EDNOS means Eating Disorder Not Otherwise Specified, and is the diagnosis when a patient has an eating disorder but does not meet the specific diagnostic criteria for either anorexia nervosa or bulimia nervosa. As such, EDNOS is the most common eating disorder, but the diagnosis is so vague it isn’t helping clinicians and certainly doesn’t help patients get treatment services when they have the best chance at success. Many people who are diagnosed with EDNOS feel a kind of shame that they were not “good enough” to be diagnosed with a “real disorder.” I hear this all the time on the ED websites I frequent online. I have also noticed that a lot of people who should be diagnosed as EDNOS are in complete denial about having an eating disorder because they know they are not anorexic or bulimic, and they haven’t even heard of EDNOS–eating disorder campaigns and stories in the media almost always focus on anorexia and bulimia.
Some people who are diagnosed with EDNOS restrict calories severely, fast, and even starve themselves like an anorexic person does, but their BMI is currently above 17.4 so they cannot be diagnosed as anorexic. People who binge and purge once a week, starve the rest of the time, but have a BMI of 17.5 or higher are neither bulimic nor anorexic, but their disorder is every bit as dangerous and life threatening as bulimia and anorexia!
According to a recent New York Times article, “Narrowing an Eating Disorder,” the updated diagnostic manual for psychiatrists and clinicians will redefine EDNOS. The following is an excerpt from the article,
Though its name is less familiar, it is diagnosed more often than those two disorders — in 4 percent of American women each year, according to the National Eating Disorders Association. (The association does not have statistics on men.) Subsets of Ednos include binge eating disorder, purging disorder, night eating syndrome, chewing and spitting out food, and even picky eating.
But the diagnosis baffles many clinicians, who call it ambiguous, vague and unwieldy. And so the American Psychiatric Association is overhauling its definition of Ednos for the next edition of the diagnostic manual, known as D.S.M.-5, to be published in 2013.
“The consensus is that Ednos is ‘too big,’ meaning it is being used more frequently than is desirable, as that label does not convey much specific information,” said Dr. B. Timothy Walsh, a professor of psychiatry at Columbia who is chairman of the eating disorders work group for the new manual.
I hope the clarification of EDNOS and possibly defining disorders such as Compulsive Over Eating, Binge Eating Disorder and Purging Disorder, will lead to improved treatment options and services for patients. Under the current system, patients are rarely able to access treatment for their eating disorder until they are already in a critical state and their lives are at risk. If patients could access treatment services before their BMI is dangerously low or their organs begin to fail, they would have a far better chance of making a full recovery. Early intervention is the key to successfully recovering from an eating disorder in most cases, so it just makes sense to clarify the disorders people commonly experience and provide options for their treatment regardless of their weight.
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