The Diagnostic and Statistical Manual – 4th Edition (DSM-IV) recognizes two distinct eating disorder types, anorexia nervosa and bulimia nervosa. 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).
According to the National Alliance on Mental Illness, examples of EDNOS include:
- All of the criteria for Anorexia Nervosa are met except the individual has regular menses.
- All of the criteria for Anorexia Nervosa are met except that, despite substantial weight loss, the individual's current weight is in the normal range.
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- All of the criteria for Bulimia Nervosa are met except binges occur at a frequency of less than twice a week or for a duration of less than 3 months.
- An individual of normal body weight who regularly engages in inappropriate compensatory behavior after eating small amounts of food (eg, self-induced vomiting after the consumption of two cookies).
- An individual who repeatedly chews and spits out, but does not swallow, large amounts of food.
- Binge eating disorder; 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.
Constance Rhodes, author of “Life Within the Thin Cage, says this about EDNOS:
“If your motivations regarding food and exercise are based on 'psychic' rather than 'physical' needs, you need to know that your struggle is important, and worthy of seeking out appropriate medical and/or therapeutic assistance.”
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