Eating Disorders Not Otherwise Specified

Eating Disorders Not Otherwise Specified (EDNOS) is a diagnosis of an eating disorder that does not meet the criteria for a specific category of eating disorder such as anorexia nervosa or bulimia nervosa. In fact this diagnosis is often generated in individuals who meet some, but not all, diagnostic criteria for another eating disorder, and are therefore said to have tendencies towards anorexia or bulimia, or are described as having disordered eating.

Signs of Eating Disorder Not Otherwise Specified

The signs and symptoms of Eating Disorder Not Otherwise Specified are those of any other eating disorder, just not all of the signs and symptoms required to fully meet a diagnosis of another disorder. The signs and symptoms may also be a combination of those of two or more eating disorders, such as severe restrictions on calories as well as purging after only a small meal or snack. Some common signs of eating disorders include:

• Obsessive calorie counting and knowledge of calories in almost all foods.
• Skipping meals, often eating only small snacks instead.
• “Playing” with or pushing food around a plate rather than eating it.
• Hiding food (in a napkin, under a plate, etc.) to avoid eating it.
• Lying about having eaten in an attempt to avoid a meal or snack.
• Eating only a limited number or type of food.
• Exercising excessively, particularly after or “to make up for” eating.
• Binging, or eating a great amount of food in one sitting.
• Purging, or attempting to get rid of eaten food by inducing vomiting or taking laxatives or diuretics.
• Hiding the food reserved for binges.
• Hiding items such as laxatives or diuretics.
• Ingesting an excessive amount of food, even when not hungry.
• Eating until uncomfortable or sick.
• “Grazing” for as long as food is available.
• Hiding eating habits due to shame or embarrassment.
• Showing excessive interest in weight, body image and fasting.

Diagnosis of Eating Disorder Not Otherwise Specified

Eating Disorder Not Otherwise Specified must be diagnosed by a qualified mental health professional, though the only diagnostic guideline is that the individual’s food and eating behaviour meets only some of the diagnostic criteria of other eating disorders.

For instance, an individual who avoids eating, severely limits calories and refuses to eat certain food groups, but still has regular menstrual cycles and is not at least 15% below a healthy body weight may be diagnosed with EDNOS as (s)he can not be fully diagnosed with anorexia (due to the presence of menstrual cycles and a total weight loss that has not yet dipped below 15% of a healthy body weight).

Similarly, an individual who binges and purges every few weeks, or who purges after only small amounts of food, can not be diagnosed with bulimia (which requires binges and purges at least twice a week, and purging after a binge) and so may be diagnosed with EDNOS. Binge eating disorder may also be diagnosed as EDNOS, as may be orthorexia, a disorder in which an individual eats a relatively healthy and appropriate diet but is scared of some food types and refuses to eat them.

Treating Eating Disorder Not Otherwise Specified

Once an Eating Disorder Not Otherwise Specified is diagnosed, a treatment plan will be drawn up in order to address all of the behavioural signs and symptoms as well as the underlying mental and emotional issues that have contributed to these behaviours. Very often treatment for EDNOS includes individual counselling or talk therapy, family counselling, cognitive behaviour therapy (to change food and eating behaviours), attendance at support groups or group therapy, and nutritional counselling and planning. ENDOS is very rarely treated with medication unless it is prescribed to treat associated conditions such as depression.

Further information on the diagnosis and treatment of EDNOS should be obtained from a GP, private mental health professional or from the Eating Disorders Association and/or National Centre for Eating Disorders.