the eating disorder you should know about

While anorexia, bulimia, and binge-eating disorder are highly stigmatized, misunderstood, and largely ignored, I argue that, for the most part, most people are conceptually aware of these disorders.

But most people have no clue about EDNOS--eating disorder not otherwise specified.

While a person with obsessive, ritualistic, and restrictive eating behaviors may not be underweight enough to qualify as "anorexic," this person likely suffers from EDNOS. The same goes for an individual who under-eats/starves all day, and binges at night. Essentially, these are eating disorders that fall through the cracks because they do not fall within a few widely-accepted categories, although they still merit treatment.

If this confuses you, you are not alone. Many health care professionals either do not understand or do not legitimate EDNOS. Facing criticism of being vague to the point of non-existence, EDNOS is mostly ignored. So much so that I was impressed to see a recent NY Times piece on the disease. Here is a snippet:

Kris Shock, for example, used laxatives and restricted her food for years, but she never threw up or binged, and her weight was average. She did not seek psychiatric help for what she and her husband called her “eating problem” until age 31, when she became addicted to the diet pill ephedra, she said in a recent interview.

Now 37 and the director of a child care center in Atlanta, Ms. Shock said that when she finally got her diagnosis of Ednos, “it was like, ‘Ah, I am sick enough to get help and have the recovery experience.’ ”

In our culture, a disproportionate preoccupation with food is acceptable and even praised. In this context, the compulsive yo-yo dieter may never receive appropriate therapy to address underlying psychological, emotional, and/or chemical imbalances that prevent peace with self, others, and food.

When considering whether or not a loved one suffers from a disordered relationship with food, the most important factor to consider is that weight is not a reliable indicator in evaluating eating behaviors. In fact, the majority of bulimics are average to over-weight.

You may find that EDNOS over-extends and abuses an "eating disorder" diagnosis. Really, I don't care what you call it (although I recognize and legitimate EDNOS as a valid "eating disorder"). Perhaps it is fair to say that victims of EDNOS do not suffer the same health ramifications as anorectics, bulimics, or binge-eaters. But at the end of the day, regardless of the label you choose to apply, these behaviors are unhealthy, sad, counter-productive--and need to be addressed.