EDNOS

Eating Disorder Not Otherwise Specified (EDNOS) is a clinical eating disorder that captures eating-disordered thoughts, feelings, and behavior that do not meet full criteria for Anorexia Nervosa or Bulimia Nervosa. While no specific criteria distinguish this diagnosis, the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM IV-TR) offers the following examples of symptoms that would warrant a clinical diagnosis:

1. For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses.
2. All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual’s current weight is in the normal range.
3. All of the criteria for Bulimia Nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than three months.
4. The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies).
5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
6. Binge-eating disorder: recurrent episodes of binge eating in the absence of the regularly use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa.

DrStaceyny’s input (by number):
1. One of the required symptoms for a diagnosis of anorexia is that you present with amenorrhea (having no menstrual period for at least three months). So, if you meet all other criteria for anorexia (less than or equal to 85% of what you should weigh, fears of gaining weight, body-image disturbance), but are still getting your period, your diagnosis would likely be EDNOS.
2. The first criterion for anorexia is “refusal to maintain body weight at or above a minimally normal weight for age and height.” This is often translated to the 85% rule stated above. However, some people might have started out at a heavier weight, and thus, even if they lose lots of weight, they’re actually not below “normal” weight expectations.
3. Think of this one as less-frequent bulimia—there is bingeing and purging, but not at the same rate (or for the same duration) as what would be required for a bulimia diagnosis.
4. This example captures those who don’t, by definition, binge, but who still rely on compensatory strategies (vomiting, laxative use) following even small amounts of food consumption (sometimes referred to as “purging disorder”).
5. Pretty straight-forward.
6. Binge Eating Disorder is, as of now, what’s called a “criteria set.” The American Psychiatric Association has recognized the condition as one which warrants further empirical attention, and it’s quite possible, that by the next revision of the DSM (supposedly in 2010), Binge Eating Disorder will be recognized as its own diagnosable (read: reimbursable) condition. Other disorders similarly on deck include: Premenstrual Dysphoric Disorder (now coded under a type of depression), Mixed Anxiety-Depressive Disorder, and Caffeine Withdrawal.

The list of six examples given above is not intended to be a comprehensive list of all of the symptom constellations that might qualify as EDNOS. Symptom presentations, as individual, may vary, and it is important to recognize that for those who suffer from EDNOS, this is a serious condition no less painful, no less subjectively detrimental, no less of a personal hell than anorexia or bulimia. While it is likely that EDNOS is not as fatal as anorexia or bulimia, EDNOS can still cause substantial ruin. EDNOS can ruin your self-concept. It can ruin relationships. It can ruin your work and your interests. It can still ruin. . . you.