that your symptoms, thoughts, and behaviors are affecting your quality of life, then you both need and deserve help. Use your voice and ask for help. Do not assume you are the only one who ‘doesn’t fit’ into a category and therefore you don’t deserve help. There are many people who suffer from EDNOS and you help not just yourself but everyone who suffers from it when you demand the care you deserve. Search out a medical professional who is familiar with eating disorders rather than struggling to educate an unsympathetic doctor or therapist. Be your own health care advocate. You know better than anyone else when you are struggling and need help. Eating disorders kill, and just because your symptoms don’t fall into the three most commonly-recognized categories does not mean they are not equally deadly.”
The health complications that arise from eating disorders are extensive, and include low blood pressure, slower heart rate, a decrease in bone density, a disruption in hormones that sometimes leads to infertility, and more. Even more alarming is the fact that eating disorders have the highest rate of death among any mental disorder — just one episode of bingeing and purging can cause an electrolyte imbalance that may lead to sudden death. That is why it is so important to recognize that eating disorders come in all shapes and sizes and present themselves in a variety of ways.
Is there treatment for EDNOS? Though whole rehabilitation centers have risen to address the problems specific to anorexia, bulimia, and even BED, there is help for other non-specified eating disorders. The effort to overcome any eating disorder is extensive and should not be downplayed. Most of the times, the help of a mental health professional is necessary, and the journey through recovery is never quick and painless. But when you consider the alternative of living a life plagued by self loathing, fear of food, and serious health risks, the effort is one that must be undertaken to break free and live a full and happy life.
As for my own journey, to be honest, it’s an ongoing process. Sometimes it’s two steps forward, one step back. But as Jenni Schaefer, author of Life Without Ed and Goodbye Ed, Hello Me likes to say, “fall down seven times, stand up eight.”
Michelle owns and operates VenusVision.com, which encourages women to be the best they can be. She has written for US Airways and I Am Modern magazines. Michelle is working on her first novel, which follows the yo-yo dieting and mommy adventures of a suburban housewife. She lives in northern Virginia with her husband, two daughters, a Lab, and a ball python. When not writing or enjoying family time, she enjoys travel, good food, and wine.