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Eating Disorders Not Otherwise Specified (EDNOS)

Classifications for eating disorders are based on guidelines developed for the Diagnostic Statistical Manual for psychiatry (DSM IV). The majority of those with eating disorders do not fall within the guidelines and are classified as having EDNOS - Eating Disorders Not Otherwise Specified.

Just because someone does not meet all of the DSM IV criteria does not mean their eating disorder is any less severe than the eating disorder of someone who meets all of the criteria. For example:

• A person with anorexia who weighs 87% of her ideal body weight (IBW) technically has an EDNOS, because the guidelines say the individual should weigh no more than 85% of IBW to meet the criteria for having anorexia.
• A woman who meets the weight criteria for anorexia, but still has her period would be classified as having an EDNOS.
• A person with EDNOS who binges and purges once a week technically has an EDNOS, because the guidelines say the individual should binge and purge at least twice a week to meet the criteria for having bulimia.
• A person with binge-eating disorder who binges once a week has EDNOS, because the guidelines say the individual should binge at least twice a week to meet the criteria for binge-eating disorder.
• A person who combines symptoms of anorexia and bulimia, but does not meet all of the medical criteria for either disease, would be classified as having an EDNOS.

Walden Behavioral Care advocates a broadening of guidelines so that individuals who are classified as having an EDNOS can receive coverage for the treatment they need.

Current guidelines give those with EDNOS an incentive to get worse, so they can receive coverage for their illness. It is difficult for those with eating disorders to achieve recovery, but the earlier treatment begins, the greater the probability of recovery.

Other Eating Disorders Not Otherwise Specified (EDNOS)
While most people with eating disorders have anorexia, bulimia or binge-eating disorder, there are also other less common eating disorders that are classified as EDNOS. These disorders include:

Night Eating Syndrome. Those with night eating syndrome typically eat little or nothing during the morning, but binge during the evening. Resulting conditions may be the same as for binge eating, with the addition of sleep disorders.

Bigorexia. Individuals with bigorexia, also known as muscle dysmorphia or reverse anorexia, worry that they are too small and go to great lengths to increase their muscle mass. The disorder is common among body builders, whose steroid use and extreme high-protein diets can lead to kidney failure and other ailments.

Medical Impact of EDNOS
Those with Eating Disorders Not Otherwise Specified (EDNOS) suffer with many of the same symptoms as anyone else with an eating disorder. The only difference is that EDNOS sufferers may not qualify for insurance coverage, because they fail to meet the guidelines for eating disorders.

Like those who meet the guidelines for anorexia, bulimia or binge-eating disorder, those with EDNOS are in danger of serious medical conditions, such as osteoporosis, retarded growth, kidney problems and heart disease. Like other eating disorders, EDNOS can lead to death.

For additional information about the impact of EDNOS, see the information on this web site about anorexia, bulimia and binge-eating disorder.

Signs of EDNOS
The signs of EDNOS vary, depending on the underlying eating disorder. See the information on this Web site about anorexia, bulimia and binge-eating disorder.

Causes of EDNOS
While more research is needed before we understand the causes of EDNOS and other eating disorders, we now know that several factors can lead to EDNOS. While there is no single root cause, we believe that people with EDNOS have a chemical imbalance in the brain that affects their behavior.

Genetics are also a major factor, as are cultural ideals about body image.

A traumatic event, which may have taken place years before EDNOS manifests itself, may also have an impact. Such events may include sexual abuse or rape, emotional abuse, parents' divorce, death of a loved one or a history of being teased or ridiculed.

EDNOS often starts with a diet, which may be meant to help the person regain self-esteem and control.