Eating disorder not otherwise specified

Editor(s)-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Mark Warren, M.D., M.P.H.; Fellow, Academy of Eating Disorders [mailto:mwarren@eatingdisorderscleveland.org]

Overview
Eating disorder not otherwise specified (EDNOS) involves disordered eating patterns. EDNOS is described in the DSM-IV-TR as a "category [of] disorders of eating that do not meet the criteria for any specific eating disorder".

Characteristics
This category is frequently used for people who meet some, but not all, of the diagnostic criteria for anorexia nervosa or bulimia nervosa. For example, a person who shows almost all of the symptoms of anorexia nervosa, but who still has a normal menstrual cycle and/or body mass index, can be diagnosed with EDNOS. A sufferer may experience episodes of binging and purging, but may not do so frequently enough to warrant a diagnosis of bulimia nervosa. A person may also engage in binging episodes without the use of inappropriate compensatory behaviors; this is referred to as binge eating disorder.

People diagnosed with EDNOS may frequently switch between different eating disorders, or may with time fit all diagnostic criteria for anorexia or bulimia.

People who eat a normal amount of food, but become exceedingly obsessed with healthy eating, or strictly categorize normal foods or entire food groups as "safe" and "off-limits", may be referred to as having orthorexia. However, this diagnosis is not formally accepted by the psychiatric community.

EDNOS is a serious eating disorder, like anorexia and bulimia, and can have long-term consequences on the individual's physical health.

DSM-IV Criteria
The EDNOS category include disorders that do not meet the criteria for a specific eating disorder. Each one of the following disorders is an example:


 * All of the criteria for anorexia nervosa are met except that the individual has regular menses.


 * All of the criteria for anorexia nervosa are met except that, despite substantial weight loss, the individual's current weight is in the normal range.


 * All of the criteria for bulimia nervosa are met except that binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than 3 months.


 * The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (eg, self-induced vomiting after the consumption of two cookies).


 * Repeatedly chewing and spitting out, but not swallowing, 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.