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Eating Disorder Not Otherwise Specified

EDNOS

Eating Disorder Not Otherwise Specified includes disorders of eating that do not meet the criteria for any specific eating disorder. Examples include:

A. For females, some of the criteria for anorexia nervosa are met except that the individual has regular menses.
B. Some of the criteria for anorexia nervosa are met except that, despite significant weight loss the individual's current weight is in the normal range.
C. Some 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 duration of less than 3 months.
D. The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (eg, self-induced vomiting after the consumption of two cookies).
Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
E. Binge-eating disorder: recurrent episodes of binge eating in the absence if the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa.

There are variants of disordered eating that do not meet the diagnostic criteria for anorexia nervosa or bulimia nervosa. These are still eating disorders requiring necessary support. A substantial number of individuals with eating disorders fit into this category. Individuals with eating disordered behaviors that resemble anorexia nervosa or bulimia nervosa but whose eating behaviors do not meet one or more essential diagnostic criteria may be diagnosed with EDNOS. Examples include: individuals who meet criteria for anorexia nervosa but continue to menstruate, individuals who regularly purge but do not binge eat, and individuals who meet criteria for bulimia nervosa, but binge eat less than twice weekly, etc. Being diagnosed as having an "Eating Disorder not Otherwise Specified" does not mean that you are in any less danger or that you suffer any less.

Profile of "Eating Disorder Not Otherwise Specified":
Having an "Eating Disorder not Otherwise Specified" can mean a variety of things. The individual may have symptoms of Anorexia but still have their menstrual cycle. It can mean the individual can still be an "average/normal weight" but still be suffering Anorexia. It can mean the individual equally participates in some Anorexic as well as Bulimic behaviors (referred to as Bulimiarexic by some).

Just as it is important to remember that doctors can make mistakes, it is also important to keep in mind that it has only been until very recently (in the last 10 years) that awareness on the subject Eating Disorders has really begun to surface. People are frequently confused (including doctors) about the real differences between Anorexia and Bulimia (Anorexia essentially being self-starvation, and Bulimia being defined as going through binge and purge cycles - simply put), and often times know nothing at all about Binge-Eating Disorder.

For example, a doctor relies completely on his diagnostic manuals and reads the criteria to diagnose an individual as having Anorexia. He finds that his patient has regularly practiced self-starvation techniques, thinks of herself unrealistically as overweight, and seems to be hard on herself... BUT she still has her monthly period (the diagnostic criteria states that there must be loss of monthly menstrual cycles). He may technically diagnose the patient as having "An Eating Disorder not Otherwise Specified".

Another example would be that of a person suffering through binge and purge cycles once a week, who feels that they are overweight and who feels depressed. (The diagnostic criteria states that the sufferer must binge and purge, on average, at least twice a week.)

Practically speaking, in the first example the person suffers from Anorexia and the second suffers from Bulimia. Clinically speaking, according to the "text book" they would suffer from "An Eating Disorder not Otherwise Specified". In either case, both people are suffering with an Eating Disorder, both are in danger of potentially deadly physical complications, and both need seek support.

The most important thing to remember is that Eating Disorders, Anorexia, Bulimia, Compulsive Overeating, or any combination of them, are all very serious psychological illnesses. They all have their physical dangers and complications. They all present themselves through a variety of disordered eating patterns. They stem from issues such as low self-esteem, a need to ignore emotional states such as depression, anger, pain, anger, and most of all. They have developed as a means to cope with one's current state. Support is always available...

Diagnostic Criteria: EDNOS
The following definition of an Eating Disorder Not Otherwise Specified is meant to assist mental health professionals in making a clinical diagnosis. This clinical category of disordered eating is meant for those who suffer but do not meet all the diagnostic criteria for another specific disorder.

Examples Include:

1. Some of the criteria for Anorexia Nervosa are met except the individual has regular menses.

2. Some of the criteria for Anorexia Nervosa are met except that, despite substantial weight loss, the individual's current weight is in the normal range.

3. Some of the criteria for Bulimia Nervosa are met except binges occur at a frequency of less than twice a week or for duration of less than 3 months.

4. An individual of normal body weight who regularly engages in inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies.)

5. An individual, who repeatedly chews and spits out, but does not swallow, 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.

Summary:

The diagnosis of an eating disorder can be difficult. The boundaries between normal and disordered eating are difficult to delineate at times. Many individuals with clearly disordered eating do not meet the formal diagnostic criteria for one of the specific disorders and are classified as having Eating Disorder NOS. The failure to meet formal criteria does not necessarily mean that the individual does not have a serious and significant disorder.


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