ED-NOS: Eating Disorder Not Otherwise Specified

Anorexia, bulimia and compulsive over-eating receive a great deal of media attention and public awareness. However, the most common eating disorders are the ones that do not fit neatly into any one of these diagnoses, and are classified as "Not Otherwise Specified" by psychologists.

What is ED-NOS?
Although there are many sufferers of the well-known eating disorders, such as Anorexia Nervosa, the most prevalent eating disorders are the ones that fall into a gray area. According to the DSM-IV, "Eating Disorder Not Otherwise Specified" or "ED-NOS" is any eating disorder that does not meet the diagnostic criteria of the other named eating disorders. For example, someone may exhibit all the symptoms of Anorexia Nervosa, such as severely restricting caloric intake, but remain at a normal weight. An individual who repeatedly chews and spits out (but does not swallow) large quantities of food can also be classified as having ED-NOS.

People who are recovering from Anorexia Nervosa and Bulimia Nervosa, but who have not fully let go of their eating disorder can also fall into the ED-NOS category. For example, an anorexic who has restored his/her weight to a healthy level, but still mentally obsesses over calories certainly still has an eating disorder.

Why doesn't ED-NOS receive the same attention as other eating disorders?
Perhaps the main reason why ED-NOS sufferers don't receive the same attention as anorexics and bulimics is that their behaviors might not be life threatening, and their weight may be normal. The sensationalism that the media seeks out is often not present with ED-NOS sufferers, although the mental struggle can be just as challenging.

In fact, many sufferers of ED-NOS feel as if their eating disorder is not valid and they are not worthy of professional help or support from their friends and family. Because they may maintain a normal weight, they may be embarrassed to admit their eating disorder to other people, for fear of not being believed or taken seriously. ED-NOS sufferers often have difficulty recognizing their disorder and talking to others about it, whereas anorexics usually cannot conceal their dramatic weight loss, and bulimics cannot deny to themselves that they have a true problem.

Why do people develop ED-NOS?
ED-NOS is caused by the same emotional triggers that cause Anorexia, Bulimia, and Compulsive Over-Eating. The sufferers are in need of a coping mechanism. A common misconception is that eating disorders are caused by the simple desire to be thin. However, if this were the case, nearly everyone in the United States would be anorexic. ED-NOS is a way of using to food as a distraction to avoid dealing with real-life issues and feelings. Whether this comes in the form of restricting calories, binge eating, purging, chewing and spitting, or compulsively counting calories, the root of ED-NOS is an emotional struggle.

ED-NOS treatment
Treatment and recovery from ED-NOS is similar to that of Anorexia Nervosa and Bulimia Nervosa. There are many inpatient programs that treat ED-NOS, or the sufferer could simply seek out the help of a therapist. As with any eating disorder, treatment should focus on the underlying issues that cause the sufferer to exhibit disordered eating patterns and think obsessively about food. Depression is commonly associated with ED-NOS, and medications can be prescribed.

If you know someone with ED-NOS, it is important that you do not downplay the severity of their problem simply because their physical health may seem to be stable. Although physical health issues can be a concern in ED-NOS sufferers, the mental struggle cannot be overlooked.