What Is EDNOS?

According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), there is a classification of disordered eating that falls outside of the criteria for Anorexia, Binge Eating and Bulimia. This category is referred to as "EDNOS", or "Eating Disorders Not Otherwise Specified."  These are also sometimes referred to as 'sub-clinical' or 'sub-threshold' disorders.

Persons struggling with EDNOS can range from 'less-extreme' behaviors like common dieting, frequent concern about body size, and/or occasional overeating, to more extreme behaviors including frequent purging, obsessive dieting, obsessive exercising and more.

Just because a person doesn't fit the criteria for anorexia or bulimia does not mean they don't have an eating disorder requiring attention. And don't be fooled by appearances; most disordered eaters are normal weight or overweight, not skinny. But they can still struggle as seriously as an anorexic or underweight bulimic.

In fact, many who struggle in the EDNOS category are at risk for the same dangers as those who meet criteria for other disorders, including the risk of heart attacks, dehydration, electrolyte imbalance and even death.

REGARDLESS OF WHERE YOU FALL ON THE EATING CONTINUUM, if your motivations regarding food and exercise are based on 'psychic' rather than 'physical' needs, you need to know that your struggle is important, and worthy of seeking out appropriate medical and/or therapeutic assistance.

DSM-IV Technical Criteria for EDNOS

Because of the wide range of eating behaviors that exist outside of anorexia, bulimia and now binge eating disorder (which is becoming more formally recognized by the professional community), EDNOS does not have a comprehensive list of technical criteria at this time. However, the DSM-IV does provide some parameters/examples, as listed below:

A Range of Behaviors

Based on the limited technical criteria above, following are some additional examples of the behaviors associated with persons struggling with EDNOS. (Please note: this is by no means a comprehensive listing).

A Common Struggle

As you might imagine from the lists above, which are not comprehensive in scope, EDNOS is a widespread problem. In fact, our discussions with respected professionals in the field of eating disorders suggest that as many as four out of five people might qualify for some type of disordered eating. If this number is accurate (which is difficult to say given the lack of research on EDNOS), it would suggest that only one out of five people have a truly healthy relationship with food - eating for physical, not psychic, reasons, not obsessing about weight, not worrying about calories, fat grams, and so on.

When thinking about eating disorders, it is helpful to think of eating as being on a continuum:

Schematic 1.0 "The Eating Continuum" as featured in Life Inside the Thin Cage, by Constance Rhodes.

Published by Shaw Books. Page 19. Used by permission.

Because eating issues appear as on a continuum, ranging from healthy to life threatening, it is common for some individuals to swing from one end of the continuum to the other. For example, a person who frequently diets might suddenly discover quicker weight loss through the use of purging. The more they engage in this behavior, the farther down the continuum they get from healthy eating. On the other hand, a person who once struggled with anorexia may now be at a healthier weight, and be having regular periods (females) but still be afraid of eating certain foods, which could place them into the EDNOS category, still making their way back to healthy eating.

Thus it is important to be aware of the ways in which an individual feels about food, so that the seriousness of their issues are clear, in order for that individual to begin making intentional steps toward the healthy end of the continuum. This process is a difficult but worthwhile one, requiring the individual's desire to change, the therapeutic involvement of others (doctors, nutritionists, counselors, friends) and, most importantly, God.