EDNOS: the Silent Killer

Everyone has heard of anorexia, bulimia, and probably compulsive eating as well. These are the eating disorders that can wreck lives and leave the sufferers devastatingly thin, morbidly obese, and with a host of physical and psychological damages. They kill, too; but the eating disorder that kills most often is little known. It is quiet, more common than the other disorders, and more deadly. It is called eating disorder not otherwise specified, or EDNOS.

Although anorexia and bulimia tend to get the attention, EDNOS actually makes up 70 percent of all 24 million eating disorder diagnoses in the United States. A person with EDNOS may be diagnosed as such because she does not fully meet the criteria for anorexia or bulimia. She may have some symptoms of both disorders, but not severely enough to warrant a diagnosis.

[highlight] If you or a loved one are suffering from an eating disorder, learn more about our Eating Disorders Treatment programs to get help today >> [/highlight]The Diagnostic and Statistical Manual, which is the bible for diagnosing psychiatric disorders, recognizes only anorexia and bulimia nervosa as eating disorders. Anyone who meets some, but not all of the criteria for either of these may be labeled as EDNOS. Someone with EDNOS may also meet some of the bulimia or anorexia criteria partly, but not completely. For instance, one criterion for bulimia is binging and purging more than twice a week for at least three months. If someone binges and compensates less than twice a week, she may not meet the requirements for a bulimia diagnosis and could be described as EDNOS.

One of the dangers of EDNOS is that it may seem less serious than anorexia or bulimia. The label, especially the “not otherwise specified” portion, can make the affected person feel as if her disorder is not as serious or as common, or even as important as the more well-known disorders. The truth, however, is that more people suffer with EDNOS than with anorexia and bulimia combined. And these people struggle with the same feelings of fear, self-loathing, shame, and obsession, and engage in the same risky behaviors. Because EDNOS is so much more common, it is the leading killer of disordered eaters.

EDNOS is more common in women, especially young women, than in men, but like anorexia and bulimia, it can occur in anyone of any age or sex. Most typically, it begins in adolescence or young adulthood. The behavior of binge eating is actually evenly split between men and women. The signs and symptoms of EDNOS are very similar to those for bulimia and anorexia:

  • A constant awareness, bordering on obsession with food, calorie counting, exercise, and weight.
  • Behaviors that are meant to compensate for eating, which can include vomiting, using laxatives, or exercising. Binging or compensating may not be initially obvious. Signs include the disappearance of food in large quantities, spending a lot of time alone, or spending a long period of time eating.
  • Restricting food intake and calorie consumption.
  • Cycles of restricting food, binging, feelings of shame and guilt, and then purging.
  • Rules about food, such as foods that can never be eaten, times of day to avoid eating, and others.

The medical risks and complications associated with EDNOS are serious and just as much cause for concern as those that go along with bulimia and anorexia. Purging can cause dehydration and electrolyte imbalances, and even heart problems and death. In extreme cases, binging can cause stomach rupture. Restricting calories can result in hearth failure, low blood pressure, a reduced heart rate, a hormonal imbalance, bone weakening, and mental and emotional issues.

Because the behaviors associated with EDNOS are varied, specific treatment plans for the disorder are hard to find. Treatments similar to those used for bulimia and anorexia are typically used and include cognitive-behavioral therapy, individual counseling, and group therapy. These treatments focus on helping to change distorted thinking patterns and to self-monitor and change unhealthy behaviors. Therapy is also often combined with nutritional counseling and sometimes with prescription medications.

Because EDNOS is so prevalent in the realm of eating disorders, prevention is also important. Not enough people know about the disorder and there are likely millions who are currently undiagnosed. When more people understand that they do not have to have anorexia or bulimia to have a dangerous mental illness and to be risking their lives with their food habits, more lives can be saved.

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