When I received the diagnosis of Eating Disorder Not Otherwise Specified (EDNOS) five years ago, I had mixed reactions.
On the one hand, the label didn’t seem to fit. Me? With an eating disorder? I wasn’t underweight, and in fact was technically on the edge of being “overweight.” I had intentionally thrown up from time to time, but certainly was not bulimic. I had tried starving myself periodically in an attempt to get my weight under control, but I definitely wasn’t anorexic. At the most I considered myself a chronic dieter, or someone who at times could be a little obsessed with healthy eating and exercise. I could agree that my eating was very disordered but to identify myself as someone with an eating disorder made me squirm in my seat a bit.
On the other hand, after hearing my therapist tell me I had an eating disorder, I felt relief. After all, I was there to get help, and if I could label my problem, perhaps the solution would come more easily. I was ready to silence the voice in my head that made me obsess over my body and food 24 hours, a day 7 days a week, and if giving that voice the name ED (for Eating Disorder) would help, I was willing to accept it.
Everyone knows about anorexia and bulimia, but EDNOS, which has only recently begun to receive recognition in the mental health community can be as equally dangerous and life consuming as its better known counterparts.
So what does eating disorder not otherwise specified mean? Well, the short answer is a “category [of] disorders of eating that do not meet the criteria of a specific eating disorder,” according to the previous version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Under the latest version, the DSM V, the same category has been renamed Unspecified Feeding or Eating Disorder (UFED) and was included as a diagnostic category for those who don’t meet the criteria for the larger category under which it falls, Other Specified Feeding or Eating Disorder (OSFED). Ultimately, whichever diagnostic label is used, the definition is more anecdotal, which explains why it is often harder to identify; however, according to the publication Eating Disorders: The Journal of Treatment and Prevention, 50% of individuals who present for eating disorder treatment receive the diagnosis of EDNOS, which affects 4 to 6% of the general population.
With the expansion of definitions for all groups of eating disorders, including a stand-alone diagnosis for Binge Eating Disorder (BED), those diagnosed with UFED may decrease as people experiencing eating disorders may fall into a more specified category. Regardless of the diagnosis, understanding the complexity of any kind of eating disorder is paramount in getting treatment.
Although many of the criteria for EDNOS and now UFED may closely mimic anorexia or bulimia, some behaviors are less obvious, and in fact, within our diet- and body-obsessed culture, can appear perfectly normal.