Introduction to EDOS: Eating Disorder Not Otherwise Specified
There are certain eating disorders that are widely recognized by the general public. They include anorexia and bulimia. With so many other diagnoses that fall somewhere between these two, a somewhat lesser known diagnostic term was coined. Ednos means eating disorder not otherwise specified. It is diagnosed more often these days than the other two more familiar conditions. In fact, 4% of American women each year are diagnosed with Ednos. Ednos can include:
- Eating disorder
- Purging disorder
- Night eating syndrome
- Picky eating (serious)
- Chewing and spitting
What is especially worrisome is that these behaviors may be so prevalent, that dieters and people who struggle with food issues may assume they are "quite normal." In fact, I will often interview women who will comment, "Doesn't everyone do this?" Ednos baffles many clinicians, and because of that the American Psychiatric Association is overhauling its definition of Ednos for its next edition of the DSM, to be published in 2013. The general consensus is that the term encompasses too many specific conditions and doesn't convey enough information to the clinician or the patient in terms of specific treatment options. Interestingly enough, some clinicians believe Ednos can be the midpoint between a full blown eating disorder and recovery or between recovery and a full blown reactivation of an eating disorder. What behaviors can fall under Ednos?
- Chronic dieting
- Frequent overeating
- Compulsive exercising
- Night eating, where the bulk of your eating (in huge quantities) occurs at night
- Chewing and spitting out food so you can taste it but not swallowing so you avoid the calories
Remember that someone who is massively overweight and successfully conquers their weight may be destined to a life of measuring food, counting every calorie, charting daily exercise totals, making certain social choices that avoid temptation. Those behaviors may be necessary in order to keep the weight off. Ednos is really an exaggeration of that behavior without clear cut understanding that you "are off" and not behaving normally.
Using laxatives to lose weight or maintain weight is another behavior that would fall under Ednos. Unfortunately, most insurance companies will not cover treatment of Ednos. It's important to realize that when Ednos persists for a length of time, you can develop: osteoporosis, heart disease (specifically heart attack due to electrolyte imbalance) and hormone imbalances. The real problem seems to be that with America's preoccupation with thinness and the health community extolling the virtues of weight loss for better health, Ednos can sometimes appear to be less of a health risk. And if your friends are doing it, you may think it's really quite normal behavior; even a virtue.
Doctors are working at better diagnostic and treatment modalities for Ednos. They are trying to remove "weight" as a diagnostic parameter, since a patient can have a healthy BMI or weight and still be seriously struggling with Ednos.