Eating Disorder Not Otherwise Specified (EDNOS)

What is EDNOS?

The Diagnostic and Statistical Manual for Mental Disorders(DSM-5) defines EDNOS as atypical eating behaviors that cause significant distress and fit most, but not all of the criteria for the DSM-5 recognized eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder). Approximately 40-60% of patients who are treated for an eating disorder are diagnosed with EDNOS.1 Contrary to popular belief, EDNOS is not a sub-clinical or less severe diagnosis. Those who are diagnosed with EDNOS experience symptoms just as severe symptoms as any other DSM-5 recognized eating disorder. 

Examples of EDNOS

The DSM-V categorizes only the following 5 disorders as Eating Disorders Not Otherwise Specified:1

            1. Atypical Anorexia Nervosa

            2. Bulimia Nervosa of low frequency and/or duration

            3. Binge-eating Disorder of low frequency and/or duration

            4. Purging Disorder

            5. Night Eating Syndrome

Atypical Anorexia Nervosa

Symptoms of Atypical Anorexia Nervosa are similar to Anorexia Nervosa without significant weight loss. The person’s weight is usually in the normal or above the normal weight range for their given height. Symptoms associated with Anorexia Nervosa include restricted food intake, intense fear of gaining weight, inability to see the severity of the situation, and a distorted perception of one’s body weight/shape.2

Bulimia Nervosa of Low Frequency and/or Duration

Symptoms of this form of EDNOS are similar to that of Bulimia except they occur less often and/or for a shorter period of time. Symptoms include consuming a portion of food larger than what most people would eat while simultaneously feeling regret, shame, and a lack of control. This is followed by compensatory behaviors such as self-induced vomiting, over exercising, laxative use, fasting, and other methods in order to avoid weight gain.2 These symptoms can occur less than once a week and/or for fewer than three months.

Binge Eating Disorder of Low Frequency and/or Duration

Symptoms for this disorder meet the criteria for Binge eating disorder except they occur less often and within a shorter time frame. A person with this disorder usually consumes a larger portion than most people would eat in a short amount of time.2 These symptoms may occur less than once a week and/or for fewer than three months. This is different from Bulimia Nervosa with low frequency and/or duration because no compensatory behavior occurs.

Purging Disorder

Purging disorder is characterized by frequent purging of calories through certain behaviors without any accopanying binge eating. Behaviors include self-induced vomiting, misuse of laxatives and diuretics, and over exercising. A person may engage in these behaviors in order to maintain or lose weight.2

Night Eating Disorder

This subtype of EDNOS is identified by episodes of excessive food consumption after the evening meal and/or eating large amounts of food immediately after periods of wakefulness during the night. The person is always aware and able to recall that they were eating, therefore the person is not eating while sleepwalking. The person consumes at least 25% of their daily caloric intake during these episodes and they engage in this behavior at least twice per week.  This disorder is not to be confused with common cultural norms such as “late nigh

t munchies;” these behaviors are inappropriate to their situation and cause the person significant distress.2

Long Term Effects

There are very serious long term effects related to EDNOS. Most of the symptoms are associated with the eating disorder that the EDNOS sub type stems from. For example, atypical anorexia has the same long term effects as Anorexia Nervosa. The important bodily systems that help your body function properly can all be affected, including your cardiovascular system, nervous system, circulatory system, endocrine system, immune system, gastrointestinal system, and muscular system to name a few.3 The body can become malnourished which can lead to fatigue and weakness. A person’s heart and other major organs can become weak and even start to shut down. A person diagnosed with EDNOS may become more susceptible to infections and illnesses due to a weakened immune system. Other symptoms include hair loss, amenorrhea, and loss of libido. If symptoms are severe and persist for a long time without any proper treatment, then this condition may even result in death.

Treatment

Treatments for EDNOS can vary on an individual basis. Most doctors tend to use Cognitive Behavioral Therapy, which concentrates on the thoughts, feelings, and behaviors that influence the eating disorder.3​ Another therapy technique includes focusing on the factors that contribute to the eating disorder such as low self-esteem, perfectionism, and societal pressures.3 It is imperative to seek professional medical help when burdened by the consequences of an eating disorder. Refraining from seeking medical help can cause serious negative health effects and may even lead to meeting the diagnosis of a DSM-5 eating disorder.

Conclusion

An individual may be diagnosed with EDNOS if they experience atypical eating behaviors that cause significant distress and fit most, but not all, of the criteria for the DSM-5 recognized eating disorders. EDNOS affects 40-60% of all patients treated with an eating disorder and the disorder should not be considered sub-clinical.

 

References

  1. "A Closer Look at Other Specified Feeding and Eating Disorders (OSFED)." Eating Disorder Not Otherwise Specified (EDNOS). N.p., n.d. Web. 19 Apr. 2016.
  2. "ANAD." Other Specified Feeding or Eating Disorder (OSFED). N.p., n.d. Web. 19 Apr. 2016.
  3. Yager, Joel. "Practice Guideline for the Treatment of Patients with Eating Disorders." American Psychiatric Association 3 (2010): n. pag. Web. 18 Apr. 2016.      

Last Updated 05 08 2016

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