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The Diagnostic and Statistical Manual, 4th Edition (DSM-IV) recognizes two distinct eating disorder types, anorexia nervosa and bulimia nervosa. If a person is struggling with eating disorder thoughts, feelings or behaviors, but does not have all the symptoms of anorexia or bulimia, that person may be diagnosed with eating disorder not otherwise specified (EDNOS). The following section lists examples of how an individual may have a profound eating problem and not have anorexia nervosa or bulimia nervosa.

• A female patient could meet all of the diagnostic criteria for anorexia nervosa except she is still having her periods
• A person coul meet all of the diagnostic criteria for anorexia nervosa except that, despite significant weight loss the individual's current weight is in the normal range.
• A person could meet all of the diagnostic criteria for bulimia nervosa  except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for duration of less than 3 months.
• The person could use inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies). This variant is often called purging disorder.
• The person could repeatedly chew and spit out, but not swallow, large amounts of food.
• Binge-eating disorder is also officially an EDNOS category; recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa.

The examples provided above illustrate the variety of ways in which disordered eating can look when a person has EDNOS, but this list of examples does not provide a complete picture of the many different ways that eating disorder symptoms can occur. 

The “not otherwise specified” label often suggests to people that these conditions are not as important, as serious or as common as anorexia or bulimia nervosa. This is not true. Far more individuals suffer from EDNOS than from bulimia and anorexia combined, and the risks associated with having EDNOS are often just as profound as with anorexia or bulimia because many people with EDNOS engage in the same risky, damaging behaviors seen in other eating disorders.

Individuals with EDNOS who are losing weight and restricting their caloric intake often report the same fears and obsessions as patients with anorexia. They may be overly driven to be thin, have very disturbed body image, restrict their caloric intake to unnatural and unhealthy limits and may eventually suffer the same psychological, physiological and social consequences of anorexic people. Those who binge, purge or binge and purge typically report the same concerns as people with bulimia, namely, that they feel they need to purge to control their weight, that they are afraid of getting out of control with their eating and that binging and/or purging often turn into a very addictive, yet ineffective coping strategy that they feel they can not do without.  In all meaningful ways, people with EDNOS are very similar to those with anorexia or bulimia, and are just as likely to require extensive, specialized, multidisciplinary treatment.

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Who develops EDNOS?

What are the common signs of EDNOS?

Are there any serious medical complications?

Do we know what causes EDNOS?

Is treatment available for persons with EDNOS?

What about prevention?