Eating Disorders Not Otherwise Specified
There are clearly defined clinical criteria for anorexia nervosa and bulimia nervosa. However, a huge number of people who have problems with food, weight and eating; worry about how they look and whether they are acceptable to others; have low self esteem and exhibit some but not all of the criteria for one of the eating disorders. These are the people for whom "Eating Disorders Not Otherwise Specified" was coined. Some examples:
- People who exhibit some symptoms which are associated with anorexia nervosa and some which are associated with bulimia nervosa.
- People who fulfill all the criteria for anorexia nervosa, but have not lost 15% of their body weight, or may still menstruate at low body weight.
- People who exhibit all the signs of bulimia nervosa, but use vomiting as a compensatory mechanism, on average, less than twice a week.
There are many more situations which could be described and all are likely to result in as much suffering as the clinically defined eating disorders.
There is a "text book" definition of Eating Disorders Not Otherwise Specified which says that the category includes:
- An individual who meets all the criteria for anorexia nervosa except the individual has regular menses.
- An individual who meets all the criteria for anorexia nervosa except that, despite substantial weight loss, the individual's current weight is in the normal range.
- An individual who meets all the criteria for bulimia nervosa except binges occur at a frequency of less than twice a week or for a duration of less than 3 months.
- An individual of normal body weight who regularly engages in inappropriate compensatory behavior after eating small amounts of food (e.g, self-induced vomiting after the consumption of two biscuits).
- An individual who repeatedly chews and spits out, but does not swallow, large amounts of food.
- Binge-eating disorder; recurrent episodes of binge-eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa.
Binge-eating disorder has a clinical definition of its own, although it is a subset of Eating Disorders Not Otherwise Specified. Many people have heard of binge eating disorder, but not many have heard of EDNOS.
People of all ages are at risk of eating disorders which present as an array of disordered eating patterns, but all stem from underlying emotional turmoil and low self esteem. The eating behaviour is a way of coping. It appears to provide a solution to some of life's problems, but becomes a problem itself. Consider these statistics: 60% of 14-15 year-old girls consider themselves overweight (Schools Health Education Unit 2000) and 5%-10% of adolescent school girls use techniques such as vomiting, laxative and diuretic abuse and excessive exercise to control their weight (Eating Disorders Association 1993). EDNOS need to be taken seriously.